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The first 20% of the full text of this section appears below.

Section 2. Recommendations for Care of Children in Special Circumstances

Children in Out-of-Home Child Care

General Practices

The following practices are recommended to decrease transmission of infectious agents in a child care setting:

  • Each child care facility should have written policies for managing child and provider illness in child care.

  • Toilet areas and toilet-training equipment should be maintained in sanitary condition.

  • Diaper-changing surfaces should be nonporous and sanitized between uses. The diaper-changing surface should be covered with nonabsorbent paper liners large enough to cover the changing surface from the child’s shoulders to beyond the child’s feet. The liner is discarded after each use. If the surface becomes wet or soiled, it should be cleaned and sanitized.

  • Diaper-changing procedures should be posted at the changing area. Soiled disposable diapers and soiled disposable wiping cloths should be discarded in a secure, foot-activated, plastic-lined container. Diapers should contain all urine and stool and minimize fecal contamination of children, child care providers, environmental surfaces, and objects in the child care environment. Diapers that should be used are modern disposable paper diapers with absorbent gelling material or carboxymethylcellulose or single-unit reusable systems with an inner cotton lining attached to an outer waterproof covering that are changed as a unit. Clothes should be worn over diapers while the child is in the child care facility. Soiled clothing should be bagged and sent home for laundering. Both the child’s and caregiver’s hands should be sanitized after a diaper change.

  • Diaper-changing areas never should be located in food preparation areas and never should be used for temporary placement of food, drinks, or eating utensils.

  • The use of child-sized toilets . . . [Go to Full Text]


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