If you've got a little one at childcare chances are you're also battling a cycle of various illnesses - particularly coughs and colds. Well, according to a new study, there could be a simple way to reduce their number of sick days - by using hand sanitiser instead of soap.
As part of the study, published in the journal Pediatrics, a group of over 900 children aged between 0 and three, were assigned to one of three groups. The littlies attended 24 childcare centres in Almería, Spain. Kids in the first group used hand sanitiser, the second group used soap and water and the third group, the control group, followed the daycare's usual hand-washing protocol which was less strict than the other two.
Before the study began, parents and daycare staff attended one-hour hand hygiene workshops, designed and taught by the researchers. Those in the hand sanitiser group and those in the soap and water group were told to maintain normal hand-washing after using the toilet or when their hands were dirty. These groups were also told to wash their hands in the following circumstances: after coming into the classroom; before and after lunch; after playing outside; when they went home; after coughing, sneezing, or blowing their noses; and after nappy changes.
The study lasted eight months and parents were later asked to report how many days their kids missed at daycare due to illness. And there were a lot of snotty noses.
Children in the study had a total of 5,211 respiratory infections, resulting in 5,186 days at home. Those using hand sanitiser missed the least number of days (3.25 per cent), compared to the control group who missed (4.2 per cent). Those in the soap and water group missed 3.9 per cent.
But as well as the number of days spent at home under a blanket watching Peppa Pig, the researchers also noted a difference in antibiotic prescriptions, depending on the way kids washed their hands.
"We found a 21 per cent and 31 per cent higher risk of respiratory infection episodes and antibiotic prescriptions, respectively, when belonging to the soap and water group instead of the hand sanitiser group," the authors write. In other words, those who washed their hands with soap had a 21 per cent higher chance of respiratory infection episodes and 31 per cent higher chance of being prescribed antibiotics than those who used hand sanitiser.
Speaking to CNN, Janet Haas president of the Association for Professionals in Infection Control and Epidemiology, who was not involved in the study, said: "Hand-washing being a way to prevent infections is not new news anymore, for sure. We know a lot about the fact that it works. We are paying more attention now to the fact that it's not just washing your hands but how you wash your hands."
According to Haas, there's a place for alcohol hand sanitisers and the public may not be aware of just how effective they can be. "I think people still think of them as 'if you can't get to a sink, this is second best,' but in this study, it showed that it was better than the soap and water hand-washing for this group," she said.
But while hand sanitiser might be effective for keeping the doctor away, parents and teachers need to be mindful of safety risks when using them with young children.
"They have to be used with supervision," Haas said, "because the caveat here is that you can't have little kids putting that in their mouth and possibly getting alcohol intoxication."
Last year a report released by the US Centers for Disease Control indicated that thousands of children are poisoned by hand sanitiser each year, with 90 per cent of cases under the age of five.
According to the CDC's analysis of the National Poison Data System, the most common adverse side effect of hand sanitiser ingestion was eye irritation, followed by vomiting, conjunctivitis, oral-irritation and coughing. Rarer side effects in child patients included coma (five cases), seizures (three cases), and two reported instances of hypoglycemia.
Similar warnings have also been issued in Australia.
In 2015, a three-year-old girl suffered severe alcohol poisoning after playing with a bottle of hand sanitiser in the home. The preschooler was admitted to intensive care at Melbourne's Royal Children's Hospital, where doctors found she had a blood alcohol level equivalent to five times the legal driving limit for adults. Discussing the case in the The Medical Journal of Australia (MJA) Dr Michael Barrett and associate professor Franz Babl referred to hand sanitiser as a "potentially fatal toy".
"The Victorian Poisons Information Centre received a total of 15,729 calls in 2013 relating to children aged under 5 years," the article notes, adding that "topical antiseptics/hand sanitisers was the fifth most frequent source of poison to which this age group was exposed.
"Contrary to perceptions, preschool children are able to ingest enough alcohol-based hand sanitiser to develop severe ethanol toxicity."