Avraham ben Yaakov
A HEALTHY FUTURE
Parents' Guide to Teaching Children Healthcare

5 Cleanliness and Hygiene

Rabbi Akiva said: "Once I followed Rabbi Yehoshua into the restroom and I learned three things from him." Ben Azai said to Rabbi Akiva, "How could you be so bold with your teacher?" Rabbi Akiva replied: "It is Torah, and I need to learn!" (Berachos 62a).

Teaching our children about cleanliness begins practically from the moment they are born. We go to great efforts to keep our children clean, and also to separate them from what is spiritually impure. Not only do we wash and bath them and change their diapers. We also wash even little children's hands with Negelwasser when they wake up from their night's sleep in order to remove Tum'ah, the unclean night-time spirit. Not only do we teach our children to use the toilet and clean themselves properly. We also train them to wash their hands on leaving the bathroom and the like, and also before prayer and Torah study. We teach them to clean and wash their hands very well before touching food. We also teach them Netilas Yadayim, ritual washing of the hands before eating bread.

The message we are giving our children is that we must keep ourselves clean, and also, we must keep ourselves pure. Physical cleanliness and spiritual purity are two different sides of cleanliness. Both are bound up with each other. The Torah teaches us to clean our bodies of their waste products and to dispose of them properly. The purpose is to keep ourselves and our surroundings clean. Only then can G-d's spirit dwell among us: "Your camp must be holy" (Deuteronomy 23:15).

The cleanliness of our bodies and surroundings is one of the principal foundations of purity. We are not allowed to say words of prayer or Torah when our bodies are not clean or in a place that is not clean. Not only does physical cleanliness contribute to our general sense of well-being. Physical cleanliness is essential for good health. The body can only function properly when it cleanses itself of its various waste products. We must play our part in the cleansing process by with proper habits of toilet, washing and general cleanliness.

Waste and dirt are the breeding grounds of harmful microbes that cause infections and illness. To avoid harm and illness, we are obliged to follow the rules of cleanliness and hygiene. This is part of the commandment, "Take care of your souls". Then our bodies will be a fit vessel fit to carry out G-d's laws and a worthy sanctuary for the soul.

Teaching children about cleanliness and hygiene

There are no fixed rules about when to start training children in proper habits of hygiene and cleanliness. Most parents have an intuitive understanding of their children, and will know when to start and how to guide each child in accordance with his or her age, character and level of development.

The first step

The obvious first practical step is when we start teaching children to use the toilet and everything that goes with this. This is usually around the age of two or three, sometimes earlier, sometimes later. Training a child may take anywhere between four or five weeks to six months or more. Parents seeking guidance in toilet-training a child can turn to others who already have experience or to a doctor.

In the first stages of teaching a child to use the toilet, each time the child needs to go, the parent (or home help, nursery teacher, etc) goes with the child to help him. This is the time to start teaching the child in his language and according to his level of understanding that dirt and waste are not good for us and we must remove them from our bodies and flush them away. For this very reason, we must not hold back when we need to attend to our needs. As soon as we feel the need, we should go as soon as possible.

We must teach the child to clean himself properly, and then wash his hands thoroughly with soap and water. The next step is to encourage the child to manage independently in the restroom without needing help, being sure to practice the rules of cleanliness and hygiene that he has learned.

Washing hands

Washing our hands after our night-time sleep, before prayer, before eating bread, after attending to our bodily needs and on other occasions is an integral part of the daily life of the Jew. Our children need to learn that having clean hands and having pure hands are two things that are bound together. We teach them that there is an obligation to wash their hands before bread (Netilas Yadayim). It is also important to teach them that their hands must be clean. Washing our hands in order to clean them does not exempt us from Netilas Yadayim. So too, Netilas Yadayim does not exempt us from first making sure that our hands are clean!

As children grow older and become more understanding, we should explain to them why we must keep our hands clean. We carry millions of tiny microbes on our hands. Most are not harmful, but some can cause infections, diarrhea, parasites, flu and even more serious illnesses. Harmful microbes can pass onto our bodies from contact with dirt in the toilet, dirty towels, door handles, stair-rails and the like handled by people carrying infectious microbes. If we touch our mouths, nose, ears, eyes or an open cut or wound with dirty hands, these microbes can enter inside our bodies. Thorough washing of the hands greatly reduces the risk of infection by these microbes.

