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Mom vs. Germs

It's Monday morning, and my 6-year-old son, Drew, is sprawled in bed with a 100-degree fever and a hacking cough. He's got a cold. Again. Mentally, I review the germ-carrying suspects whose microbes may have wandered his way. Was it my friend's son, 18-month-old Benjamin, who came to dinner sporting mucus-coated cheeks? Our next-door neighbor, 3-year-old Rachel, with the prolifically runny nose? Or perhaps it was the germ of the unknown toddler, the 2-year-old at the market who coughed all over Drew while exploring our shopping cart.

How could I know for sure? Being a mom means herding your child through a germ-filled world. And while I've come to regard playdates as organized virus exchanges, my twins have no qualms about playing freeze tag with their coughing, sneezing, mucus-dripping pals. But after more than our fair share of fevers, vomiting, ear infections, and lingering colds this year  -- even this summer, when pesky illnesses like these are supposed to stop striking for a while  -- I'm on a mission to keep my kids healthier.

The problem: I'm not sure how. Should I be swabbing every surface in every room of our house with some sort of disinfectant? Banning all visitors who have runny noses and sore throats? Raising my kids as hermits? How, exactly, do kids get sick  -- and what can we do to protect them?

Jane Meredith Adams is a contributing editor of Parenting.

Immune system 101

Few things were as agonizing to me as trying to aspirate mucus from my babies' stuffed-up noses when they were tiny, crying 1-month-olds. If I had my way, colds wouldn't come onto the scene until a child knows how to breathe through his mouth and has a decent-size nasal passage. But beginning at birth, children actually need to get sick. "Kids need these relatively harmless viruses and infections in order to build their immune systems," says Stuart Levy, M.D., author of The Antibiotic Paradox (who, incidentally, was nursing a cold he'd picked up from his 11-year-old son when we spoke). This is because viruses, bacteria, parasites, and fungi  -- the four basic types of microbes we call germs  -- trigger the body to develop antibodies, the molecules that fight specific illnesses. The only way to survive on our disease-filled planet is to develop an appropriate antibody response to these germs.

So beginning in utero, a baby prepares for the outside world by receiving his mother's antibodies through the placenta. These antibodies provide crucial, though temporary, immunity to the diseases Mom has encountered or been vaccinated against. After birth, breast milk continues to boost a baby's immune system, while at the same time, the temporary immunity the baby was given in the womb begins to wear off.

After about six months, a baby has to rely on his own immature immune system to keep him healthy. Not surprisingly, he often loses the battle against constantly mutating viruses and infections. Hence, the seemingly endless succession of runny noses in the first two or three years of life. The good news is that by the time your child is a preschooler, his immune system has become fairly sophisticated. In fact, by the time a child is between 24 and 36 months old, his immune system is able to respond to an infectious agent in the same way as an adult's, according to Cody Meissner, M.D., vice chair of the American Academy of Pediatrics (AAP) Committee on Infectious Diseases. The bad news is that your 3-year-old is probably spending a lot more time out of the house mingling with other 3-year-olds and their germs  -- far too many for even a stronger immune system to ward off.

Passing a bug along

Lonnie Rule, a mom of four and owner of Desert Thunder Gymnastics in Sierra Vista, Arizona, sees plenty of cold viruses roll through the toddler tumbling classes at her gym. "They seem to pick off one set of kids and then come right back for the others," says Rule.

And this occurs despite her practice of regularly washing down the mats with a bleach solution. "I'm diligent about disinfecting after every class I teach," she says. But even right after a wipe-down, all it takes is one runny-nosed child holding hands with another youngster to keep a virus in circulation, because kids are pretty much perfect germ carriers.

Think about it:
They love to be extremely close to people.
They experience the world through their hands and mouths.
Their immune systems are less mature than ours.
They're slackers in the hand-washing department.

