FM-AA-CIA-15 Rev.

0 10-July-2020

Study Guide in ECED 102 Health, Nutrition and Safety Module No. 5

STUDY GUIDE FOR MODULE NO. 5

COMMON ILLNESSES AND INJURIES

MODULE OVERVIEW

The FRESH framework, an intersectoral partnership to Focus Resources on Effective School Health,
provides the context for effective health related school policies.  School policies, promoting good health and a
non-discriminatory, safe and secure physical and psychosocial environment, are most effective when
supported by other reinforcing strategies such as provision of safe water and sanitation, skills based health
education, provision of health and other services, effective referral to external health service providers and
links with the community. 

Ensuring that children are healthy and able to learn is an essential component of an effective education
system. This is especially relevant to efforts to achieve education for all in the most deprived areas. Good
health increases enrolment, reduces absenteeism and brings more of the poorest and most disadvantaged
children to school. It is these children who are often the least healthy and most malnourished, who have the
most to gain from improved health, and who need health related school policies that, when effectively
endorsed, can lead to better educational outcomes.

Because children in child care spend so much time together, it’s not unusual for germs to spread. Child
care providers can reduce the spread of common illnesses by using simple precautions like thorough hand
washing and keeping surfaces and toys clean. Child care programs can also help prevent the spread of
illnesses by requiring immunizations and by developing rules to exclude children with specific symptoms. The
following will help child care providers, directors, and parents keep children healthy while they are in child
care.

MODULE LEARNING OBJECTIVES

At the end of this module, you should have:

1. enumerated heath policies including safe medication administration; and
2. explained healthy practices to prevent the spread of illness in early childhood settings.

HEALTH POLICIES IN EARLY CHILDHOOD SETTINGS

Why Health related School Policies?

Health policies in schools, including skills-based health education and the provision of some health
services, can help promote the overall health, hygiene and nutrition of children. But good school health
policies should go beyond this to ensure a safe and secure physical environment and a positive psychosocial
environment. Such policies, should address issues of abuse of students, sexual harassment, health-related
practices of teachers and students, school violence, and bullying.
 
Policies regarding the health-related practices of teachers and students can reinforce health education:
teachers can act as positive role models for their students, for example, by not smoking in school. The
process of developing and agreeing upon policies draws attention to these issues.  The policies are best
developed by involving many levels, including the national level, regional and district level, and the school
level – including the teachers, children, parents and the wider community. 

Why School Health Policies are Necessary for Effective School Health and Nutrition Programs?

 School health policies can provide highly visible opportunities to demonstrate commitment to equity,
non-discrimination, gender issues and human rights and be a positive model for the whole society.

PANGASINAN STATE UNIVERSITY 1

 FM-AA-CIA-15 Rev. 0 10-July-2020

Study Guide in ECED 102 Health, Nutrition and Safety Module No. 5

 Policies are necessary for and can give a clear structure to a safe, protective and inclusive school
environment.
 Policies, when clearly communicated to the school population and the whole society, can give rules
on how to behave and what is accepted or not in the school setting.
 Policies that are actively accepted and endorsed by the PTA and the community can be followed
more effectively. In cases when policies are not followed there will be a demand for change and
stricter monitoring will be possible.

School health and nutrition policies must be developed and supported by key stakeholders at all levels.  At
the national level, for example, this involves an agreed framework of responsibility, policies and action
between the key government ministries (such as Health and Education ministries) and other institutions and
organizations with an input and responsibility for school health programming.  At district and school levels,
policies should be clearly understood, implemented and supported by all those responsible for the education,
health and well-being of the children.  Policies should cover a broad spectrum of areas critical for the health
and development of school age children.  Examples given here include policies relating to: sanitation in the
school environment; sexual harassment and abuse of students; the role that teachers can play in delivering
simple health services through schools; and the public-private partnerships for delivery of school food
services.

To be effective, school policies need resources for their implementation.  This means that adequate
resources must be made available at the national, regional, district and local levels.  Such resources include
government financing, but may also include contributions from other donors such as NGOs, and ultimately, to
ensure long term sustainability of effective implementation of school health and nutrition policies, support from
parents and the local community.

Content of School Health Policies

Strong intersectoral cooperation is required to plan, implement and monitor a sustainable school health
program. It should be clearly defined and inscribed in a common statement, describing who is responsible for
the interventions planned and who will be implementing those interventions.  This cooperation and
communication strategy should be written down in a ‘protocol d’accord’ or ‘memorandum of understanding’
between the education and health sectors.
 
