While attention is currently focused on the H1N1 flu, foodborne infections exert a considerable toll on the health of infants and children. One has only to think about the food recalls over the past 2 years (spinach, tomatoes, and peanut butter) to know that foodborne infections are quite common (Maki, 2009). While infants do not consume peanut butter, young children do, and in the case of the contaminated peanut butter, more than half the cases occurred in children. In fact, as nurses well know, "Despite their limited diet, infants remain at risk of acquiring enteric pathogens that are commonly associated with consumption of contaminated food." (Marcus, 2008, p. 83). This column revisits helpful information to share with parents to decrease the probability of such an infection in their infant or child.
Recent evidence indicates the most common organisms causing foodborne infections in infants are Salmonellosis, Campylobacteriosis, and Yersiniosis (Marcus, 2008). There are several ways by which infants are exposed to these organisms. Jones et al. (2006) found, in their case control study of sporadic Salmonella infection, that type of infant feeding, international travel, and environmental exposures (including exposure to reptiles) were contributing factors. While breastfeeding was protective against Salmonella, particularly in infants < 6 months of age, use of concentrated infant formula was not, even when controlling for breastfeeding. Similar findings, however, were not obtained for ready-to-drink or powered formula. The association with international travel, while significant, comprised only 3% of the cases in their study. Nonetheless, nurses can incorporate such information into caregiver education.
Environmental exposures occur in a variety of ways. One of the most common is by means of cross-contamination in the environment, including the home. As nurses know, good hygienic practices are critical to preventing cross-contamination, which may occur in a variety of ways. It can be as simple as not cleaning the kitchen counter after handling meat products and then preparing finger foods such as apple slices for a toddler, or in the relatively unusual situations where reptiles are in the home, of not washing one's hands after handling the reptile. In fact, the association between exposure to reptiles and contracting Salmonella is well known (Jones et al., 2006; Marcus, 2008). While infants and young children typically do not handle reptiles, exposure may occur through contact with a caregiver's contaminated hands or with some aspect of contaminated environment. The Centers for Disease Control and Prevention has recommended that households with children < 5 years of age should not own reptiles (Jones et al., 2006). Jones also suggested that "illness in all infant age groups was associated with infants riding in a shopping cart with meat or poultry placed next to them, with a population-attributable fraction of 11%." (p. 2385).
So what can nurses do to help parents reduce the possibility of foodborne infections? The first step is to initiate a discussion with caregivers about foodborne infections, including how infants and children can be exposed to organisms around the home. Incorporate this information into routine assessments conducted during routine infant and child health checkups. Review proper hand-washing techniques and remind caregivers to use ample amounts of soap when washing hands, to scrub for at least 15 seconds, and to use a clean towel to dry their hands. Should they use an alcohol-based sanitizer, remind them to use about half a teaspoon on their hands, and to continue to rub their hands together until completely dry. These simple strategies require minimal time, and are key to preventing foodborne infections. Incorporating them into caregiver education should be a routine activity.
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