We are smack in the middle of summer now and with the season comes an onslaught of germs (viruses, bacteria and parasites) that can cause diarrhea and vomiting, particularly in children. The youngest children, those less than two years of age, are most vulnerable to diarrheal diseases. Fortunately if we take proper precautions we can prevent these diseases. The simplest hygiene procedures can ensure the good health of our families and yet, a surprising number of families overlook these simple measures. Prevention in infants Breast feeding is a natural form of protection for most diseases, especially diarrhea. The World Health Organization (WHO) recommends that babies should be exclusively breast-fed until six months of age. Those who are not breast-fed should be fed with a breast milk substitute like infant formula milk. However, it is important that certain precautions should be taken in preparing the feeds when formula milk is used. Every component of the bottles should be sterilized in a commercial sterilizer (follow the manufacturer's instruction) or boiled in a pan. The water that is used for preparing the feeds should be boiled even if you are using bottled water. After boiling, the water should be cooled for less than 30 minutes (to not less than 70 degrees Celsius) and should be mixed with a measured amount of powder. The rationale behind this is that the milk powder may not be sterilized, so mixing it with hot water, will kill the bacteria. The prepared feed should be cooled down quickly in running cold water or in a pan of cold water. If not consumed within two hours it should be thrown away. The prepared formula feeds can be refrigerated for 24 hours. After taking out from refrigerator, they can be warmed in a bowl of hot water and then used. Babies can also easily get germs from the hands of those who touch them so those who handle them should wash their hands with soap and water or use a hand sanitizer before touching. Prevention in older children Using clean water is most important to prevent diarrheal diseases. Bottled water is usually safe but be sure to check that the seal has not been tampered with. If one is not sure about the water supply, then the water should be boiled before consumption. If boiling is not possible then micropore filtering or disinfecting agents like iodine tablets should be used especially while one is traveling abroad. Bottled or properly packed beverages are usually safe; again the seals should be checked. Diarrhea can attack from anywhere When one is eating in restaurants and is not sure whether proper food hygiene precautions apply there, then be sure that the food you eat is well-cooked and steaming hot. Uncooked food items like salads should be avoided. It is not just outside food that can make you sick. One can get diarrhea from home-made food as well if certain precautions have not been taken. While buying food from stores, always check the expiration date. Frozen food should be brought home within one hour of buying and placed in the refrigerator or freezer immediately. Food, once thawed, should not be frozen again. Raw food and ready-to-eat items should be kept separate. Food especially poultry, meat, and fish should be cooked thoroughly. No part of it should remain pink, while uncooked eggs should not be eaten unless they have been pasteurized. Cooked food, if not consumed immediately, should be cooled quickly (within one to two hours) and kept in the refrigerator. Do not keep hot food in the refrigerator, as this will cause the temperature in the refrigerator to rise, therefore causing bacteria to grow in the other food items. Cooked food can be kept in refrigerator for two days; in the freezer as long as it remains frozen, but the texture and taste will change with prolonged storing. Food that has been taken out of the refrigerator and warmed or kept out for a length of time, should not be placed back in the refrigerator. In the kitchen: The sinks, work tops and utensils should be cleaned thoroughly. Dish clothes should be washed in hot water frequently or disposables ones should be used. Hands should be washed after touching uncooked food. The knife and chopping board which have been used for cutting uncooked food should be thoroughly washed, and a separate knife and chopping board should be used for other food items like vegetables and fruit. If you are taking cooked food to be eaten outside the home, then it should be transferred to a cool and airy bag with ice trays to keep it cool. The most elementary rule for children and adults alike - and one that is often overlooked - is to wash the hands before eating. Taking such simple measures will keep the germs away from you and your loved ones to a great extent and make this summer a much more enjoyable one. – SG Dr. Rani Raj Mitra is an eminent pediatrician working in the Kingdom and has recently written a book on childcare. The book is available on the following website: www.easybabycare.net __