The Ministry of Health (MoH) is responsible for the health of school age children, but this age group is
rarely a priority for the health sector. Delivery of health services to children under 5 and pregnant women – the
typical priority groups for the MoH – frequently leaves few resources left for the school children.  The
education of school children is the priority of the Ministry of Education and if “improved learning and education
achievement by improving health and nutrition” is adopted, then it also becomes their priority to assure the
health of the school-aged child. Thus the protocol d’accord needs to make transparent the tasks to be shared
between the two ministries. This is the first step towards a successful school health program.

Examples of Policies
1. Sanitation, gender and privacy, as well as maintenance of facilities by the community

Lack of facilities and poor hygiene affect both girls and boys. They should have access to safe, clean,
separate and private sanitation facilities in their schools. If there are no latrines and hand washing facilities at
school or if they are in a poor state of repair, then many children would rather not attend than use the
alternatives.

There is a need to develop a national sanitation policy and an implementation strategy in collaboration
with all key stakeholders. Local level collaboration is required to develop commitment and support
maintenance of the facilities in schools by the community.
Policy:
 Separate latrines for teachers, boys and girls
 Safe water in all schools
 Active commitment from PTA for maintenance of water and sanitation facilities

2. Sexual harassment and abuse of students including by teachers

PANGASINAN STATE UNIVERSITY 2

 FM-AA-CIA-15 Rev. 0 10-July-2020

Study Guide in ECED 102 Health, Nutrition and Safety Module No. 5

Sexual abuse and violence are serious problems that transcend racial, economic, social and regional
lines. Accurately estimating the prevalence of sexual abuse and violence in the developing world is difficult

due to limited amount of research done on the subject, and the fact that cultural acceptance prevents it from
being reported.

Studies have shown that children who witness violence, particularly within an abusive household, may
experience many of the same emotional and behavioral problems that physically abused children experience
such as depression, aggression, physical health complaints and poor school performance.

An effective school system requires clear policies and strict laws that ensure children a safe and secure
school environment without sexual assault and harassment by teachers and older classmates.  The policies
must be well known and accepted by everyone, including school children, and effectively enforced by the
community and PTA.
Recommendations for Strategic Actions:

 The key to addressing the issue is breaking the silence at all levels, among children, teachers, school
heads, parents and Ministry officials, open a dialogue, information sharing and co-operation.

 Teachers can create a more friendly and supportive environment, avoid verbal abuse and act as
positive role models for both boys and girls at all times. Teachers can also take the schools Guidance
and Counseling lessons more seriously, make them more participatory, encourage children to speak
about difficult issues, and using drama, drawings and writing to include everyone.

 School management can change the school culture of violence by enforcing effective disciplinary
measures against teachers and pupils who indulge in abusive behavior. Provide a forum for pupils to
talk about issues of abuse in a non-threatening environment possibly with individuals outside the
school. School management can ensure that Guidance and Counseling is taught only by qualified,
trained teachers. Ensure that teachers know that they will be reported if they transgress the
regulations and that all rules are enforced regarding pupil behavior. Ensure that parents know what
the school regulations are and involve parents in the formulation of the school policy on teacher and
pupil management. Work closely with parents and the community.

Policy:
 Ensure by law that sexual harassment and violence is prohibited in the school environment by
teachers and pupils.
 Make the law well known and accepted by everyone, empower adolescents to report cases, and
enforce effective disciplinary measures for those who abuse.

3. Role of teachers in delivering a simple health package through schools

Schools can effectively deliver some health and nutritional services provided that the services are simple,
safe and familiar and address problems that are prevalent and recognized as important within the community.

School health policies that allow teachers to deliver a simple health package (including micronutrient
supplements) have been shown to be effective, inexpensive and acceptable to teachers and parents. The
impact of these school based control programs show tremendous promise for reducing morbidity and increase
learning of school age children (WHO 1999).  Teachers need to be trained well to monitor and deal with any
side effects of treatment, in cooperation with local health workers.
Policy:
 Training and use of teachers to deliver simple health interventions, in collaboration with health sector
workers and with involvement of the local community. 

4. Food vendors – nutrition and hygiene

Policy development and setting the objectives of school nutrition provides the framework for implementing
all the other recommendations aimed at improving education through better health and nutrition. Analyzing the
nutrition and health situation of school children with focus on causes of energy and micronutrient deficiencies

PANGASINAN STATE UNIVERSITY 3

 FM-AA-CIA-15 Rev. 0 10-July-2020

Study Guide in ECED 102 Health, Nutrition and Safety Module No. 5

has become a way to engage governments in the problems of that age group and the necessary content of
the policy for school nutrition programming and provision of school food services.

