Features
Teaching children personal hygiene

by Barbara Langham

Where do we learn personal hygiene—habits of cleanliness and health? At home certainly, when parents teach us as children to bathe, brush our teeth, and wash our hands.

What about at school? Chances are you remember a teacher in kindergarten or the primary grades instructing you to blow your nose in a tissue or checking your hair for lice.

Although home is the first learning environment for children, school plays a supplementary but important role. As teachers, we work in partnership with parents to help children develop and strengthen habits of cleanliness and good health.

Learning good personal hygiene is important because it helps rid the body of bacteria and viruses that can cause illness and infection. Staving off illness protects not only an individual child but also other children and adults within your program.

Good personal hygiene also has social benefits. It reduces body odor and improves appearance, thereby enhancing the perceptions of other people and improving self-confidence. It shows that you value yourself by taking care of your body.

Activities
The activities below describe key hygienic habits for children as young as 3 years and suggest ways for teachers to include them in daily routines. Before starting, inform parents via email or print about your plans and invite their input and cooperation.

Learning how germs spread
As an introduction, help children understand what germs are (bacteria and viruses) and how they spread. “Germs are tiny bugs that might make us sick,” you could say. “They’re almost everywhere, and everyone has them—on the hands, in the nose, and in the tummy. Some germs can make people sick. We can’t see them, but want to be careful to not share the germs that might make us, or someone else, sick.”

Explain that we can pick up germs in several ways, including by touching things that others have touched. We can spread germs by sneezing and coughing and letting others use our personal items, such as eating utensils. Suggest playing a game to better understand how germs spread.

Here’s what you need:
tempera paint
tissues
wastebasket

Inform children that you will pretend to sneeze and then you will splatter your hand with paint as pretend germs. After doing that, go around the room touching things, such as tables, shelves, and door handles. Encourage children to follow you, and use tissue to wipe up paint residue. Ask children to talk about the things they have touched in the room and how they may have picked up germs.

Ask: How can we avoid spreading germs? Mention sneezing into a tissue, washing hands, bathing, and brushing teeth, for example.

Handwashing
This personal habit cannot be stressed enough. Even we as adults may hurriedly run our hands under water or occasionally forget to wash them at all.

Review handwashing guidelines with children. Be clear that children should wash their hands before eating or handling food and before playing in the water table. Insist that they also wash hands after using the toilet, blowing the nose, playing outdoors, touching pets, and playing in sand.

Post a sign with illustrations of handwashing steps (wetting hands, soaping up, rinsing, and drying with a towel) above the sink in your room. To emphasize the length of time (30 seconds) needed for the soaping step, play this game.

Here’s what you need:
shaker of glitter
soap
sink with running water
paper towels
wastebasket

With children in a small group, sprinkle their hands with glitter, which is naturally sticky. Ask them to pretend the glitter is germs and then wash their hands with soap and water. Washing off the glitter will take up to 30 seconds. The Centers for Disease Control and Prevention (CDC) recommendation for handwashing is 20 seconds, the length of time it takes to sing “Twinkle, Twinkle” twice (www.cdc.gov/handwashing/when-how-handwashing.html). Explain that children should scrub their hands as long as they did with the glitter each time they wash their hands. Note: Glitter is irritating to the eye; supervise children carefully and make sure all of the glitter is washed away.

For information on helping children understand germs, see “Talking with children about germs,” in the Spring 2010 issue of Texas Child Care Quarterly.

Brushing teeth
Dentists recommend brushing teeth at least twice a day, usually after breakfast and before bedtime. You can assist parents in helping children learn this habit by having children brush their teeth after lunch. Have one soft-bristle toothbrush for every child, and label each brush with the child’s name.

Demonstrate how to apply a pea-sized amount of toothpaste to the brush, and brush back and forth on the outer sides, tongue sides, and the chewing surfaces of teeth. Teach children to follow a standard routine: upper right quadrant, upper left quadrant, lower left quadrant, and lower right quadrant, for example. It’s easy to get distracted in brushing teeth, and a routine helps ensure you won’t miss any surface. Dentists recommend brushing for two minutes, but children may need more time.

Flossing at least once a day is important for cleaning between teeth and preventing gum disease. But handling floss is difficult for preschoolers and may best be left for parents to do together with their children at home. Instead consider having children use floss toothpicks. These plastic toothpicks have bristles on one end and are pointed or flat at the other.

To illustrate how thorough brushing and flossing need to be, invite children to do the activity below using disclosing tablets. These tablets contain a harmless dye that reacts with the plaque that may remain on teeth after brushing.

Plaque is a sticky film that builds up naturally on your teeth from the food you eat. It contains millions of bacteria that can lead to tooth decay and bad breath. If not removed within 48 hours, it starts to harden into tartar that must be removed by a dentist.

Here’s what you need:
dental disclosing tablets, available at pharmacies
one-minute or two-minute sand timer, available at amazon.com
toothbrush for every child
toothpaste
sink with running water
paper cups
paper towels
hand-held mirror

Have children brush their teeth as usual, using a sand timer to measure two minutes. Then give each child a disclosing tablet to chew and swish around in their mouth for about 30 seconds. After they have spit it out, ask them to look at their teeth in a mirror. Explain that the disclosing product shows areas they missed or didn’t clean well enough. Encourage them to pay special attention to those areas every time they brush.

