9 Seriously Germy Places—And How to Protect Your Child

By Sandra Gordon
There's no escaping from germs and bacteria—some of which can get your child sick. Follow these guidelines to protect your little one in germ-infested hotspots.

The Playground

Your local jungle gym is more germ-infested than a public bathroom, according to one study. Why? "Restrooms tend to get disinfected often," says researcher Kelly Reynolds, PhD, associate professor at the University of Arizona College of Public Health, in Tucson. "But playground equipment almost never gets cleaned." Harmful germs—such as those in the mucus that kids wipe from their noses—can linger for days. Sandboxes are gross too: Squirrels and birds can leave behind fecal matter, which may cause stomach illnesses and skin infections in young kids.
Staying Safe at the Playground
Tempted to clean ladders and handles with a disinfecting wipe? Don't bother. It's practically impossible to get rid of all the germs. Instead, teach your child not to touch her mouth, nose, or eyes when she's at the playground, and clean her hands with an alcohol-based hand gel before you leave the park. And if you have a backyard sandbox, keep it covered when you're not using it.

Ball Pits

Enclosed play areas containing plastic balls, which are popular at kids' gyms and fast-food restaurants, are among the dirtiest places to let your child roam. In fact, researchers at the University of North Georgia found 31 types of bacteria in the ball pits of six physical-therapy clinics. "Kids with leaky diapers play in them, and the pits rarely get cleaned," says Dr. Reynolds. A child's feces can contain E. coli, rotavirus, and salmonella, all of which can cause severe vomiting and diarrhea. Young children can also pass germs onto the balls with their hands and feet.
Staying Safe in Ball Pits
Although ball pits may have a high risk factor, they’re low risk for kids, says Adam Ratner, M.D., director of the Division of Pediatric Infectious Diseases in Hassenfeld Children’s Hospital at NYU Langone. “Your child can come into contact with these bacteria anywhere,” says Dr. Ratner. Those like Streptococcus oralis and Staphylococcus hominis may sound scary, but they’re not just crawling in ball pits; they also live on virtually every kid’s skin and tongue. Unless your child has skin lesions or a compromised immune system, playing in a germy ball pit shouldn’t put him at any higher risk for infections. However, do keep in mind that cleaning standards and schedules vary widely from one pit to another. Ask when the balls were last sanitized. If the attendant doesn’t know (or you smell something funky), it’s best to stay out. As always, common-sense precautions apply: Your kid should wash his hands before and after he jumps in, and you should make sure he’s up to date on his vaccinations

Petting Zoos

Petting zoos have been linked to major E. coli outbreaks in recent years. It's not hard to see why: Farm animals aren't choosy about where they lie down, and traces of feces from an animal's fur or saliva could easily get onto your child's hands—and (yuck!) into her mouth.
Staying Safe at Petting Zoo
Don't take a child younger than age 3 to a petting zoo (or, if you do, let her look but not touch). "No matter how much you warn her not to, a young child is likely to put her fingers in her mouth," says Andrew Nowalk, MD, PhD, assistant professor of pediatrics at the University of Pittsburgh School of Medicine. Even older kids need reminders not to touch their mouths after petting—and to use an alcohol-based hand gel when they're done.

Water Fountains

A typical drinking fountain contains more harmful germs than a public toilet seat, according to a recent study at elementary schools by NSF International, a nonprofit health and safety organization based in Ann Arbor, Michigan. Kids tend to touch the spigot with their fingers or their mouth, passing on germs to the next person who drinks. Cold and flu viruses can live on the metal for up to five hours.
Staying Safe with Drinking Fountains
Teach your child to keep his lips (and fingers) off the spigot and let the water run for a few seconds before sipping. "That helps wash away harmful organisms," says Robert Donofrio, director of the microbiology lab at NSF International. Or take along a separate water bottle—just make sure he's the only one who drinks from it.

Shopping-Cart Handles

Supermarket workers and shoppers are constantly touching cart handles and spreading germs. If the blood from raw meat reaches a handle, your child could ingest harmful bacteria, including E. coli, salmonella, and campylobacter
Staying Safe while Grocery Shopping
Clean the handle with a disinfecting wipe before putting your child in the cart. If you buy a shopping-cart cover, keep in mind that these can also carry germs (which survive longer in fabric than on a plastic handle), so you should wash them regularly.