Many governments have given private enterprises the responsibility for preparing and delivering a ready to
eat meal or snack. It is argued that governments should encourage small local enterprises.
Another problem to tackle with policies are quality and hygiene of the food served. Governments need to
regulate what is sold by commercial vendors and regulate the standards of sanitation. Working with street
vendors to improve the nutritional quality and safety of these foods involves an approach that considers not
only the needs of children but also the financial viability of the enterprise and the training and management
needs of the individual vendor. It is suggested that the success of using this approach for school nutrition
programming depends on involving all institutions which may affect the legitimacy of this economic activity,
i.e., municipal and local government, ministries of education and health, and non-governmental organizations
which represent vendors’ interests.
Policy:
 Regulation of vendors and the quality, hygiene and standard of the food provided.

LEARNING ACTIVITY 1

Report on common illnesses and injuries in young children 1st batch

TEACHER’S ROLE IN MANAGING ILLNESS AND COMMON INFECTIOUS DISEASES & HEALTHY
PRACTICES TO PREVENT THE SPREAD OF ILLNESS

Hand Washing in Child Care

Keeping all children healthy is an important goal of child care programs, and washing hands carefully and
thoroughly can help children and child care providers prevent the spread of germs that cause illness.
Thorough hand washing can remove as much as 90 percent of the virus-containing particles and bacteria on
your skin. That’s a lot of protection from infection for the amount of time and effort it takes. Child care
providers and children should wash their hands regularly during the day.

1. Creating Safe and Appropriate Diapering, Toileting, and Hand Washing Areas in Child Care
Diapering, toileting, and hand washing are important routines in child care, and those areas of the child
care classroom are important parts of children’s experience in child care. With thoughtful planning, child care
providers can set up an area to handle these important caregiving routines while also significantly reducing
the spread of germs and disease.
The Diapering Area

Diapering is a regular, everyday occurrence in infant and toddler classrooms. It is important to set up a
diapering area that is safe and comfortable for young children and that also reduces the risk of spreading
germs. The diapering area in a child care program should be:

 Located where the child care provider can see other children while changing a diaper.
 Very close to a hand washing sink.
 Separate from food preparation areas.
 Set up with space to store supplies near, but not on, the diapering surface.
 Protected with a raised edge to prevent children from falling.
 Covered in a non-porous surface that can be cleaned and sanitized easily.

The Toileting Area

Learning to use the toilet is an important self-care routine for young children. The toileting area is an
important part of the classroom, especially when children are going through the toilet learning process. There

are several different options for toilet areas in a child care setting. All can be equally successful if used and
cleaned properly. The options include the following:

PANGASINAN STATE UNIVERSITY 4

 FM-AA-CIA-15 Rev. 0 10-July-2020

Study Guide in ECED 102 Health, Nutrition and Safety Module No. 5

 Open Toilets in the Classroom. In some child care centers, two to four toilets, without stalls, are
integrated into the classroom environment for toddlers and preschoolers. In this open setting, children
can learn how to use the toilet by observing each other because toileting is a normal part of the daily
routine. It is also easy for child care providers to monitor all children if the space is open.
 Toilet Stalls in the Classroom. Some child care centers have toilets in the classroom, but the toilets
are divided into stalls, with or without doors. Having stalls provides more privacy for older
preschoolers and school-age children. Having the toilets in the classroom simplifies supervision
because a child care provider does not have to leave the room when a child needs to use the toilet.
 Separate Bathrooms. In some child care centers, toilets are in a bathroom with a door. Bathrooms
may have one or several toilets, with or without stalls. When the bathroom is separate, a child care
provider must accompany children to the bathroom.
No matter which type of toilet area is part of your classroom, child care providers play important roles as
young children learn to use the toilet. Child care providers should encourage children to use the toilet as
independently as they are ready to, help with toileting as needed, and supervise children to ensure that they
are following the rules. Bathrooms have many potential safety hazards, and children are at risk of injury if not
properly supervised in the bathroom.
The Hand Washing Area

Washing your hands is one of the easiest and best ways to prevent the spread of germs and disease. An
effective, easy-to-use hand washing area can make hand washing simpler. Here are some issues to consider
when planning the hand washing area in a child care setting:

