Is There Such a Thing as 'Too Clean' When it Comes to Kids?

Disinfectants, antibacterial wipes, gel sanitizers...Pediatricians and other medical experts weigh in on whether our nation's obsession with cleanliness could lead to harmful effects for our children.

"No eat, wipes," says three-year-old Evan Goldstein as he refuses a cookie from his father at the playground. In his short life, he has been trained not to eat anything unless he cleans his hands with disinfectant wipes or covers them in Purell. Some parents would admire his restraint, but Evan may be on the road to an unhealthy tolerance for germs, not to mention a harmful obsession with cleanliness.

   While Evan's mom, Stacey, carries antibacterial wipes and hand sanitizer everywhere she goes, Evan's dad, Joe, thinks a little dirt never hurt anyone. It's a source of conflict for the Goldsteins. And one that's not as easily resolved as you might think, as doctors themselves don't always agree on an answer.

   Dr. Nilfar Karimova, an internist at Patients Medical in midtown Manhattan, feels that the best defense is a good offense. She advises parents to make sure their child's immune system is strong by feeding them nutritious meals, making sure they get enough sleep, providing them with the time and space to be physically active on a regular basis. Beyond that: "If hands are dirty, washing with warm water and soap is my top choice. Purdue University issued a warning about the efficacy of 'waterless, antibacterial hand sanitizers,' saying they may be misleading. And other reports have warned that hand sanitizers containing triclosan, benzalkonium chloride, and alcohol may be harmful, especially to small children."

   When we were kids, soap and water was enough. This begs the question: Have parents become overly cautious?

   Pediatrician and medical director of Belilovsky Pediatrics in Brooklyn, Dr. Anatoly Belilovsky believes that since "most colds and viruses are spread by hand-to-hand and surface contact, any of the anti-germ products are better than nothing." He says that while soap and water still suffice for washing hands, instant sanitizers hold the attraction that anything 'instant' does in today's culture. "It's not that we need different products in order to sanitize; it's that we need different products to motivate us to sanitize."

Tips on Teaching Kids Clean Habits

   With all the talk and fear lingering around super-strain viruses and immunity, Dr. Belilovsky believes that sanitizers won't cause super-strains of viruses to develop. "Many people worry about the 'hygiene hypothesis' - that all of the sanitizing antibacterial products are preventing children from developing immunities - and a lot of research is being done on it. However, the jury is still out; there is no solid proof for the hygiene hypothesis."

   Conversely, Dr. Karimova feels that the threat of resistant strains is a concern. "The super-strains of viruses and bacteria arise from the overuse or abuse of antiviral and antibiotic medicines respectively. The staph or strep infections that were responsive to commonly used antibiotics are becoming resistant, and responsive to a very few or to one," she says. "The news has increased the attention on illnesses recently - such as the bird flu, swine flu, and other types of illnesses that seem scary," says Dr. Karimova. "Also, media is more readily accessible now than ever before, so illnesses which were isolated before that we never would have heard about, now are headline news viewed by everyone in the world with a computer, television or radio. The flu, however, is not new. There were many types of illnesses in the past that humans weathered without the aid of hand sanitizers."

   Despite this ongoing debate, doctors and parents do agree on this: One good bet to keeping your kids healthy is to educate them on proper hygiene techniques and boost their immunity with healthy food, adequate sleep and exercise. "Surprisingly, Evan has not really been sick in his three years," says Stacey Goldstein. "So although I never let him eat anything without wiping his hands, and Joe sometimes does, I hope that his immunity is strong from the nutritious diet he eats, and that's something that Joe and I agree on wholeheartedly."