Children's Museums

Those buttons your child presses to activate electronic exhibits have been pushed by dozens of other little hands, making them major bug conductors. And elevator and vending-machine buttons are just as germy.
Staying Safe at Children’s Museums
 Tell your child not to touch his eyes, nose, or mouth at a children's museum. You don't have to spoil his fun by keeping him away from the interactive exhibits, but make sure he washes his hands or uses a hand cleanser afterward.

Public High Chairs

A restaurant may be kid-friendly, but that doesn't mean it's germ-proof. Chances are the chair you plop your toddler into hasn't been cleaned since the last child used it. Your home high chair may not be so clean either: Germs commonly fester in corners and crannies you can't reach.
Staying Safe at Restaurants
Bring a disposable high-chair cover to restaurants, or use a disinfecting wipe to clean the high chair. Wipe down your child's home high chair after every meal with disinfecting spray and a paper towel (the sponge you use to clean dishes or wipe counters could contain harmful germs). Also consider getting a model made with antimicrobial plastic, which does some of the germ-killing for you.

Computer Keyboards

There are more germs on school computer keyboards than on doorknobs, according to the NSF study. That's because door handles are polished daily; keyboards are rarely (if ever) cleaned.
Staying Safe While Using Computers
Teach your child to sneeze into the crook of her arm and to blow her nose with a tissue, so she's less likely to spread germs to keyboards and computer mice. At home, have her wash her hands before and after using the computer. Wipe the keyboard with a disinfectant cloth once a week—and whenever someone with a cold uses it.

Your Pediatrician's Waiting Room

Don't be fooled by the antiseptic smell. With all the sick little patients (especially during cold and flu season), the doctor’s waiting room is a virtual petri dish. Then there's your busy doctor: If he forgets to wash his hands after seeing each patient, he could transmit viruses to your child.
Staying Safe at the Doctor’s Office
Have your child wash her hands before going to the doctor so she'll be less likely to pass along a bug to other kids. If she's just getting a checkup, ask whether there's a well-child waiting area (where the germ load is probably a lot lower). Take along your own toys and books so she isn't tempted to play with communal ones. "The last thing you want is for your healthy child to contract an illness at the doctor's office," Dr. Nowalk. It's also perfectly acceptable to ask the doctor and the nurse whether they've washed their hands before they touch your child. "It's smart, not rude," says Dr. Nowalk. "I wish parents asked me more often."

Asthma Fables and Facts

Although our knowledge of asthma is expanding year by year, many people still cling to outdated beliefs about the disease. Following are some that are often repeated:




Fable: Asthma comes and goes.
Fact: Asthma is often an inflammatory condition that is always in the airways, even when the person is not having trouble breathing. Exposure to an asthma trigger can worsen symptoms, but the underlying condition never goes away, although it can be controlled with medications and environmental control measures.
Fable: Asthma is an emotional disorder; it’s “all in the mind.”
Fact: Asthma is a lung disease; it affects the airways, not the brain. It’s true that symptoms may get worse when a person is under emotional stress, but this is probably more marked in adults and less so in children. Changes in the airways in asthma occur through physiological mechanisms, not emotional ones.
Fable: People with asthma should use medications only when they have attacks; otherwise, the medications lose their effect.
Fact: Regularly using medications is the only way to calm the underlying airway inflammation and prevent asthma flare-ups. Used at the correct dosage, daily medications do not lose their effect or cause uncomfortable side effects. Effective antiasthma medications include inhaled beta-agonists such as albuterol to stop attacks, and inhaled steroids, long-acting beta-agonists, and leukotriene modifiers to prevent attacks from occurring at all.
Fable: Asthma is just an annoying condition, not a real disease.
Fact: Asthma can kill when people do not get treatment to control the underlying condition and stop severe attacks. If everybody who needed medications used the proper ones to control symptoms and prevent flare-ups, hospitalizations and deaths from asthma would be greatly reduced.
Fable: Children grow out of asthma.
Fact: Most people who have asthma are born with a tendency to the condition and keep it for life. It is true many children get much better with age, and their asthma appears to go away completely. However, many have it return in adulthood. Other children who still have asthma are less likely to lose their asthma as they go in to their adult years.
Fable: Asthma clears up when you move to a warm, dry climate.
Fact: If the proper environmental measures are taken and medications are regularly used, people with asthma can live comfortably in any climate they prefer. Very rarely do people ever have to move out of a city or other area because of their asthma.
Last Updated
11/21/2015
Source
Guide to Your Childs Allergies and Asthma (Copyright © 2011 American Academy of Pediatrics)

Causes of ADHD: What We Know Today

Causes of ADHD: What We Know Today

Causes of ADHD: What We Know Today
​Attention deficit hyperactivity disorder (ADHD) is a neurobiologic condition whose symptoms are also dependent on the child's environment.
ADHD is now one of the most common and most studied conditions of childhood.