 Sink location. Hand washing sinks should be located in areas where they are most useful for both
adults and children. If you are planning a child care space, locate sinks near the toilet and diapering
areas to encourage prompt, proper hand washing. Remember that hand washing sinks must be
separate from sinks used for washing foods or other food preparation tasks.
 Child-sized hand washing sinks. Providing sinks that are low to the ground makes it easier for
young children to practice independent hand washing, with appropriate adult supervision. When
children can easily reach the sink and turn on the faucets independently, they feel a sense of
accomplishment and are more likely to engage in voluntary hand washing.
 Automatic faucets. Adding motion-sensitive automatic faucets can cut down on the spread of germs
because children do not have to touch the faucet to turn the water on and off. Automatic faucets can
also prevent children from wasting water while washing their hands because the faucets turn on only
when hands are placed in front of the sensor.
 Stools. If low hand washing sinks are not available, place a sturdy, stable stool at the sink area so
children can easily reach the sink. Select stools with a handle if possible to reduce the chance of falls.
Be sure to supervise children when they are using stools to reach the sink.
 Paper towel dispensers. Disposable single-use paper towels are an essential tool for hand washing.
Mounting the towel dispenser low to the ground, just like the sinks, will enable children to practice
self-help skills by getting their own towels. If possible, choose dispensers that dispense only one
paper towel at a time to prevent waste and overuse. If very young children will be using the dispenser,
avoid complicated levers or knobs.
 Liquid soap dispenser. Just like the towel dispenser, it is a good idea to have an automatic soap
dispenser to cut down on waste. It is also important to have liquid soap available, even without the
automatic dispenser. Bars of soap hold germs and are thus are not as effective as liquid soap in
reducing the spread of germs. Hand sanitizers are not a substitute for washing hands with soap and
water.

2. Hand Washing Tips for Child Care Providers

Washing your hands and the children’s hands, or encouraging them to wash their hands, is one of the
best ways to reduce the spread of disease. Child care providers should be washing their hands many times
throughout the day.

When Child Care Providers Should Wash Their Hands

PANGASINAN STATE UNIVERSITY 5

 FM-AA-CIA-15 Rev. 0 10-July-2020

Study Guide in ECED 102 Health, Nutrition and Safety Module No. 5

Some of the key times to wash your hands include:

 upon arrival at the child care program
 before preparing, serving, or eating food
 before and after giving medication
 after eating
 after using the bathroom
 after changing a child’s diaper or helping a child in the bathroom
 after wiping noses, mouths, sores, or cuts
 after handling body fluids such as diarrhea, blood, mucus, or vomit
 after handling raw eggs, meat, or poultry
 after playing outdoors
 after touching or feeding pets or other animals
 any time your hands look or smell dirty

Tips to Make Hand Washing in Child Care More Effective

In order for hand washing to be effective in eliminating germs, child care providers must learn – and teach
children – how to wash their hands properly. Here are some important tips to ensure that children and child
care providers wash their hands thoroughly while in the child care program.

 Use liquid soap. Bars of soap may collect germs from the previous user, which can spread when
others use the soap. Most children seem to like liquid soap, which makes them more likely to use it
every time they wash their hands.
 Use warm running water. Cold water is less effective at removing germs than warm water. But
remember that young children can be burned by water that is too hot. To prevent burns, be sure your
hot water supply does not get hotter than 120° Fahrenheit.
 Scrub hands for at least 20 seconds. The process of scrubbing hands together helps remove grime
and germs. Teach children to sing a hand washing song while they wash their hands to help them
remember to scrub thoroughly. Singing a song like “Twinkle, Twinkle, Little Start” or “Happy Birthday”
through twice should take about 20 seconds.
 Use disposable single-use towels. A shared hand towel in the bathroom is a prime spot for germs
to grow and spread. Disposable paper towels and tissues go a long way toward preventing illness by
reducing the opportunity to share germs.
 Use hand sanitizers sparingly.  Routine hand washing should happen with liquid soap and
warm running water. Hand sanitizers may be better when soap and water is not available (such as on
field trips) but should never be used to replace hand washing with soap and water. Hand sanitizers
contain ethanol, which is toxic if ingested, and are not a safe option for children under 2 who may put
their hands in their mouths. Baby wipes can be used to wipe infants’ and toddlers’ hands when there
is no soap and water. Keep all hand sanitizers out of the reach of children.
 Wash infants’ and toddlers’ hands too. Some child care providers forget to wash infants’ and
toddlers’ hands with running water because it is difficult to get them in the right position at a sink.
Proper hand washing begins in infancy, and washing infants’ and toddlers’ hands is an important way
to teach them proper hand washing and prevent the spread of germs. As infants and toddlers grow,
encourage them to begin washing their hands independently.  A step stool may come in handy to help
raise children to sink level, but make sure you never leave young children unattended around water.

