5 things you didn’t know about preschool hygiene practices

According to the Ministry of Social and Family Development (MSF), over 90% of Singaporean children aged five to six years were enrolled in preschools as a direct consequence of both parents working.

When the children fall ill, many parents take to blaming the schools for not doing enough to protect them. Their concerns are not without grounds, however, especially when cases such as Hand Foot Mouth Disease (HFMD) and food poisoning are at a record high. In an earlier article, I compiled a list of the recent infectious cases that happened in Singapore:

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Guidelines from the relevant authorities

In Singapore, all preschools follow guidelines issued by the Ministry of Health (MOH) and the Early Childhood Development Agency (ECDA).

The following are some policies provided to operators, supervisors and principals of early childcare institutions such as child care centres, kindergartens and preschool centres, These policies seek to prevent and control infectious diseases by maintaining a high standard of hygiene and sanitation:

Soft toys are discouraged

All soft toys are strongly discouraged in preschool. Parents may not have noticed but there are hardly any soft toys remaining in these schools. If your little ones bring their favourite plushies to school, teachers will usually keep them in their schoolbags until the end of the day.

According to the guidelines, only washable toys shall be used with diapered children. Separate toys shall be provided for each child group so that no sharing shall occur between groups. This will limit the exposure of the disease to only a single group to minimise the spread of diseases. For toys with hard-surface (e.g. Lego, toy cars), they shall be washed and disinfected with household bleach regularly. The toys that cannot be sanitized shall not be purchased. A toy that has been mouthed by a child shall be washed and disinfected before other children handle it.

Preschools are cleaner than most homes

The following requirements are but some examples that illustrate the strict level of cleanliness in preschools. They may be difficult to implement and fulfill but goes a long way to protect our children.

  1. Centre premise and toilets: Wash and disinfect daily with household bleach diluted 1 part of bleach with 10 parts water; Clean and disinfect 2 to 3 times throughout the day to provide a clean and safe environment.
  2. Communal toys that are shared between ‘children’: Disinfect at least daily or at the end of every session.; The used toys should be segregated in an empty basin that is out of the children’s reach until disinfected and dried.
  3. Diaper-changing areas: Disinfect with a solution of household bleach diluted 1 part of bleach with 10 parts water. ; Diaper-changing surfaces should be sanitized between uses. Alternatively, the diaper changing surface should be covered with disposable paper pads, which are discarded after each use. If the surface becomes wet or soiled, it should be cleaned and sanitized.

Most preschools employ full-time cleaners while some schools spread the cleaning responsibilities among teachers. From my experience working with preschool teachers, there is a gap between the guidelines provided and routines practised in schools. For example, many do not know the proportion of bleach dilution requirement for proper disinfection.

Turning down a sick child is difficult

By RIGHT, if your children are sick, you should keep them at home until they are well. For example, if your child went to the GP for chicken pox and was issued a 5day MC, how many of you will insist that the centre must accept the child even at the end of the MC? By RIGHT, each centre has the right to request the parent to produce a letter stating that the child is fit to attend school. This is clearly written in the MOH hygiene guideline and in the centre SOP.Let’s look at by LEFT… You looked at the blister and most of them appeared to have dried up. Your child no longer had a fever, and he/she looked active and irritating.  The centre teacher looked at the blisters and told you to get a doctor’s letter before bringing back the child again. How many of you will insist that the child is well enough and the centre must accept the child? The truth is that the sick child is still infectious after 5 days, and it will likely affect the rest of the children in the same class as well.During one of my workshops, one teacher shared with me a horror story about a centre principal and teachers receiving a bad scolding from a parent, who is a medical doctor, insisting that his child had fully recovered from his illness. The parent lodged a complaint with ECDA on the centre’s lapse in operation and hygiene standard. The incident left a bad taste in every party involved, and frankly, I can empathise with both parties, each having different priorities. Despite having all the policy and guidelines, managing the parents remain one of the toughest challenges for the centre to prevent the spread of diseases.Chickenpox_blisterChicken pox’s blisters may appear dried up after 5 days, but the child may still be infectious! 

Kitchen Outsourcing is Common

Times are difficult for preschool operators to find cooking aunties for their centre. Instead of having each centre hire their own cooks, they now have the central kitchen prepare the food, which is then delivered to the pre-schools. The hygiene standards for these kitchens are checked and audited by Singapore Food Agency (SFA), a new statutory board to oversee food safety and food security from farm-to-fork. The SFA brings together food-related functions carried out by the former AVA, NEA and HSA.In the recent two cases of massive food poisoning cases, which led to over 300 teachers and students ill, the root cause was traced to these central kitchens delivery processes. Though these kitchens were suspended from providing cooked food to the preschools, it is a fair reminder for the importance of food hygiene, from ingredient purchase, food handling, food preparation to food delivery and serving. There are too many points of potential contamination.Food hygiene principlesSource: Singapore Food Agency

Young Children are Vulnerable

It is a fact that children are more vulnerable than adults to environmental risks. Children are constantly growing, physically, mentally and emotionally. They breathe more air, consume more food, and drink more water than adults do, in proportion to their weight. Their central nervous, immune, reproductive, and digestive systems are still developing. At certain early stages of development, exposure to infectious agents will tend to lead to more damage on the children. Young children crawl on the ground where they can be exposed to dust and chemicals that accumulate on floors and soils. Children have little control over their environment. Unlike adults, they may be unaware of risks and unable to make choices to protect their health. Despite all the measures put in placed to prevent the spread of disease, children will still fall ill, and there is nothing we can do about it.

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