Does it make a difference if the people handling a newborn wash their hands first? Researchers from Johns Hopkins University and the Nepal Nutrition Intervention Project looked at this in southern Nepal. Their findings appeared in the journal Archives of Pediatrics & Adolescent Medicine.
The study involved more than 23,600 newborns and their mothers. Before delivery, the birth attendant told the women about clean and safe birthing, including hand-washing. Each woman also received a clean birthing kit with a small bar of soap. Researchers questioned the mothers on days 1 and 14 about care practices and risk factors for infection and death.
Mothers who washed hands: a 44% lower risk of newborn death
Newborns had a 44% lower risk of death when their mothers reported washing their hands before handling them. The risk was 19% lower when the birth attendant washed their hands before delivery. Overall, newborn deaths were significantly lower when the attendant and/or mother washed with soap or antiseptic.
The researchers suggest that hand-washing reduces a newborn's exposure to life-threatening germs.
Why a newborn is so exposed in the first weeks
A newborn's immune system, the body's defence against viruses and bacteria, is still immature. Babies can become very sick from an infection, and premature or sick babies find it even harder to fight germs. The source article says newborns are also more likely than older children to die from a serious infection.
It gives a few theories for why. One is that the immune system simply matures over time. Another is that mother and baby both have dampened immunity so they do not reject each other. A 2013 study in the journal Nature found that this early dampening is deliberately engineered by the body, so helpful bacteria can settle in the baby's gut, lungs, skin and mouth.
Whatever the reason, the article advises protecting a baby from infection for at least the first two months. That gives the immune system time to toughen up, and it is around this age that babies receive more routine vaccinations.
The catch: what this study cannot tell us
The hand-washing figures rest on what mothers reported, and the source does not describe how the researchers accounted for other differences between families. This was one study in southern Nepal. It did not cover Singapore, and we cannot say the same percentages would apply here. The study supports the idea that clean hands protect newborns, but it does not prove an exact effect for any one family.
Asking visitors to wash up, without the awkwardness
The article suggests these steps for the first two months:
- Ask every visitor, including grandparents and relatives, to wash with soap and water before holding your baby, and follow the same rule yourself. The Nepal study linked mothers' hand-washing to a 44% lower risk of newborn death.
- If there is no soap and water, use an alcohol-based hand sanitiser with at least 60% alcohol. Rub it over all surfaces until hands feel dry.
- If a guest says "I'm not sick", gently remind them that people can spread germs without visible signs of illness.
The article also says that a baby under three months with a temperature of 38°C or higher should see a doctor straight away. Even a mild-looking fever can signal a serious infection in a young baby.