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To Wash or Wipe: A survival guide against germs

Everybody wants a safe, clean environment.  And no one wants it more than than new parents.  As physicians we regularly use soaps, cleansers, and sterilizing agents in our hospitals and clinics, so we know a thing or two about keeping things clean.  And what we’ve learned in our practices influence the decisions we make about cleaners in our home and with our children.

First, dirt don’t hurt - well not necessarily.  Bacteria is all around us.  There’s simply no escaping it.  In fact, our bodies need a certain amount of ‘good’ bacteria to stay healthy and to help our immune system defend against ‘bad’, or pathogenic, bacteria.  Babies need a slow, steady exposure to these environmental bacteria to build a strong, healthy immune system for the long term.  So keep clean, but there is generally no need to try to maintain a sterile environment.

Second, when it comes to cleaning, keep it simple.  One of the first lessons in medical school was that, ‘The solution to pollution is dilution’.  In other words, the best way to prevent the spread of germs is with diligent washing of hands and other surfaces.  Bacteria cells need large numbers to grow, spread, and cause infection.   A healthy dose of soap and water literally washes those bacteria away, diluting their numbers, and preventing their ability to spread.

Third, not all chemical cleaning agents are created equal.  In recent years, chemical cleaners in the forms of wipes, sprays, and gels have added convenience to our lives.  But that convenience comes at a cost.  Certain chemical agents actually stimulate the bacteria to adapt, breeding more resistant strains that are often more difficult to kill.  Some of these chemical agents may, themselves, be harmful and in many case there is no evidence to show that these agents work any better than plain old soap and water.

Growing concern regarding chemical cleansers recently led the US Food and Drug Administration (FDA) to order that manufacturers to remove 19 such ingredients found in consumer antiseptic hand and body washes. The most common of these is triclosan, found in almost all liquid products labeled “antibacterial” or “antimicrobial.”  The targeted ingredients won’t be banned from all products however, and may still be found in hand sanitizers and wipes, toothpaste, and antibacterial soap used in hospitals and food settings.

We recommend that if you do need to use a chemical cleaner or hand sanitizer (because no soap and water is available) that you follow the recommendation of the U.S. Centers for Disease Control and Prevention (CDC) and use alcohol-based products that contain at least 60% alcohol.  Alcohol based cleaners are more natural, less likely to irritate the skin, highly effective, and do not promote bacterial resistance.