6 Common Germ Questions, Answered

"Good hand washing can block the transmission of most common diseases," says Charles Shubin, MD, medical director of the Children's Health Center at Mercy Family Care, in Baltimore. Indeed, a study conducted by the CDC in the poorest neighborhoods of Karachi, Pakistan, found that frequent hand washing cut the rates of pneumonia and diarrhea by half.

It's when they touch contaminated surfaces, such as a friend's hand or a toy, and then put their fingers in their mouth or nose or rub their eyes that kids typically pick up germs that cause respiratory infections and diarrhea. Although most health experts recommend scrubbing your hands with soap in warm water for at least 20 seconds -- the time it takes for two rounds of the "Happy Birthday" song -- research shows that even a 10-second wash removes about 90 percent of germs. This doesn't kill illness-causing bacteria and viruses, but it lifts them off skin and cuts infection risk. When there's no water around, use an alcohol-based hand sanitizer.

Also make sure your entire family is current with vaccinations, including an annual flu shot for children older than 6 months. "The idea is to have a cocoon of protection around them," Dr. Iskander says.

A baby's immune system is the most vulnerable during her first two months. But provided you use some common sense, there's no reason to stay cooped up at home. "There's a distinction between taking your baby for a walk to the park in a stroller and going out in a big crowd," Dr. Iskander notes. The mall on a Saturday afternoon when it's teeming with people who could cough or sneeze on, perhaps even touch, your new baby? Not the best idea. Ditto for crowded airplanes. Your risk of catching most airborne illnesses is high only when you're within two rows of a sick passenger for more than eight hours, according to a study published in Lancet. But why chance it with your new baby?

For everyday outings, shield baby by putting her in a front carrier. "When your baby's in a stroller, everybody comes over and touches her, but people are less likely to stick their hands near your chest," says Laura Jana, MD, coauthor of Heading Home with Your Newborn. And if someone does touch your baby before you can stop him? Just clean the area with a baby wipe.

Unless your doctor has put you on medicines he says can harm your baby, it's fine to breastfeed. In fact, it might prevent her from catching your illness at all -- or reduce the severity of her symptoms if she does get ill. The antibodies your immune system produces to fight bacteria and viruses get passed to your baby through breast milk.

As for antibiotics, most are safe. "If it's an antibiotic we'd give the baby anyway, we don't worry about her getting it through breast milk," says Ruth Lawrence, MD, chair of the American Academy of Pediatrics' section on breastfeeding. Most over-the-counter cold medications are also safe; if you're unsure about the safety of a particular medicine, check with your doctor.

You can count on it. That's why you want to make sure you teach older children about good hand hygiene: to cough and sneeze into their sleeves instead of in hands and to avoid touching baby's mouth, nose, or eyes. Another strategy, especially for toddlers or preschoolers, is to deputize them as the "baby police." As Dr. Jana says, "They get to be 'in charge' of making sure that everybody washes their hands before they touch the baby. And they don't need to be as tactful as you do. It's much easier for a 3-year-old to say, 'Grandma, you need to wash your hands,' than it is for you to instruct your mother-in-law to do it."

That really depends on how sick he is. If your child just has a runny nose and a slight cough but otherwise seems well enough to participate in class activities, let him go. But if he lacks the energy or feels too miserable to participate at school, then he should stay home and recuperate. A child should also be kept home if he has a fever. "That's when he tends to be most contagious, and you want to prevent the spread of infection," Dr. Jana says. A general rule of thumb: A child can return to school or daycare once he's been fever free for 24 hours.

If you have more than one child, disinfect their toys. Pay special attention to plastic and wooden ones, since viruses can survive on hard surfaces for hours, even weeks.

Also, wash a sick child's clothing and linens in the hottest water possible with bleach or bleach substitute, and then put them in the dryer for at least 45 minutes. In a University of Arizona study, viruses that cause respiratory and gastrointestinal infections easily survived a typical cold-water wash plus a 28-minute permanent-press dry cycle. And wash your child's things last so they don't end up cross-contaminating other family members' laundry.

There are, surprisingly, worse things your child will touch than the toilet seat. Charles Gerba, PhD, professor of microbiology at the University of Arizona, and his team conducted numerous studies on germs. Their conclusion: You'll want to thoroughly clean your child's hands after she comes in contact with the following.

Playground Equipment "Kids always have the most fecal bacteria on their hands when they return from the playground," Gerba says. In one study, 20 percent of playground equipment was infested with this contaminant.

Shopping Carts "These are worse than we ever dreamed of," Gerba says. "About 70 percent have fecal bacteria on them, largely because of kids sitting in those little seats that carts have."

High Chairs Out of 30 restaurant high chairs, 17 percent were contaminated with E. coli and 10 percent with methicillin-resistant staph.

Restaurant Tables "Cleaning" a table can actually make it dirtier. In an analysis of 10 restaurants, tabletops had 45 times more bacteria, including E. coli, on them after they'd been wiped: Towels used to sponge off tables aren't always thoroughly clean.

Elevator Buttons "The first-floor button is always the germiest because everybody has to touch it to get out," Gerba says.

Phones In homes with sick kids, 80 percent of phones were contaminated with the flu virus.

Originally published in the September 2008 issue of American Baby magazine.

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