Every month, we will ask a pediatrician questions about health and what we can do to improve our habits and behaviors. This month, we asked Dr. Gabriella Dauer, a pediatric resident at Children's Hospital at Montefiore, about one of the most common (yet overlooked) behavior to better health: washing our hands. Here's a short interview we did her.
CHIL: Why is washing your hands so important?
Dr. Dauer (DD): It is something that is so basic, but so forgotten by children and adolescents. We actually were taught about hand washing in medical school and it was something that came up in the 1840’s by a Hungarian doctor. He was an OB-GYN and he was on the floors and realized that all the babies kept getting sick from each other, all the moms were getting sick from each other and realized there’s so many germs we carry on ourselves that we can spread. When you wash your hands, you can really predict that you’re getting rid of the big things that can make kids ill.
CHIL: What are some of things hand washing can prevent?
DD: Common colds and even serious infections like the bacteria that causes meningitis, the bacteria that can cause infectious diarrhea can be on your hands and other viruses like the flu is spread easier when you’re not washing your hands.
CHIL: Why is it especially important for kids?
DD: When it comes to getting colds, we expect the kids in my clinic to get sick 10 to 12 times a year, but that’s a lot. Even if their immunity can handle that amount of illness, it’s really decreasing their quality of life to be sick that many times. Kids who wash their hands and parents who help them wash their hands don’t get sick as much as kids who don’t wash their hands. It really is to decrease the amount of illness that they’re passing around to each other because there’s a lot of negativity that comes from being sick that many times.
CHIL: What are some ways that kids can remember to wash their hands?
DD: In medical school, we were taught that kids should sing the happy birthday song [when they're washing their hands]. That’s about 20 seconds and that’s the length of time you should be washing your hands. There’s a slew of songs you can sing that you can look up online.
For the adolescents, it’s really just making it habitual more than washing their hands at a sink. We encourage adolescents to carry around Purell [because it] has been shown to not be inferior to washing hands and it has the same amount of protection as washing hands.
CHIL: How effective are hand sanitizers when you’re not immersing your whole hands in water with soap?
DD: They’ve done studies on Purell efficacy versus washing hands. They do studies on us in the hospital because as physicians, we are moving room to room to room and it’s very easy to spread infection. They do these tests on physicians’ hands and on patients’ hands to look at the types of bacteria and viruses are cultured off of their hands and there were no difference when you use Purell correctly. Back in the days, [doctors] used to literally stop and wash their hands every single time with water and soap, but with the invention of antibacterial gels, they have been able to shorten that time and they have not seen an increase in risk of infection.
Most people who wash their hands will not do it correctly. They will stick their hands under the water, they won’t use soap and then they will just pat them dry. It’s not long enough and it’s not done correctly. So, you can even argue that Purell may be even more effective because you’re putting this strong antibacterial gel into your hands. If it’s not effective, it can be more effective than hand washing appropriately.
CHIL: What is the correct way to wash your hands?
DD: What I tell my parents and kids is to turn on the water and make sure that it’s warm. Take the soap and you lather for 20 seconds, that’s when you’re singing the happy birthday song, so you don’t have to go under the water just yet. The kids have to be rubbing their hands together with soap and then they have to wash it, they have to rinse their hands and then dry it clean.
CHIL: What can families, doctors and teachers do to encourage hand washing?
DD: It really is at the level of their parents and caregivers to help small kids, but singing a song is happy for them and they associate cleaning their hands with something happy. Stickers are [also] a godsend. Anytime we want kids to do something, we want to give them some kind of positive reinforcement. If parents can think of it as something they can reward, it’s like, “Okay, once everybody washes their hands, we’re all going to sit down and watch the movie. Okay, once everybody washes their hands, everyone is going to get a sticker on their sticker chart.” It is something that is tedious for kids who don’t understand why they have to do it, but they see the positive results from a sticker or a happy face on their chore chart.
With teenagers, [it is] to just simply [have] those Bath and Body Purell things that they can keep in their bags.
CHIL: When should we wash our hands?
DD: Parents ask me that a lot because a lot of parents have pets in their house like dogs and cats and I definitely say, especially for pets that go outdoors, absolutely have the kids wash their hands because the pets can step on things outside and you pet them. You don’t want your kid touching anything or eating anything after playing with pets.
Think about what’s on your hands because you’re going to touch your eyes, your mouth, your nose, and you’re going to transmit that bacteria. If you’re eating, if you’re going to drink something, you have to wash your hands before. [For] parents, as soon as they’re changing diapers, [they should] wash their hands. Definitely after blowing your nose, sneezing or coughing into your hands, every time you use the bathroom and afterwards and before eating, but pets are something that parents always ask me about.
CHIL: When can kids start using hand sanitizers?
DD: I don’t use Purell on newborns, the really tiny little babies, and infants. They’re not washing their hands anyway. I say if they’re old enough to wash their hands, then they can use Purell and that’s usually at the age of 2 or 3 because before that, kids don’t really have the dexterity to mush their hands together or do the washing behavior. Purell is not harmful in any way as long as it’s kept out of the face.
Let us know if you have any other questions for our next "Ask a Pediatrician."