3. Simple Steps for Thorough Hand Washing in Child Care

One of the best ways to prevent the spread of germs and reduce the chance of illness in child care is
through thorough, careful hand washing. Child care providers need to wash their hands regularly and to teach
children how to wash their hands as well. If children are too young to wash their own hands, be sure to wash
their hands for them.

Follow these steps to get your hands clean every time. Teach children this process as they learn to wash
their hands. Post these steps, with pictures, on the wall near the sink as a reminder.
1. Turn on warm water.
2. Wet your hands with running water.

PANGASINAN STATE UNIVERSITY 6

 FM-AA-CIA-15 Rev. 0 10-July-2020

Study Guide in ECED 102 Health, Nutrition and Safety Module No. 5

3. Apply liquid soap.

4. Rub your hands together for at least 20 seconds. Rub the palms and backs of your hands, scrub
under nails, and rub between fingers. When teaching children to wash their hands, introduce a hand
washing song to be sure they have scrubbed long enough.
5. Rinse your hands under running water for at least 10 seconds.
6. Dry your hands with a clean, disposable paper towel.
7. Turn off the water using the paper towel instead of your bare hand.
8. Throw the paper towel away in a lined trash container.

4. Using Hand Washing Songs to Encourage Children in Child Care to Wash Hands Thoroughly

Hand washing is one of the most important ways to prevent the spread of germs in child care. When
washing hands, it is important to scrub for a full 20 seconds. Many children forget to wash their hands for this
long. Teaching children in a child care setting to sing a “hand washing song” while they wash is a good way to
help them measure if they have been scrubbing long enough. 

The following are a few examples of hand washing songs. Choose a song that you enjoy, teach it to the
children, and practice singing it while they wash their hands. The songs listed below should take
approximately 20 seconds to sing through twice.

Wash, Wash, Wash Your Hands

(Sing to the tune of “Row, Row, Row Your Boat”)
Wash, wash, wash your hands,
Play our handy game.
Rub and scrub and scrub and rub
Germs go down the drain
(repeat)

Good and Clean

(Sing to the tune of “Happy Birthday”)
Wash my hands so good and clean
Wash my fingers and in between
Watch the germs all go away
Now they’re clean, I’ll go and play
(repeat)
 
This Is the Way We Wash Our Hands
(Sing to the tune of “Here We Go ‘Round the Mulberry Bush”)
This is the way we wash our hands, wash our hands, wash our hands,
This is the way we wash our hands, every single day.
This is the way we scrub our fingers, scrub our fingers, scrub our fingers,
This is the way we scrub our fingers, every single day.
This is the way we rinse our hands, rinse our hands, rinse our hands,
This is the way we rinse our hands, rinse those germs away!

Writing Your Own Hand Washing Song

Looking for more creative ways to encourage children in your child care program to wash their hands? Try
writing your own hand washing song. Choose a well-known children’s song, and write new words that teach
children how to wash their hands. Preschoolers and school-age children may enjoy making up their own hand
washing songs. Write down the words they come up with, and encourage them to decorate the page.
Laminate the words and hang them near the hand washing sink as a reminder. Children will enjoy singing the
songs they make up and may even wash their hands longer as a result.

Immunization Requirements for Child Care

Children in child care may be more susceptible to sharing illnesses because they spend so much time
together. Immunizing children is a simple step that prevents the spread of potentially serious illnesses in the
child care program. Be sure all children receive their immunizations on schedule to protect everyone’s health.

PANGASINAN STATE UNIVERSITY 7

 FM-AA-CIA-15 Rev. 0 10-July-2020

Study Guide in ECED 102 Health, Nutrition and Safety Module No. 5

Most child care programs require that children be up-to-date on all immunizations. Parents who are
enrolling their children in a child care program for the first time may have to supply a copy of each child’s
immunization records. Child care directors and family child care providers keep those records in each child’s
file to ensure that all children in the program are properly protected from diseases. Parents are responsible for
keeping their child’s record updated. Many child care programs request updated immunization records from
parents once a year in order to be sure the information is current.

Types of Immunizations

The following are some of the diseases for which routine immunizations are available. Each immunization
has its own schedule. Most immunizations require more than one dose to be effective.
 Diphtheria
 Tetanus
 Pertussis (whooping cough)
 Haemophilus influenzae type b (Hib)
 Measles
 Mumps
 Rubella (German measles)
 Polio
 Meningitis
 Varicella (chicken pox)
 Hepatitis A
 Hepatitis B
 Rotavirus
 Influenza

When to Immunize

Parents are responsible for ensuring that their children are immunized. They should talk to their child’s
pediatrician to find out when they need to begin immunizations. If their child has missed some regular
immunizations, the pediatrician can help the parents plan a catch-up schedule. 