Research to date has shown ADHD may be caused by a number of things: 

  • Brain anatomy and function. A lower level of activity in the parts of the brain that control attention and activity level may be associated with ADHD. See ADHD and the Brain from Understood.org. 
  • Genes and heredity. ADHD frequently runs in families. A child with ADHD has a 1 in 4 chance of having a parent with ADHD. It’s also likely that another close family member, such as a sibling, will also have ADHD. Sometimes,  ADHD is diagnosed in a parent at the same time it is diagnosed in the child. See Inheriting Mental Disorders.
  • Significant head injuries may cause ADHD in some cases.
  • Prematurity increases the risk of developing ADHD.
  • Prenatal exposures, such as alcohol or nicotine from smoking, increase the risk of developing ADHD.
  • In very rare cases, toxins in the environment may lead to ADHD. For instance, lead in the body can affect child development and behavior.

There is no evidence that ADHD is caused by: 

  • Eating too much sugar
  • Food additives
  • Allergies
  • Immunizations

Why do so many children have ADHD?

The number of children getting treatment for ADHD has risen. It is not clear whether more children have ADHD or more children are receiving a diag­nosis of ADHD. Also, more children with ADHD are getting treatment for a longer period.
According to national data, ADHD affects about 9.4% of U.S. children ages 2-17―including 2.4% of children ages 2-5 and 4%-12% of school-aged children. Boys are more than twice as likely as girls to be diagnosed with ADHD. Both boys and girls with the disorder typically show symptoms of an additional mental disorder and may also have learning and language problems.

Because of more awareness and better ways of diagnosing and treating this disorder, more children are being helped. 

It may also be the case that school performance has become more important because of the higher ­technical demand of many jobs, and ADHD frequently interferes with school functioning.

Anaphylaxis in Infants & Children


Anaphylaxis in Infants & Children
Anaphylaxis is a rapid and severe allergic reaction. It is also a life-threatening emergency.
Research shows a rising number of children being treated in emergency departments for anaphylaxis in recent years. Allergic reactions are unpredictable in terms of when they occur, what types of symptoms develop, and the severity of those symptoms; they can happen to children at any age, including infants.  
Being prepared and knowing the signs of an allergic reaction can save a child's life. At any age, anaphylaxis can be deadly without immediate medical help. Read on.

Anaphylaxis includes a wide range of symptoms that can start quickly—within minutes or several hours after exposure to an allergy trigger. 

Be aware of any of the following symptoms, especially if they appear suddenly:
  • shortness of breath, wheezing, coughing or tightness in chest
  • trouble breathing or swallowing
  • skin changes like rash, redness or hives, and/or pale or bluish color
  • swelling of the lips or tongue 
  • sneezing, stuffy nose, runny nose
  • tight throat, difficulty swallowing, hoarseness
  • weak pulse, symptoms of shock
  • vomiting, diarrhea (if severe or combined with other symptoms)
  • dizziness or fainting
  • feeling of "doom," confusion, drowsiness or agitation
Infants may also experience other symptoms such as:
  • irritability, fussiness, or inconsolable crying   
  • sudden drooling  
  • unusual sleepiness  

Epinephrine is the recommended emergency treatment for symptoms of anaphylaxis.

Epinephrine helps quickly reverse the life-threatening symptoms of anaphylaxis. If it is available, epinephrine should be given immediately to anyone experiencing symptoms of anaphylaxis, followed by a call to 911, and a trip to the emergency department. 
The medicine comes in auto-injector syringes to make this easier. The best place to inject it is in the muscles of the outer part of the thigh.
Epinephrine autoinjectors should be prescribed for anyone who has ever had an anaphylactic attack and for infants and children at high risk for anaphylaxis.  Because a second dose may be needed if symptoms don't ease quickly, children at risk for anaphylaxis should carry at least two autoinjectors with them at all times.
Children who are old enough can be taught how to give themselves epinephrine, if needed. Epinephrine autoinjectors should be readily available in school or child care settings and trained staff should be available to act quickly in case of a reaction. Keep in mind, schools may require detailed instructions from your child's doctor about how and when to use it. See Administrating at School: Tips for Parents.

