The alcohol based hand sanitizers work by dehydrating germs.  This is
not a mechanism that they can easily evolve a defense to, so there is
not a danger of reducing sensitivity.

Triclosan based "antibacterial" soaps, on the other hand, need to be in
contact with germs for 20 mins in order to kill them, and persist on
surfaces.  On surfaces (sinks, handles, etc), these compounds could
easily provoke bacterial resistence.  Since triclosan works the same way
the beta-lactam antibiotics (pennicillins) do, this could be big trouble.

It makes sense to switch to the alcohol based hand sanitizers in a
hospital environment.

In my private practice, I do handwashing with whatever soap the parents
have, and carry a bottle of alcohol based hand sanitizer for use if the
baby or mom has yeast, staph, or any other visible rash or infection.  I
use nylon gloves if touching the nipple area or the baby's mouth.  And I
wash my hands before I leave the home as well as when I arrive, and in
between as needed.  I clean my scale and pumps with disinfecting wipes,
and use a clean cloth diaper to line the scale for each baby.  So far,
this strategy has worked well.  When I visit a baby in  NICU, I use the
surgical scrub brushes and iodine based soaps provided there.

--
Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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