When you have an infant, keeping him or her away from germ hazards is hard enough -- the dirt, the dog's water bowl, the surface of a public changing table.
But there's one potential source of germs that's a lot harder to control: people. Specifically, the swarms of family, friends and complete strangers that always seem to surround little babies. Smiling grannies and grubby preschoolers alike, they lurch toward your defenseless baby like zombies, arms outstretched, desperate to hold, touch, or kiss the baby.
It can make keeping your baby healthy tough. Unfortunately, all that contact with germy people can make babies sick – especially infants. "Infections in small babies can be pretty serious," says Tanya Remer Altmann, MD, a pediatrician and author of Mommy Calls. "They can get very sick quite quickly."
So how can you keep your baby healthy and get other people to keep their germs to themselves? And how can you do it without getting a rep for being a high-strung, OCD freak? Here's some advice.
Keeping Baby Healthy: Do I Need to Worry About Germs?
Of course, you may wonder whether you really need to protect your baby against germs. After all, doesn't exposure to germs build immunity, and doesn't that help keep babies healthy in the long run?
It is true that getting exposed to germs makes the immune system savvier. When the body is infected by a virus, the immune system usually figures out how to defend itself. Then, the next time you come in contact with that specific microorganism, the immune cells are ready. They can often fight it off without your getting sick.
However, that doesn't mean that deliberately exposing your child to germs is smart. Your baby will get all the germ exposure he or she needs naturally, says Robert W. Frenck Jr., MD, professor of pediatrics at the Cincinnati Children's Hospital Medical Center. You don't need to help along the process by having your uncle sneeze on your baby.
Keep in mind that germs like cold and flu viruses that are pretty benign in adults can cause problems in young babies. For that reason, Altmann stresses that parents should be very careful to protect their babies from germs in the first three months -- and if possible, the first six.
Finally, remember that it's not only about your baby's health. Think about the logistics too.
"When a baby gets sick, it can be really challenging for the parents," says Altmann. "One parent may have to take time off from work to stay home with him, and that can cause a lot of problems."
What's more, once your baby's sick, the odds that someone else in the family will get sick are higher too. That one preventable cold could have repercussions that last for days or even weeks.
How to Keep Your Baby Healthy
So to protect your infant and your family, you need to play defense. Here are some tips on how to keep your baby healthy and how to keep those admirers - or at least their germs -- off your kid.
Make hand washing a rule. The most common way of spreading an infectious disease is by touch. So you should always wash your hands before picking up your baby or preparing food, and after diaper changes, using the bathroom, or walking into the house. Insist that anyone who wants to hold your baby meet the same standards.
Redirect. If you can't stop the hordes from touching your baby, you can exert some control over what they touch. "Parents should ask people to touch or kiss the baby's feet instead of the hands or face," says Altmann. That way, everyone's happy. The admirers get to touch the baby, but their germs are confined to an area of the body that's unlikely to make the baby sick. "That approach usually works until about 9 months," says Altmann. "Around then, kids start sucking on their toes."
Carry hand sanitizer. While experts say that soap and water is the best way to get rid of germs, alcohol-based hand sanitizers work very well too. Always have a bottle with you when you're out and about. If someone insists on touching, ask that they take a dab of it on their hands first to keep your baby healthy. For it to work, people need to rub vigorously for a full 15-20 seconds, says Frenck.
Practice crowd control. "When you've got a newborn, you really don't want to be around a lot of people," Frenck tells WebMD. "There's always the potential that some of them will be sick." So when your baby is small, you may want to avoid large family gatherings and crowded places like malls. Once your baby's a little older -- at least over the 3-month mark -- then you can start being more adventurous.
Screen your guests. People may forget just how vulnerable little babies are to germs. So it won't hurt to remind anyone who's planning a visit that they should stay home if they're sick. Offer to reschedule as soon as they're feeling better.