Cleaning, Sanitizing, and Disinfecting in Child Care

Keeping the child care environment clean is one of the best ways to help ensure that children stay healthy.
Dirty toys, bedding, linens, eating utensils, and surfaces can carry and spread germs. Regular disinfecting
should be a part of the routine in a child care setting.

Getting things clean and reducing the spread of germs requires two different steps:

1. Washing the item, using soap and water. Be sure to rinse thoroughly.
2. Disinfecting the item. Cleaning removes dirt but does not kill all germs. To be sure germs are gone,
you must disinfect them as well. The most common ways of disinfecting are as follows:

 You can disinfect with a bleach and water solution. A solution of regular household bleach and
water is an inexpensive and easy way to disinfect surfaces and objects in child care programs. The
amount of bleach and water to use depends on the concentration of the bleach you choose. 
 You can use your dishwasher. Durable plastic toys can be washed in the dishwasher. High water
pressure and temperatures do a great job of removing germs.
 You can use your washing machine. Wash cloth toys, linens, and bedding in the washing machine.
Add one-half cup of chlorine bleach to the wash cycle when washing colorfast material; for non-
colorfast material, add one-half cup of non-chlorinated bleach.
Remember that disinfecting is included in most states’ child care licensing regulations. Different states
have different rules about disinfecting solutions, water temperatures, and the use of dishwashers.

Be Cautious about Using Commercial Disinfectants

PANGASINAN STATE UNIVERSITY 8

 FM-AA-CIA-15 Rev. 0 10-July-2020

Study Guide in ECED 102 Health, Nutrition and Safety Module No. 5

Not all cleaning chemicals are safe and appropriate for use in a group child care setting. Here are some
cautions to be aware of:

 Products that meet the Environmental Protection Agency’s (EPA) standards for “hospital grade”
germicides (solutions that kill germs) often are promoted for use in child care. But many of these
products are dangerous and potentially even toxic to children. It is important to read product
labels carefully.
  Do not use cleaning products that carry a DANGER or a CORROSIVE label warning in your
child care program. Be cautious about commercial or industrial products that advertise themselves
as “disinfectants,” having “germicidal action,” or being able to “kill germs.” Often these products carry
a warning label on the front of the container because they are toxic.
 Before using anything other than a bleach and water solution for disinfecting, check with your child
care nurse consultant or licensing agency to make sure it’s acceptable for use in child care. If you do
decide to use an EPA-approved industrial product as a sanitizer, carefully read the label and always
follow the manufacturer’s instructions exactly.

Guidelines for Excluding Sick Children from Child Care

Although most parents would not take a very ill child to child care, they may try to leave a child who is
recovering from a mild illness or injury. State regulations usually specify under what conditions children must
be excluded from child care. Child care programs should provide parents with information to help them clearly
understand state regulations and their policy on sick children.

When deciding whether to accept a child who has been sick, it is important to consider three factors.

Is the child still contagious? Unfortunately, this is a difficult question to answer. Germs may have
already spread to other children via urine, stools, nasal drip or saliva before visible signs of illness appear. For
example, cold germs can be spread a few days before a child shows symptoms of being sick. By the time the
cold symptoms appear, isolating the child may not prevent the infection from spreading since the other
children have already been exposed.

However, other illnesses, such as diarrhea, strep throat and eye infections usually spread after symptoms
occur. In these cases, the child should be isolated for the first 24 hours of treatment or until the symptoms
disappear. The best way to determine if a child is still contagious is to check with the child’s doctor.

Can you give the child the care needed? Recovering children may still need extra care. They may be
irritable and whine or cry frequently. They often need to sleep for longer periods of time. And they may not be
able to participate in activities you have planned. They may also need to have their temperature monitored
and given medication at certain times. If you cannot provide this level of care, it is best not to take the child,
even if the child is no longer contagious.

Can you provide a safe and stimulating environment for the other children while also meeting the
needs of the recovering child? If you have many children to care for, it may be difficult for you to meet
everyone’s needs. In this case, it is best not to care for the recovering child. The other children have a right to
a stimulating and safe day. It is not fair to them if you must give all your attention to a sick child.

It is often hard for working parents to balance work and family life when children are sick. Be sure to be
clear about your policy on sick children during the initial interview. This will encourage parents to develop an
alternative plan for times when their child may be sick. You can help parents by providing the names of
community services or other child care providers who care for sick children. This will often keep parents from
pressuring you to accept a sick or recovering child.

