Young children in group care settings are known to spread infections easily, which makes preventing illness in your home-based child care a number one priority.
With developing immune systems that aren’t yet strong enough to fight off some illnesses, and habits like putting toys and fingers in their mouths and noses, toddlers and preschoolers are at risk to spread viruses and bacteria amongst themselves.
To maintain the health of the children in your care, their families, and yourself, we have listed some essential practices for preventing illness in your home-based child care.
1. Basic precautions for preventing illness in your home-based child care
You will likely have to take a health and safety class to receive your family child care license. It’s important to put what you learn into practice.
Some basic best practices to remember include:
- Regularly using gloves and disinfectant
- Sanitizing diaper areas with a bleach solution between changes/children
- Handwashing between each diaper change/bathroom visit (even if you’re wearing gloves)
- Sanitizing tables before and after eating (while children aren’t at the table)
- Never sharing sippy cups, bottles or other eating utensils
2. Designate separate sinks for handwashing and diapering or toileting
Always use separate sinks for cleaning up after diapering or toilet use, and for regular handwashing and food prep. The simplest solution is to designate the bathroom sink for all things that happen in the bathroom (i.e. diapering, toilet use) and the kitchen sink for all food prep and regular handwashing.
3. Clean toys often and properly
Regular toy cleaning is essential for preventing illness in your home-based child care.
If you’re working with infants or under 2-year-olds, you should be disinfecting toys every day to avoid the spread of germs and bacteria from mouthing and drooling.
In a 3-5-year-old program, you should be doing major disinfecting cleans once per week.
Wonderschool mentor, Terei Baker recommends a bleach-water solution for disinfecting toys and surfaces. Here’s her recommended toy cleaning process:
- Step 1 — Dip toys into hot water
- Step 2 — Dip toys into bleach-water solution (1 tbsp bleach to 1 quart of water), and
- Step 3 — Air dry
You can also clean and disinfect toys in the dishwasher.
4. Always wear gloves when handling body fluids and soiled clothing and bedding
You should wear gloves whenever you’re handling any bodily fluids. This is both for your own protection and to lower the risks of transferring bacteria or germs between children.
Whether it’s cleaning up a bloody nose, changing a diaper, or cleaning up accidents on the carpet, you need to be wearing disposable plastic gloves. These are easy to find at your local drugstore or pharmacy and essential to preventing illness in your home-based child care.
If you have soiled (e.g. by vomit, diarrhea, blood, etc.) bedding or clothing, we recommend returning it to the parents in a sealed plastic bag rather than washing it yourself. If you wash soiled clothing or bedding, you run the risk of cross-contaminating the rest of your laundry.
5. Safely prepare and store breast milk and formula
Some providers wear gloves while handling breast milk as well since it’s technically a bodily fluid. There is no need to wear gloves while preparing bottles with formula milk but you do need to wash your hands.
Be sure to tell parents to label breast milk with their child’s name and the date it was bottled or bagged. Also make sure to be aware of the dates on the breast milk, as it will only last six months in the freezer.
Bottles are only good for an hour after a child starts drinking from them, so make sure to mark the bottle with the time feeding began. After an hour, dispose of the contents. Do not re-refrigerate. There is a risk of cross-contamination between the nipple and the inside of the refrigerator.
Whether breast milk or formula, be sure to label bottles with the child’s name so you don’t accidentally share bottles between children.
6. Avoid food-borne illness with proper food preparation
Handwashing is your number one defense for preventing illness in your home-based child care. Always make sure you wash your hands before and after food prep. Some providers use gloves for food prep, but this is a personal preference.
7. Only use antibacterial soap when you have to
You may think using antibacterial soap for all cleaning and handwashing will help to prevent illness in your home-based child care. But, believe it or not, there is such a thing as being ‘too clean’.
The FDA has released statements saying research shows antibacterial soap is no better at preventing illness than regular soap.
In fact, it just might make things worse.
Studies have found that because of frequent antibacterial soap use, children’s immune systems are not building up the resilience to fight bugs and bacteria. The constant use of antibacterial soap has made way for ‘super bugs’. These are illness-causing bacteria that have adapted to withstand antibacterial soaps and are much harder to fight. This means that when children do get sick, they get much sicker and the bacteria are more resistant to treatment.
It’s also important to remember that antibacterial soap does not protect against viruses.
8. Be familiar with immunization schedules & reportable communicable diseases
By law, all children and child care providers need to have up-to-date immunizations.
You need to know how to read immunization schedules and abide by the law. For example, in California, you’re not allowed to have children in your program that don’t have up-to-date immunizations.
Breaking the law could endanger the lives of children or their family members who have compromised immune systems. It could also result in stiff legal penalties and your child care could be shut down.
The Center for Disease Control (CDC) and the public health department has a list of reportable communicable diseases. You need to know which diseases you’re required to report if two or more cases break out. If you have an outbreak in your program, you may have to shut down your child care until it has cleared.
9. Have a clear sick child policy—and enforce it
The key to preventing illness in your home-based child care is a clear sick child policy – also known as an exclusion policy.
At some point, children will get sick. You’ll want to have a policy in place to keep other children in your care, their families, and yourself healthy. You should also support parents from the beginning in developing a backup plan if their child is sick.
Because “being sick” often occurs on a gradient rather than as a black-and-white presentation of symptoms, it can be difficult to enforce a policy. How sick is too sick to go to school? It’s possible that some parents will medicate their child in the morning, only to have the symptoms show up again a couple hours later.
As an example, your policy might be that children must stay home if they have any of the following symptoms:
- Fever over 100
- Coughing that produces mucus
- More than one instance of diarrhea in one day
- More than one instance of vomit in one day
- Vomiting and diarrhea together
- Diagnosis of foodborne illness
- Combination of any of the above with fever
In addition, you should have a clear and written policy for what to expect if a child gets sick during the school day. For example, your policy might be to contact the parents and expect the child to picked up within an hour of your call.
It’s helpful to have your sick child policy posted in plain sight on the parent board.
Most importantly, whatever your policy is, be consistent in enforcing it.
10. Plan for your own sick days
We encourage providers to not feel shy about taking care of themselves. In your first year, you may find it difficult to take any sick days as you’re establishing yourself. By the second year, you should plan for at least 5+/- paid sick days.
Communicate your sick day policy with parents clearly as they enter into the program, preferably in the contract. And again, support them in developing a good backup plan in case you have to close for the day.