With their fondness for licking, smooching, touching, hugging, and wrestling, it's an all-day Simon Says game: Touch hands to mouth, hands to nose, hands to eyes. In fact, one study found that children under 24 months put their mouths on objects 81 times per hour. For kids over 24 months, that number went down to a still-staggering 42 times per hour. And let's not even talk about nose picking, rubbing, poking, and wiping.

Germs could not be happier about this. Take six common childhood infectious diseases  -- colds, ear infections, strep throat, eye infections, diarrhea, and croup  -- and every single one can be spread by contact between hands and either mouth, nose, or eyes, says Philip Tierno, Jr., M.D., director of clinical microbiology and immunology at New York University Medical Center.

Can we fight back?

Since kids are never going to ditch that hands to mouth, nose, or eyes habit, what's a mom to do? The first step is to follow the recommendation of the AAP and the Centers for Disease Control and Prevention (CDC) and make sure children 6 months to 2 years get a flu shot. Both the AAP and the CDC also recommend flu shots for the people who take care of kids: that would be us. The best time to get a flu shot is in September or October, right before peak flu season, so it's a good idea to schedule an appointment for one now. Also key in the fight against germs is to vaccinate your children on schedule against serious illnesses such as diphtheria, tetanus, rubella, and polio.

Okay. Now go wash your hands.

And have your kids wash their hands, too, for at least 20 seconds  -- long enough to sing the ABC song or "Happy Birthday" twice (that's right  -- two times, which may feel like an eternity). Until she can do it on her own, help your child scrub the palms and the backs of her hands, and even under her fingernails. Soap is key: The germs cling to it and then get washed down the drain. Alcohol gels, such as Purell, are also effective  -- they kill germs by dehydrating them. But as you've probably heard before, it's best to steer clear of non-alcohol antibacterial soaps and gels, which can act like antibiotics and encourage the development of resistant strains of bacteria.

Hand washing is more important than the impossible task of trying to de-germ your environment, says Charles Gerba, Ph.D., a University of Arizona microbiologist who spends his days measuring germs in public bathrooms. In his studies of the most germ-ridden areas in public places, the floor of a bathroom, water taps on sinks, and sinks themselves are the worst. In an elementary school, the pencil sharpener is a hot spot; in a hotel room, the television remote control can be loaded with germs. And in your home, a kitchen sponge is far more likely to harbor large colonies of microbes than the toilet bowl. (Here's something to keep in mind before you flush again, however: Germs from water spray have been found as far as 20 feet away from the toilet!)

While closing the lid before you flush, wiping down a remote or pencil sharpener, and throwing the sponge in the dishwasher (water temperatures above 140 degrees will kill most of the germs) can keep bacteria from spreading, the best way to prevent catching those germs is still to wash your hands  -- and again, make sure your kids are washing theirs.

Of course, getting kids to wash often enough and long enough is tricky. Suzanne Newpher, a mom of two from Gibsonia, Pennsylvania, remembers the hand-washing battles from when her boys were young. She could enforce mandatory washing before supper, but after playing? A hard sell. "It was tough, because they thought they had much better things to do," she says.

Roxanne Fiscella, M.D., a family practitioner in Berkeley, California, recommends talking to your kids about what a drag it is to be sick. Ask them what they think they can do to keep from getting sick. If it's their idea to wash their hands, compliance will be much easier.

And what happens when the germs win and your child comes down with something? Keep washing your own hands, and try to stay out of the line of germ-fire if you can help it, says Dr. Fiscella. "Don't put your face right up against your kid's face," she says. "Cuddle with your child's back against your front. Read with your child facing forward." Also, she says, teach kids to cough into the crook of their arms and to throw out their own used tissues.

After ten days of hacking, Drew has almost shaken off his cough. He lost a whole week of activities and playdates, and, of course, now I'm sick. Yes, I carried his wads of used tissues to the trash. Yes, I snuggled up close to him and let him breathe in my face (I could just about feel those germs landing in my nose and mouth). And no, I didn't make him wash his hands enough, and I didn't wash mine like a fiend, either. But that was before I knew that I could fight back. Mark my words, things are going to be changing around here. In fact, I'm going to wash my hands right this minute.

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