What to do after giving an infant or child epinephrine:

  • Note what time the epinephrine was given and call 911. Ask for an ambulance with epinephrine. Tell rescue squad when epinephrine was last given when they arrive.
  • Stay with child and give a second dose of epinephrine if: symptoms get worse, continue, or do not get better in 5 minutes.
  • Keep child lying on his or her back. If the child vomits or has trouble breathing, keep child lying on his or her side.
  • Give other prescription medicine (such as the child's inhaler/bronchodilator or an antihistamine prescribed by the doctor), but never use other medicine in place of epinephrine.

Lots of things can cause a severe allergic reaction.

Common Allergens that Can Trigger Anaphylaxis​

Foods
  • Peanuts are one of the most common U.S. food allergies. The American Academy of Pediatrics advises parents to introduce peanut-containing foods after their baby has tried low allergy risk foods as an allergen prevention strategy for high-risk infants"
  • Milk
  • Eggs
  • Tree nuts such as walnuts, pistachios, pecans and cashews
  • Shellfish (such as shrimp, lobster)
  • Fish such as tuna, salmon, cod (although, like with peanuts, there is some evidence that consuming fish early in life may help prevent allergic diseases such as asthma and eczema).
Insect stings
  • Bees
  • Wasps
  • Hornets
  • Yellow jackets
  • Fire ants
Medicines
  • Antibiotics and antiseizure medicines are some of the more common medicines that cause anaphylaxis. However, any medicine, even aspirin and other non­steroidal anti-inflammatory drugs, have the potential to cause severe reactions.
Other
  • In rare cases, anaphylaxis may be related to a certain food followed by exercise.


 

Be prepared: have an allergy and anaphylaxis emergency care plan.

Anyone caring for an infant or child with a life-threatening allergy must be able to recognize anaphylaxis and know when and how to give the lifesaving treatment (epinephrine). 
If your child is at high risk for allergies, or has had a previous severe allergy reaction, the American Academy of Pediatrics recommends you have an Allergy and Anaphylaxis Emergency Plan. Your pediatrician can help you and your family use this plan with anyone who cares for your child. It's also clearly written and easy to understand. See for yourself! 

Cleaners, Sanitizers & Disinfectants

Cleaners, Sanitizers & Disinfectants

​​Housecleaning may not be the most enjoyable activity in your day, but a few minutes killing germs can go a long way toward keeping your family healthy.
  • Routine cleaning with detergent or soap and water removes dirt and grime from surfaces (ex: floors, walls, carpet, windows).
  • Sanitizing removes dirt and small amounts of germs. Some items and surfaces are cleaned to remove dirt then sanitized (ex: bathrooms, counters, toys, dishes, silverware).
  • Some items and surfaces require the added step of disinfecting after cleaning to kill germs on a surface (ex: changing tables, sinks, counters, toys).

Use Caution Around Cleaners, Disinfectants & Sanitizers

Although chemical disinfectants and sanitizers are essential to control communicable diseases, they are potentially hazardous to children, particularly if the products are in concentrated form.
  • Products must be stored in their original labeled containers and in places inaccessible to children.
  • Diluted disinfectants and sanitizers in spray bottles must be labeled and stored out of the reach of children.
  • Solutions should not be sprayed when children are nearby to avoid inhalation and exposing skin and eyes.
  • Before using any chemical, read the product label and manufacturer’s material safety data sheet.

Questions to Consider When Selecting a Disinfectant:

  • Is it inactivated by organic matter?
  • Is it affected by hard water?
  • Does it leave a residue?
  • Is it corrosive?
  • Is it a skin, eye, or respiratory irritant?
  • Is it toxic (by skin absorption, ingestion, or inhalation)?
  • What is its effective shelf life after dilution?

About Bleach:

Household bleach (chlorine as sodium hypochlorite) is active against most microorganisms, including bacterial spores and can be used as a disinfectant or sanitizer, depending on its concentration.

Bleach is available at various strengths:

  • Household or laundry bleach is a solution of 5.25%, or 52 500 parts per million (ppm), of sodium hypochlorite.
  • The “ultra” form is only slightly more concentrated and should be diluted and used in the same fashion as ordinary strength household bleach.
  • Higher-strength industrial bleach solutions are not appropriate to use in child care settings.
Household bleach is effective, economical, convenient, and available at grocery stores. It can be corrosive to some metal, rubber, and plastic materials. Bleach solutions gradually lose their strength, so fresh solutions must be prepared daily, and stock solutions must be replaced every few months. Bleach solution should be left on for at least 2 minutes before being wiped off. It can be allowed to dry, because it leaves no residue. Household bleach can be used to sanitize dishes and eating utensils. The concentration of chlorine used in the process is much less than that used for disinfecting other objects.

