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Lynne asks how old a baby can be before a caregiver (or stranger) cuts back on frequency of handwashing before touching the child.

I haven’t kept up with the latest pediatric advice. I would check with a doctor first or the university extension program, especially about a specific baby. Surprisingly, this is another topic difficult to locate specifics for implementation. I suspect the information needed (with supporting documentation) is there, just locked behind subscriptions and as an unfunded person I can’t get to it.

Lynne’s question is really about assessing risk. Here are general guidelines.

  • Age-related development terms are: Newborns or neonates are under 1 month old; Infants or babies are usually 3 months to 18 months; toddlers 12-2 years
  • Situation posed by Lynne is likely–
    “Normal” or routine baby maintenance
    involving some strangers and family
    with or without other babies around
    We aren’t talking about neonates (newborn) nor day care and play groups nor nurseries. We aren’t speaking of health care providers (who are exposed to many ill people).

In general, my guess would be 18 months is an age when others can resume everyday handwashing, certainly no sooner than 12 months or whenever infants can get around on their own (crawling or scooting). Their immune system should be in good shape then. If I remember my development biology correctly, babies get some immunity protection from their mothers for the first few months, while they switch over to their own developing system. However, getting born is a shock. Babies even experience a growth suppression then growth spurt. A lot is going on with them, so hand hygiene by others is important.

I would think there are three four main considerations–
* everyone should practice good hygiene (not excessive germ phobia) because as people we share our environment This includes keeping the living areas clean and dry.
* babies usually have pretty intimate contact with others (diapers, kissing, sharing food, sharing toys, mouthing everything) so others need to be aware of how they transmit germs to babies (don’t share chewed food or teething toys, for example)
* babies are developing their own immune systems. They need exposure to the normal environment, but intense exposure or exposure to contaminated environments can overwhelm.
* if you live in a community with an ongoing outbreak of salmonella, listeria, RSV, pneumonia, TB, norovirus, etc. and / or difficult access to clean water, then be extra vigilant with hand hygiene. see related, Give germs the boot, not our babies: unwashed hands make everyone sick

As babies get older, regular hand hygiene *by everyone* should be sufficient (by everyone is the key) for simple contact with the baby. That is, wash hands after bathroom use, after food preparation, after returning home from work, after contact sports, after petting the cow, etc.

I’m not real happy with this answer because I think it is too general. However, I’ll keep looking. I don’t really trust a lot of those new baby books either, but I don’t have access to their science to evaluate them. If anyone runs across a better suggestion, please let us know.

Protecting Against Flu – Infant Care
http://www.cdc.gov/flu/protect/pdf/infantcare.pdf

for hcw (health care workers) http://www.cec.health.nsw.gov.au/campaigns/cleanhandssavelives/documents/FAQ020207.pdf


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