For more information on brushing teeth, see “Healthy smiles: Start now” in the summer 2014 issue of Texas Child Care Quarterly.

Wiping the nose
Teaching children about wiping their noses may best be done individually. Take advantage of a child’s sneeze or runny nose to demonstrate how to use a tissue. Point out how a sneeze makes mucous come out of the nose, often easing breathing, and that blowing the nose may make more mucous come out.

Explain that mucous contains germs that can spread easily in the air and on contact. If a tissue is not available, instruct the child to sneeze into the inner part of the elbow (rather than the hands) to lessen the chance of spreading germs by hand contact. Stress that after using a tissue, the child should discard it in a wastebasket and then wash hands. Handkerchiefs are not advised because they store germs.

If a child doesn’t know how to blow the nose, place a feather on the child’s hand and encourage blowing the feather using only the nostrils.

When mucous dries inside the nose, a child will often try to remove it by poking a finger inside the nostril. Explain that nose picking is likely to spread germs unless you do it with a tissue. Because nose picking can be an unconscious habit, divert the child by offering an activity that will keep both hands busy, such as playing with clay.

In seasons when colds and allergies are rampant, you may need boxes of tissues in the learning centers, bathrooms, and other areas. Consider having children decorate tissue boxes as an art activity.

Here’s what you need:
several boxes of tissues, or small empty boxes that you can fill with tissue
markers, crayons, or paint
ribbon, yarn, colored tape, or contact paper
glue, collage materials, fabric scraps, and other art materials

Provide art materials and boxes in the art center. Invite children to work individually or in pairs to decorate a box. Avoid showing a model or finished box so that children will use their own creativity and imagination. Place tissues in the boxes and distribute them in easy reach of children.

Caring for hair
This subject has the potential to not only reinforce good hygiene but also help children appreciate diversity.

At story time, read a book such as I Love My Hair by Natasha Anastasia Tarpley (1998). Afterward, invite children to talk about why they like their own hair. Discuss differences in hair color and texture. Observe differences in hair length and styling such as curls, braids, dreadlocks, and ponytails.

Other books to read or put in the library center include the following:
Big Hair, Don’t Care by Crystal Swain-Bates (2013)
Princess Hair by Sharee Miller (2017)
Same Difference by Calida Garcia Rawles (2010)

Offer one or more of the following activities, depending on children’s interest:
Invite children to cut or tear out pictures of people in old magazines. Have children group the pictures by color and hairstyle and glue to construction paper or butcher paper to make collages or class mural. Note that many adult men today have hair growing on their faces (beards).
Invite children to wash the hair of a plastic doll in the home center or outdoors. Use the activity to stress the need to wash hair and bathe the body regularly.
Invite children to learn braiding, using three strands of yarn, cloth, or cord.
Set up the home center as a hair salon patronized by both boys and girls. Props may include blunt scissors and old barber clippers (with cord removed) for pretend haircuts, empty bottles of shampoo and conditioner, brushes and combs, towels, smocks, cash register and play money, telephone, appointment book, and chair.

Caution: Check children’s hair carefully for any sign of lice and avoid sharing brushes and combs. For more information about recognizing and dealing with head lice, see “Get a heads-up on lice treatment” in the parenting section in the fall 2016 issue of Texas Child Care Quarterly.

Caring for nails
Most children have healthy fingernails, but the nails may get dirty after playing in mud or sand or working in the class garden. Keeping the nails trimmed is a job for parents until children are able to care for their nails themselves (usually at around 9 or 10 years old). But you can help children learn to care for their nails in the following ways:
Provide a nail brush at the sink where children wash their hands, and encourage children to brush over the nail or under the nail edge as needed to remove dirt.
Dry hands well to help prevent infection.
Offer hand lotion occasionally to rub on fingernails after handwashing to keep them flexible.
Suggest that parents avoid using nail polish on children’s nails. The acetone used to remove polish is not only poison but also extremely drying.

Good to know: The cuticle is part of your skin that protects the nail root from germs. For that reason, the American Academy of Dermatology advises leaving the cuticle alone. Don’t push it back or cut it. See “Teaching your child healthy nail care,” www.aad.org/public/skin-hair-nails/nail-care/child-nail-care.

Nail biting is a nervous habit that often begins in childhood and can last into adulthood. It poses the risk of passing harmful germs between fingers and mouth and may indicate stress or anxiety. Diverting children to an activity that uses both hands can help.

Toileting
The younger children are when they begin using the toilet by themselves, the more they may need help with hygiene. A 20-month-old child, for example, may need more help wiping after a bowel movement than a 36-month-old.

As you assist children, instruct them in the following ways:
Show how to count squares and fold over an adequate amount of toilet paper so that urine or feces does not soak through.
each girls to wipe from front to back after urination and bowel movements to avoid bringing germs from the rectum to the vagina or bladder. You might demonstrate on a naked plastic doll.
Demonstrate how to flush the toilet. Explain that only bodily waste and toilet paper are allowed in the toilet bowl. Paper towels, toys, and other objects can clog the plumbing and help germs grow.
Stress that children wash hands thoroughly after toileting to remove all germs on their hands.
Keep extra underwear on hand in case a child has an accident. Don’t shame or punish the child. Accidents happen.

For more on toileting, see “‘Use both hands’: Helping toddlers learn self-help skills” in the summer 2008 issue of Texas Child Care Quarterly.