I have 2 questions that I need the official guidelines for:

1. Below what age/weight is it acceptable to wipe a young infant’s hands rather than holding him or her at the sink? My understanding was that if the child has poor head control it is safer to bypass the sink experience.

2. Recognizing that gloves are to be removed after the used diaper has been taken off, is it acceptable to don two pairs at the outset in order to maintain universal precautions? One could take the outer pair off at that time & leave the second pair on for the rest of the procedure. Thank you for your response.

SC Child Care Licensing regulations are intended to be the minimal requirements for child care. Keeping that in mind, our regulations simply state that diaper changing procedures shall be consistent with those recommended by the Center for Disease Control and Prevention. The message of the regulations is to take everything into consideration that you asked in your question. The age of the child is a factor, and when the child is very young, wiping with a disposable wipe is preferred over hand washing at a sink for the reasons you gave. They do not have the neck strength to hold up their heads as you wash their hands. When the child is older and hand washing is possible, it would be preferable over the use of a wipe because it is also teaching a good habit. Hand sanitizers are discouraged due to the high alcohol content of most brands.

In the second part of your question you described a procedure that would exceed standards, and I would never tell someone that’s a bad idea. I can say that I really like your suggestion about how to ensure against transmission of pathogens, although our regulations would not require the use of two sets of gloves. Caring for Our Children: National Health and Safety Performance Standards Guidelines for Early Care and Education Programs, is published by the American Academy of Pediatrics in association with the American Public Health Association and the National Resource Center for Health and Safety in Child Care and Early Education. You can get a free PDF copy on the internet or buy one for your center. They have a detailed chapter on diaper changing procedures that stresses the use of procedures that prevent the spread of disease. We consider their book to be the best source for standards of practice.