We all feel compassion for sick children and their parents. But child care providers also need to decide
whether caring for a sick child is fair to that child, to the other children and their families, and to you and your
family.

PANGASINAN STATE UNIVERSITY 9

 FM-AA-CIA-15 Rev. 0 10-July-2020

Study Guide in ECED 102 Health, Nutrition and Safety Module No. 5

Preventing the Spread of Germs during Toileting

Learning to use the toilet is an exciting process for young children. Child care providers can make toilet
learning smoother and prevent the spread of germs from one child to another by remembering these basic
toilet learning “dos.”

 Consider a potty attachment instead of a potty chair. A potty attachment has a smaller seat that
snaps on to the regular toilet. Attachments are more sanitary than potty chairs. Remove urine
deflectors because they can cut the child.
 Clean and disinfect potty chairs. If you choose to use a potty chair you must empty the chair, clean
thoroughly and disinfect after each use. Clean the entire chair with a spray bottle of soap and water,
wipe clean with paper towels, and then spray with a solution of bleach water to disinfect the chair.
 Keep supplies handy. Have all supplies needed in the bathroom with you — clean diapers or pull-
ups, wipes, gloves, and clean clothing.
 Assist the children as needed. Children often need help removing diapers or pull-ups, getting on the
seat, getting toilet paper, wiping, and getting off the seat. Gloves are recommended when assisting
children with wiping. Your help in removing pull-up diapers may help to keep things clean.
 Use a “hands free” plastic-lined trash container. You may need the trash can for soiled diapers or
pull-ups, wipes and gloves. Show children how to use this type of trash container as well. Using a
trash container with a foot pedal reduces the chance of spreading germs from the container to your
hands.
 Wash hands. Use a step-stool or other equipment so children can wash their hands in the sink. Help
as needed. Wash your own hands immediately after helping a child with toileting, even if they don’t
seem dirty.

Tips to Prevent Spreading Germs during Diapering

Diaper changes are an important part of caring for infants and toddlers. But diaper changing can also be a
source of spreading germs if child care providers are not careful. To prevent the spread of germs, child care
providers need to set up a clear procedure for diapering, and follow that procedure with every diaper change.
Here are some tips for keeping the diaper area clean and changing diapers safely.

Setting Up the Diaper Area

Use one central place for changing diapers, preferably near a sink. Have a specific changing table,
counter, or other designated surface for diaper changing. Be sure the changing area is set up so you can still
supervise the other children while changing a diaper.

 Choose a nonporous surface. The surface of the changing area needs to be nonporous so it can’t
absorb any contaminants (no seams, quilting, cloth belts, or cracks) and can be thoroughly cleaned
and disinfected. An example would be a hard plastic or laminate like a countertop.
 Select a surface with a raised edge. This will help keep the children from falling off. A raised edge
of 6 inches is ideal.
 Store all diapering supplies and extra clothing in the area, but not on the diapering table. You
will need diapers, disposable wet wipes, plastic bags for soiled clothing, extra clothing, a spray bottle
with soap and water and one with bleach solution or other disinfectant, disposable paper towels, and
a covered, plastic-lined trash container. Store these items off the actual diapering table, but within
arm’s reach.
 Avoid changing diapers on the floor. Babies often wiggle off disposable coverings. It is very difficult
to keep the floor free from contamination. This is especially important for other children who sit or
crawl on the floor.
 Keep the diapering area separate from all food preparation areas. Germs from the changing table
can infect food and utensils and spread illness. The diapering area should never be used for food

PANGASINAN STATE UNIVERSITY 10

 FM-AA-CIA-15 Rev. 0 10-July-2020

Study Guide in ECED 102 Health, Nutrition and Safety Module No. 5

preparation, storage, or drying dishes. Some child care programs recommend that different people be
responsible for changing diapers and for serving food on any given day.
Diapering Tips to Avoid Spreading Germs