Invoke a higher authority. If you're worried that you won't be able to stop a particularly determined relative from kissing your baby's cheeks, cite doctor's orders. "I usually tell parents to blame it on me," says Altmann. "I suggest that they tell people that because their baby is just so small, the pediatrician said that no one should touch him because he might get sick."
Coping with sick sitters. Here's one scenario that parents dread: opening the door to a babysitter to find her pale and sniffling. What's a parent to do when a child-care worker is sick? There's no easy answer. If your baby's in day care, ask the management about their policies. Are teachers supposed to stay home when they're sick? If they do work sick, what extra precautions do they take to protect the kids? One thing to consider when choosing a day care is whether employees get paid sick days. If they don't, the staff is more likely to work sick out of necessity.
Ultimately, you have to make a judgment call. In some cases, it may be better to cancel your plans or take a day off instead of letting a sick person take care of your kid. But that's not always an option. If you have to leave your baby with a person who's sick, just ask that they do what they can to keep your baby healthy – and make sure they're stocked with lots of hand sanitizer and tissues.
Follow the vaccination schedule. Experts are unanimous: one of the most important ways of protecting your kids from other people's illnesses is to make sure they're getting all their vaccines.
"A lot of people don't realize this," says Frenck, "but two of the most important things we've done in medicine are getting people to wash their hands and getting them the recommended vaccines."
Contrary to what you might hear, vaccines don't only protect against diseases that have now become rare. Altmann says that she's seen a huge drop in cases of meningitis in the last ten years because of the pneumococcal and Hib vaccines. The newer rotavirus vaccine has also made a difference, she says.
"Every winter, we also used to hospitalize a number of infants with vomiting, diarrhea, and severe fever caused by rotavirus," Altmann tells WebMD. "But since we started giving the rotavirus vaccine three years ago, those numbers are way down."
So make sure that your kid is up on her vaccines. If you have any concerns about vaccines or the schedule, talk them over with your child's pediatrician.
Don't worry too much. If you can't intervene fast enough to prevent someone from touching your baby, don't freak out.
"When I took my babies out in public, people would come up and pinch their cheeks," says Laura A. Jana, MD, a pediatrician in Omaha, Neb. and co-author of Heading Home with Your Newborn. "I just waited until they walked away and discretely wiped them off."
Remember that you are the parent. It's easy to feel cowed by pushy relatives clamoring to hold your baby. But remember, this is your kid. You're in charge and it's your responsibility to keep your baby healthy. If you're not comfortable with other people holding him, just say so. People might be more respectful of a parent's wishes than you expect. (And even if they're not, who cares?)
When Germ Precautions Don't Work
Of course, no matter what you do, your baby is going to get sick anyway. It just happens.
When it does, and you're cradling your fussy, sniffling infant, it's easy to blame yourself. Oh, if only I had wiped down that shopping cart more thoroughly! If only I'd kicked Aunt Jeannie out of the house as soon as I heard her cough!
But don't beat yourself up. Germs are everywhere, and there's just no way to avoid them. The best you can do is practice sensible precautions and accept that you can't always keep your baby healthy.
Don't get too preoccupied with blaming other people either. While you might be convinced that your snotty-nosed nephew is responsible, the odds are quite high it was someone else -- your neighbor who wasn't even showing symptoms yet, or some person you never met who left germs behind on the checkout counter.
Caring for a Sick Infant
For now, you need to shift gears: you have to protect other people -- especially other small children. If your child's in day care, that means following the day care's policy about sickness. Yes, it can be terribly inconvenient to keep your kid home from day care and miss work. But it's your responsibility to protect other kids, just as you hope that other parents will feel obligated to protect yours.
In the meantime, when you're stuck at home with a sick kid, remember that this is a parental rite of passage.
"Young kids get sick all the time, especially if they're around other babies," says Altmann. "They catch something, they're sick for a week, they feel better for a week or two, and then they catch something else. It happens with all my patients and it happened in my own house with my kids too."
The good news is that their immune systems will get stronger with time. It won't be like this forever.