Cleaners Containing Disinfectants:

By separating out the cleaning and disinfecting processes, you will reduce the amount of disinfectant chemicals used.
  • Soiled objects or surfaces will block the effects of a disinfectant or sanitizer. Therefore, proper disinfection or sanitizing of a surface requires that the surface be cleaned (using soap or detergent and a water rinse) before disinfecting or sanitizing.
  • Bleach (the sanitizer/disinfectant) and ammonia (the cleaner) should never be mixed, because the mixture produces a poisonous gas.
  • Not all items and surfaces require sanitizing or disinfecting. See the Cleaning, Sanitizing, and Disinfecting Frequency Table from the National Association for the Education of Young Children (NAEYC) for more information. 

Alternative/Less Toxic Homemade Cleaning Products:

Alternative or less toxic cleaners are made from ingredients such as baking soda, liquid soap, and vinegar. Many of the ingredients are inexpensive, so you may save money over time. However they may require more “elbow grease,” which means you may have to scrub harder.
Although the ingredients in homemade cleaners (e.g., baking soda for scrubbing, vinegar for cutting grease) are safer, not all are nontoxic. Treat them as you would any other cleaner, with caution.

Additional Resources:

Last Updated
10/8/2019
Source
Adapted from Pediatric Environmental Health, 3rd Edition (Copyright © American Academy of Pediatrics 2011)


We still have the Flu shot vaccine and are vaccinating children over the age of 2. (We are out of Flumist and can no longer vaccinate adults due to the national shortage of the vaccine.) If you haven't already - please bring your children in for their Flu shot. Healthy Kids = Happy Kids!

7 Hints for Easing Kids Through Childcare Changes

https://www.parents.com/toddlers-preschoolers/childcare/daycare/7-hints-for-easing-kids-through-childcare-changes/

 

Q. We are moving and will be switching childcare centers. How can we help our 18-month-old son say goodbye to his current teacher (someone he adores) and transition to the new center?

A. Transitions can be hard for young children, especially toddlers who are, by nature, not fond of change. Being sensitive to the fact that this will be difficult for him, especially because he will also be dealing with the house move, is the most important first step.
Toddlers don't have a firm grasp on time, so don't start talking about the change in childcare until a week or two before the change will take place. Talking about the center change too far in advance may just create more anxiety. In addition, while 18-month-olds do understand a lot, and certainly understand more than they can actually say, they can't begin to fully comprehend complex ideas such as making this kind of social transition by words alone.
Here are some ways to help him accept the change:
1. Ask your child's current teacher to write some brief notes about your son to share with his new caregiver. Some important issues to cover would be: how he handles transitions (does she do anything special to help with this?); what his routines are for naptimes and mealtimes; how to comfort him; and what his favorite toys, books, and activities are. Sharing this information with your son's new caregiver helps to ensure some consistency in his life during a period of great changes and can ease the transition into a new childcare setting.
 
2. Read books with him about making changes. Hearing about the similar experiences of others can be a powerful way for young children to make sense of their own situation and may help them feel less alone.
3. Create ways to help your child remember and hold on to the old center in his mind. Take photos of the teacher, the room, the playground, his friends, his favorite toys, and create a memory book for him to look at.
4. Ask his teacher if there is something special she can give to your son -- such as a cuddly stuffed animal -- that he can take to the new center for comfort when he needs it. This kind of transitional object can help your son hold his old caregiver in his mind and provide the comfort he needs to adapt to his new setting. While some parents worry that these remembrances from the old center will be more upsetting and interfere with the transition, in fact, such keepsakes are very important. They help children remember and honor their experience in a special place. They also give children permission to express their feelings of loss and sadness, which is key to helping them move on and adapt to what comes next.
 
5. Have a special goodbye ritual for his last day. You can bring in his favorite snack or music tape and have a small party to celebrate his time there. Marking partings like this is important for helping children say goodbye.
6. If possible, take him to see the new childcare center several times before he makes the actual transition. Let him explore the room where he will be cared for and meet the caregivers.
7. During the first week in the new center, stay with him for an hour or two each morning. Gradually decrease the time you stay until you simply drop him off by the end of the week. He will take his cues from you; if you interact warmly with the new teachers and other children, he will know that the new center is a good and trusted place.
Taking a thoughtful and incremental approach will help your son successfully adjust to his new childcare setting. It will also help him learn how to cope with future changes as he grows.