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Millions of kids in developing countries can't wash their hands because they don't have access to soap, clean water, or sinks. In the US, many just don't bother. How can parents change that — without being a nag?

As adults, we all know we should be washing our hands, as the CDC says, an awful lot. After using the toilet, changing diapers, and helping our young kids go potty. Before and after handling and preparing food. Before and after caring for a sick person or cleaning a wound. After cuddling up with our pets and cleaning their messes, and after taking out the trash. 

If we don’t practice optimal hand hygiene — and that means wetting our hands, soaping up, scrubbing for 20 seconds, rinsing, and then drying — we risk social shaming. That is, presumably, why 94 percent of us say we routinely do it, but only five percent actually follow this protocol after an up-close-and-personal encounter with a public bathroom. 

Because most adults don't wash their hands properly, it’s hardly surprising that one study found that only 58 percent of middle-school girls and 48 percent of boys washed their hands at all after going to the bathroom — but only 33 and 8 percent bothered to use soap. In another piece of research with shocking results, a mere 32 percent of Utah fifth graders practiced “some form” of hand hygiene before lunch. Even after a teacher reminded them! 

Why aren’t handwashing rates better? 

Millions of children in poorer countries don’t have access to soap, clean water, or sinks and actually can’t wash their hands. Kids in the US don’t have that excuse, and the real reason behind substandard hand hygiene might be altogether more mundane. ​Handwashing boring — and that applies to doing it, nagging your kids about it, and being nagged at, too. 

It’s also important. Handwashing might have less of a life-saving potential in the US than in rural Bangladesh or Peru, but it still matters. Dr Sasa Milosevic told SteadyHealth just why: 

"Children are very sensitive to loss of water, and highly susceptible to gastrointestinal infections. Therefore, proper hygiene, which includes handwashing, can greatly reduce the likelihood that your child will suffer a GI infection and subsequent diarrhea."

Kids who wash their hands may lower their risk of diarrhea by up to 40 percent and their odds of ending up with respiratory infections like colds by around 21 percent. What’s more, one study found that hand hygiene programs cut school absences in half. 

What if you could make handwashing such an automatic part of your family’s routine that your kids wouldn’t even have to think about it? It would certainly save you a lot of agro — you could skip the nagging, wind up with fewer proverbial gray hairs from worrying about sick children, and save the money lost workdays and medications would rob you of.

Your kids would grow up to be the kind of people who don't need CDC tweets like this one to remind them that germ-fighting depends on handwashing: 

#DYK: CDC has a new national #handwashing campaign, Life is Better with Clean Hands! Download or order free materials here: https://t.co/3wHPEKmRHY. #KeepHandsClean pic.twitter.com/ks6VycSAWA

— CDC_eHealth (@CDC_eHealth) December 2, 2019

The question is, how do you get there?

Helping your kids make handwashing second-nature by harvesting habit-forming science

A habit is — basically — any action that has become so automatic that we don’t have to consciously consider it any more. Habits don’t form that easily, but humans thankfully have it down to a science by now. 

Any parent can take a hands-on approach to germ-fighting by following the steps known to create successful habits:

  • Rewards. We’re more likely to repeat inherently rewarding actions. That presents a bit of an issue when it comes to handwashing, because the real reward isn’t something that happens, but something that doesn’t — getting sick. Parents of little children may be able to make handwashing a more rewarding experience if they offer praise, create a fun atmosphere by singing a silly handwashing song while soaping up, or even create a sticker chart. 
  • Consistency. We stop the habit-forming process in its tracks when we interrupt it — something that actually reduces the odds that we’ll do the right thing next time. So, parents who make sure their kids wash their hands in every situation that calls for it, every time, are more likely to instill strong habits that last a lifetime. 
  • Powerful cues. We’re better at remembering to do something if something else reminds us that we should. Perhaps you always call your mom right after you make a cup of tea, for instance. The fact that hand hygiene is often called for right after we finish other tasks — toileting, taking out the trash, or snuggling with the cat — is good news. Kids should solidify this link over time. 

Parents have one more powerful habit-forming weapon in their arsenal. Whether you have a toddler who just wants to make you happy, or a grumpy teen who barely utters two words when you talk to them, our children do look up to us. And it’s easier to get them to do as we do than do as we say. 

Why not chirpily announce that you’re “just going to wash your hands”, and frequently let your kids see you taking good care of your own hand hygiene? You might think this won’t make any difference, but research shows that students have better handwashing rates if their teachers soap up, first.

Creating a more handwashing-friendly home

Even with solid habits in place, parents can continue to nurture healthy hygiene habits by making the home as handwashing-friendly as possible. Children report, after all, that gross bathrooms, a lack of soap, and insufficient reminders are among their most common reasons for skipping the soap and water. 

Try:

  • Letting your children pick what soap they use. Kids participating in one study reported that they loved “foamy” soap, while yucky, slimy bar soaps made them slack on their hand hygiene. Liquid soaps are actually a superior choice, because bar soaps that can’t drain properly are known to pick up hefty doses of Pseudomonas and other bacteria. They’re also hard for the littlest children to handle properly. 
  • Washing your hand towels often. Cloth hand towels do a far better job of drying the hands than the paper towels and electric hand dryers you come across in public bathrooms — but they also top the list of most contaminated items in the kitchen. Don’t “reward” your kids for proper handwashing with a germ-infested towel. Wash hand towels every few days and allow them to dry completely before they’re reused. 
  • Put up friendly reminder posters. We all need our memories jogged sometimes. Consider placing handwashing reminder posters on the inside of your bathroom door and on the fridge to boost the odds that your kids will remember this crucial step. If you’re anything like me, you’re thinking about digging up pictures of the grossest bacteria and the infections they can cause — but don’t do that. Research shows that “scare-tactic” reminders just make people want to run for the hills. Keep it positive!

Clinical pharmacist Tony Gerlach from Ohio State University asked why we don't get something so simple right all the time when he tweeted: 

#handwashing prevents spread of infection. Why arent you doing it 100% of the time? @jonessurgery @Alistair_MD @michellechii215 @mpmeara

— Tony Gerlach (@SICUPharmD) February 27, 2015

Maybe it's time for us, parents, to ask our kids the same. We have more power than we think we do — my own two kids have noticeably doubled down on their hand hygiene efforts since the start of Handwashing Awareness Week. Two things explain why. I've talked to them about it and shared links, and I've been taking my own handwashing to the next level, too. You can do the same, not just for Handwashing Awareness Week but all year round. 

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