Cleanliness Is Next To Godliness In Preventing Childhood Pneumonia

The best way to prevent serious respiratory infections such as pneumonia is to practice good hygiene. Infection control is highly dependent on the principles of personal hygiene, and by keeping ourselves and our surroundings clean, illnesses like pneumonia can be contained or even prevented. Most cases of pneumonia, whether acquired in the community or in the hospital, are caused by bacteria, and some by viral or fungal infections. These pathogens travel as airborne particles, ready to cause infection once they are inhaled and able to attack the lungs, filling the lung sacs with pus and fluid, limiting oxygen intake and making it hard to breathe. To prevent the recurrences of acute pneumonia, maintenance of community hygiene is as important as personal hygiene.

Children are more vulnerable to this respiratory infection, due to their still developing immune system, and hence need special attention. So it is imperative to maintain proper hygiene and cleanliness to prevent the infection from spreading. Going back to the basics of hand washing and maintaining general cleanliness can go a long way in controlling pneumonia and several other childhood maladies.

Studies have revealed that hand washing with soap prevents the two clinical syndromes that cause the largest number of childhood deaths globally—acute lower respiratory infections like pneumonia and diarrhoea. In fact, studies have proved that children younger than 5 years in households that received plain soap and hand washing promotion show a 50% lower incidence of pneumonia. A simple way to help prevent Respiratory Syncytial Virus (RSV) associated pneumonia in children is to wash our hands often, especially before touching the baby. It would be worthwhile to mention here that according to the ARI Atlas, RSV infection is the most common source of severe respiratory illness in children worldwide killing an estimated 66000 to 199,000 children annually, most of who are in the developing world.

According to Dr Dinesh Chandra Pandey, a Specialist in Paediatric Medicine at Nelson Hospital of Paediatrics and Neonatal Medicine Lucknow , “Basic hygiene rules should be followed. Hand washing is very important. Food should be cooked with clean hands, kept in clean pots, served in clean plates and eaten in a clean place. It is important to keep the environment clean too. Unhygienic conditions can result from over congestion, unplanned urbanization, improper ventilation in houses and a defective drainage system.”

Dr Amita Pandey Associate Professor of Obstetrics and Gynaecology at the Chhatrapati Shahuji Maharaj Medical University (erstwhile King George’s Medical College), also feels that it does not cost much to maintain proper hygiene. Simple rules of hygiene are proper cleanliness, clean air, no overcrowding and protecting the child from other infected persons.

Dr Ajay Misra Managing Director Nelson Hospital Of Paediatrics and Neonatal Medicine, lists the simple rules of hygiene as cleanliness and hand washing, and a clean, open environment. He insists that homes and hospitals, both should maintain high standards of cleanliness. The doors, windows, floors should be cleaned regularly and parents, family members, children, hospital staff should wear clean clothes. All this does not cost much—it only requires a proper mindset and attitude. Living in posh houses behind closed doors and windows, with no proper ventilation and flow of clean air also poses a danger. Babies are at particular risk of developing infections due to their delicate anatomy and levels of immunity. Bottle feeding, which seems to be a fashion in urban as well as rural India, seriously compromises the hygiene and health of the baby. Adherence to the regimen of exclusive breast feeding during the first 6 months is low in India too, and mothers often combine breast milk with bottle feeding, increasing the risk of infection, and the risk that infants ingest water and other liquids that lack essential nutrients.

In Dr Ajay Misra’s opinion, “These days, bottle feeding has become a fashion in urban as well as rural areas. This is more out of peer pressure and also because of personal convenience. Due to lack of proper information mothers feel that bottle feed will improve a child’s health as they can feed the child more. Usually there is just one bottle and even that is not washed properly. This becomes a major cause of many infections. One should resort to bottle feed only if mother’s feed is not possible due to medical reasons, and in that case very high standards of bottle hygiene should be maintained.”

Dr Amita Pandey also advises against bottle feeding the baby for two main reasons: “Firstly, maintaining proper hygiene with bottle feed is just not possible in a majority of cases. Secondly, a baby once acclimatised to bottle top feed, will not make the effort of taking mother’s breast feed easily because suckling the mother requires more effort than sucking the nipple of the bottle. ” She says that if the mother cannot breast feed the baby all the while, then expressed mother’s milk can be given as top feed with a sterilized cup and spoon. This milk can be stored in a sterile container for up to 8 hours at room temperature and for 24 hours in the refrigerator. In fact mothers in western countries have been known to freeze their milk for as long as 3 months. In order to reduce the chances of spreading the infection of pneumonia, all of us should maintain good hygiene by frequently washing our hands after every contact with contaminated water/food, tainted surfaces, animals and animal waste, and by disposing the garbage in a proper manner to prevent germs from growing. The kitchen is another breeding ground for bacteria and strict kitchen hygiene is required at all times. A lot of cleanliness and a little bit of common sense is all that is needed to ward off illnesses like pneumonia.

Shobha Shukla - CNS
(The author is the Managing Editor of Citizen News Service (CNS). She is a J2J Fellow of National Press Foundation (NPF) USA. She has worked earlier with State Planning Institute, UP and taught physics at India's prestigious Loreto Convent. Email: shobha@citizen-news.org, website: http://www.citizen-news.org/)