 Cover diapering surface with disposable paper. Paper towels, waxed paper, clean paper bags, or
butcher paper are inexpensive choices for covering the diaper change surface.
 Remove all wet wipes from the container ahead of time. Do this before you undress the child to
avoid contaminating the container.
 Have empty plastic bags ready. Use these for diapers and soiled clothing. Using empty bread bags
or plastic grocery sacks will cut down on odors.
 Use disposable latex gloves, especially if the child has diarrhea or another illness. Many child care
providers use gloves for all diaper changes.
 Always wipe from the front of the child to the back. Use a new wipe each time. Be sure to clean
all cracks and creases in the child’s skin.
 Remove gloves by turning them inside out. Grab the middle of one glove with the other one and
pull it off. Slide your ungloved hand inside the edge of the second glove and pull it inside out over the
first glove. This will keep contamination inside the gloves and off your hands. Be careful not to touch
the soiled glove with your bare hand.
 Remove gloves before putting on the clean diaper. This will prevent you from spreading germs
back to the child.
 Use a covered, plastic-lined trash can with a foot-operated lid. Using your hands to open the
trash contaminates the can and your hands and is an easy way to transmit germs.
 Limit handling of soiled cloth diapers. If reusable cloth diapers are used, put the soiled cloth diaper
and its contents – without emptying or rinsing to prevent contaminating yourself – in a plastic bag or
sealed plastic container to give to parents at the end of the day. Do not dump out diaper contents into
the toilet. If the diaper has a waterproof cover, change both diaper and cover, and do not reuse the
cover until it has been laundered.
 Wash and disinfect the diapering table after every use. Once the table is clean, disinfect by
spraying the table with a solution of bleach and water, and allow it to stay on the surface for at least 2
minutes. Wipe clean with a paper towel. If the sink being used for hand washing also is used for food
preparation or other purposes, it must be cleaned and disinfected with a bleach solution after each
use.
Child care providers can reduce the spread of germs by keeping the diaper area clean and by following
these diapering tips and guidelines every time you change a diaper.

LEARNING ACTIVITY 2

Report on common illnesses and injuries in young children 2nd batch

SUMMARY

The Convention of the Rights of the Child, now ratified by most countries of the world give Governments
the political responsibility to endorse and monitor clear health related policies. School health policies can
provide highly visible opportunities for the Governments and the whole society to demonstrate commitment to
equity, non-discrimination, gender issues and human rights in all the schools in their countries. School policies
should be clearly communicated to the school population and actively monitored by the PTA and the
community. In the new FRESH framework school policies providing a safe, inclusive and non-discriminatory
environment are most effective when supported by other reinforcing strategies such as provision of safe water
and sanitation, skills based health education and provision of basic health and other services that will lead to
better learning outcomes  and health of  school children in the 21st century.

Disease-causing germs spread anytime large numbers of people are together or when people share
items. Germs spread more easily during the colder months, because people spend a lot of time indoors

PANGASINAN STATE UNIVERSITY 11

 FM-AA-CIA-15 Rev. 0 10-July-2020

Study Guide in ECED 102 Health, Nutrition and Safety Module No. 5

around one another. Close and frequent contact with others makes it easier for germs to spread.

Immunizations help protect your child from vaccine-preventable infections. Most are given as shots. They:

 Protect your child from dangerous diseases and help to keep disease from spreading.
 Cost less than getting treated for the diseases.
 Have very few serious side effects.
 Often are needed before a child can attend school or day care.

Children younger than age 2 need a caregiver's help to prevent the spread of germs. Wash your child's
hands frequently, and disinfect shared toys. If your child attends day care, closely review the policies
regarding sick children and hygiene issues.

If your child becomes ill, keep him or her out of day care and away from other children until the contagious
period has passed. If you are unsure about how long this should be, contact your doctor.

REFERENCES

http://www.schoolsandhealth.org/health-related-school-policiesPositionStatement_PreventPromote.pdf
Fleitas, J. (2009). Bandaides and Blackboards. Available from http://www.lehman.cuny.edu/
faculty/jfleitas/bandaides/ Head Start. (2012). I am Moving, I am Learning: A proactive approach for
addressing childhood
obesity in Head Start children. Available from
http://eclkc.ohs.acf.hhs.gov/hslc/ttasystem/health/Health/Nutrition/Nutrition%20Program%20Staff/
IamMovingIam.htm
https://childcare.extension.org/preventing-illness-in-child-care/#:~:text=Child%20care%20providers%20can
%20reduce,exclude%20children%20with%20specific%20symptoms.
Hill, C. and Campos, M. (2012). I am moving, I am learning: a proactive approach for
addressing childhood obesity in Head Start Children [slide show]. Available from http://
caheadstart.org/2012HI/CHill.pdf Illinois Department of Children and Family Services. (2010, December 15).
Licensing standards for day care centers. Available from http://www.state.il.us/dcfs/docs/407.pdf Illinois State
Board of Education: Division of Early Childhood Education. (2002, March). Illinois Early Learning Project.
Illinois early learning standards.

PANGASINAN STATE UNIVERSITY 12