[Late Bloomer]

We had a 3-day-old placed with us 10 weeks ago, for fostering, possible adoption, who appears and acts very healthy in spite of his birth mom's lifestyle which included drugs and prostitution. The Child Protective Services worker who brought him to us had said he'd been tested for all sexually transmitted diseases and found negative. But it took a long time to get copies of his birth/medical records to the pediatrician, and they apparently weren't all that complete.

Now that the pediatrician has checked all the available records, she's recommended we have him tested for syphillis, hepatitis B & C, and have a gammoglobulin shot, which we're planning to do tomorrow. She said the risk of transmission is very low, but just wants to be 100% sure these tests come back negative, since she can't find any documentation of it in his records. It could take a week or more for the results to come in.

We had everything planned for a week's visit with my folks 1000 miles away next week, and I'm not sure now. Wondering if anyone here has cared for children under these circumstances. If so, what types of precautions do you take? Do you avoid contact with other people? Is it still safe for him to be in day care? Should we cancel our trip? I'll be asking the p-doc. all this tomorrow too, but wanted to get some feedback from y'all as well. Thanks!

[hope4kids]

One thing I know is that Hepatitis C cannot be ruled out in an infant that young. Infants often test negative for it until they are at least 18 months old. He would have to be retested after that to be sure he is testing negative. I don't know if other STD's are like that or not.

Day care should still be okay, and contact with other people should be fine. These diseases are transmitted through contact you wouldn't have with a baby. Universal precautions should be used handling bodily fluids like blood. Your trip should still be okay to go on in my opinion.

[lucyjoy]

You may want to run a HEP B search for info. The info I was given was really picky like not even keeping toothbrushes next to each other or eating off the same fork. Babies spit up. You may want to check to be sure this is handled safely. Be sure also, that everyone in your household has been immunized for it.

[Barksum]

The kinds of exposure you have to be careful of depends on the disease you are discussing. Hep B, as has been pointed out, is more easily contracted than Hep C, but BOTH can be contracted from an infant. Some of the diseases you mentioned can be contracted by contact with body fluids, which includes mucus, saliva, urine, blood, etc. Some are blood to blood (ie you would have to have a scratch that the infected person's blood got into). You would have to take many things into consideration and I would urge you to do a web search, gather questions and list them out in writing and have your pediatrician answer them so that you know exactly what you are doing. Sounds all extreme and everything, but I've found that this really helps as I'm not the only one needing this info: caseworkers, spouse, babysitters, etc. all need the same info in varying degrees, so it's good to get it in the clearest format possible.


You should be aware of what they call 'universal precautions'. This is being very hygenic about how you go about doing things. Wearing gloves to change diapers, being careful to wash hands frequently, not kissing baby on the mouth, etc. Hep C and HIV can not be ruled out until about 18 months of age, so you would have to maintain these precautions until those were ruled out. Baths, runny noses, scrapes or cuts, etc. as well should be attended to with care, so do be sure to discuss it ALL with your pediatrician. For best safety measures have your pediatrician give you a brochure or list out for you what you should do, why and for how long.

One of our placements had nasty diaper rashes that were difficult to control (poor little thing!) and would often become bloody rashes with just the first diaper. In this case you would, obviously, want to wear gloves to handle the diaper changing and make sure that the diapers were disposed of properly. You can see how, even with infants, you can be exposed to what we normally think of as sexually or I V drug transmitted diseases.

Sounds ominous and intimidating, but it's really not all that bad as long as you know what to do and how to do it.

[Late Bloomer]

I appreciate your feedback a lot. The advice I've gotten has varied, but I'm a lot less nervous now that I've got a clearer idea of the level of risk. My big concern was saliva, and from what I've read, and what our pediatrician told me, the amount of virus found in saliva is so small and dilute that it's not a real danger. In fact, parents of children with Hep B are not even required to report the fact to daycares or schools, and kids aren't restricted from playing with other kids, because that risk is so low. Unless a child is known to bite other children -- that's another story. Blood to blood contact is a greater risk. But nobody at the day care does that. Diaper changing is safer with gloves... apparently 'cause if you have contact with those body fluids on a regular basis, and have a scratch or cut, it could increase the risk, but the day care should be doing that anyway, according to our pediatrician, as well as being vaccinated. I did talk to the daycare just in case, about using "universal precautions" (lots of hand washing, gloves to change diapers) and hubby and I are getting the vaccine. Apparently for the past 8 years or so, kids have been getting the Hep B vaccine routinely now at school, but they didn't back when we went to school. Meanwhile, we've both come down with colds but baby hasn't caught anything so far and seems to be thriving!