Children should be taught to wash their hands carefully

AFTER

1. Leaving the toilet or bathroom

2. Touching garbage and anything dirty (including children's play-sand).

3. Touching a dirty nose

4. Touching an open cut or sore

5. Touching an animal, bird or insect

6. Touching raw meat or fish

BEFORE

1. Touching food

2. Eating

3. Tending a cut or sore

4. Inserting or removing contact lenses

The hands should be washed with soap and water. When hot water is not available, the hands should be washed thoroughly with cold water and soap. The entire surface of the hand should be washed up to the wrist, including the palms and back of the hands, the fingers and under the nails. The hands should be rubbed together with soap and rinsed well with water. The hands should be dried with a clean towel, preferably disposable, or with a hand-drying machine.

Factors that contribute to better standards of hygiene and cleanliness include:

1. Adequate supplies of toilet paper

2. Soap for washing of hands

3. Clean towels. Where possible in educational and other institutions, these should be disposable, or hand-drying machines should be provided.

4. It is best to keep children's nails short, and they should be taught the importance of keeping them clean.

5. Parents should provide their children with tissues to clean their noses.

6. Parents and teachers must repeatedly remind children about the importance of keeping their hands clean in order to make sure that the message gets across.

Washing the body

"The one who tends to his soul is the man of kindness" (Proverbs 11:17). This verse applies to Hillel the Elder! When he used to leave his students and go on his way, they would accompany him and ask: "Rabbi, where are you going?" "To carry out do a mitzvah," he would reply. "Which mitzvah is that?" "To wash inthe bath-house." "Why?" they would ask. "Is it a mitzvah to wash?" "Yes," he replied. "The statues of kings that stand in public theaters and circuses have a special officer whose job is to rinse and scrub them to keep them clean. They pay him for this, and he sits with the elite of the kingdom. How much more so must I wash and clean myself. For I am made in the form and likeness of the King of kings, as it is written "For He made man in the likeness of G-d" (Genesis 9:6; Vayikra Rabbah 34:3).

When parents take care to keep their children clean from the earliest age, consciousness of cleanliness and its importance penetrates deep inside the children. Everything parents do to keep their little children clean, rinse their hands and faces, wash and bath them, is a part of helping them acquire clean habits. As they grow older, we should explain to them according to their understanding why it is so important for them to keep their bodies clean. This way they will come to do so of their own accord.

We should explain to our children in addition to the good feeling when we are clean, first and foremost we are thereby guarding our health. The skin is one of the most important body parts, even though many people don't pay too much attention to it unless there is a problem. The protective coat with which G-d in His wisdom has our bodies not only protects us from harm from the world around us. Our skin also plays an important role in the elimination of certain bodily waste products. Our task is to wash and clean our skin to keep it healthy.

Water has an essential role in keep the body clean, and we should teach our children to wash regularly. The frequency with which one needs to wash varies from person to person depending on individual physical factors, daily activity, environment, the weather and other factors. Just as it is no good to wash too little, so there is no need to exaggerate.

It is best to wash the body in warm water using a delicate soap. An important part of washing is thorough rinsing of all traces of soap in order to avoid irritation. Children should be taught to dry themselves well after washing.

Regular washing of the hair is an important part of overall bodily cleanliness. Having clean, orderly hair gives a good feeling and contributes to a pleasing appearance. When children's hair is clean and healthy, this also helps against the "Third Plague" - lice.

Clean nails are also an important part of bodily cleanliness. Parents should cut their children's nails, hands and feet, before they grow too long. It is good to teach children that cutting nails is one of the things we do each week prior to and in preparation for Shabbos. Any time that dirt gathers under the fingernails, they should be brushed with soap and water. It is worth teaching children how to cut the nails of their big to in such a way as to avoid ingrowing toenails.

Even though the specific obligation is only to wash the hands [each morning], nevertheless it is a mitzvah also to wash ones face, for "G-d made everything for His sake" (Proverbs 16:4). The body is created to serve G-d and is the garment of the soul - and "man's soul is G-d's lamp" (ibid. 20:27). It is proper to show respect for the garment in the same way as a king's officers take good care to keep the garments they receive from the king them free of all dirt. In the same way, it is proper to wash one's face and keep it clean. Similarly, the clothes a person wears - and this applies particularly to a Torah scholar - should be kept clean and free of all dirt.

Chayey Adam 2:6

Cleanliness in puberty

Puberty is a new stage in development that parents must be aware of. As children enter this important time in their lives, parents should draw their attention to the need to take extra care to keep clean because of the physical changes in their bodies. The skin and hair are likely to become more oily. The sweat glands are more active not only when we are hot, but also as a reaction to feelings and emotions. The armpits, folds of the body, palms of the hands and soles of the feet exude a more concentrated sweat that may cause unpleasant odors.

Adolescents should be encouraged to pay greater attention to bodily cleanliness and orderly appearance, and to bath or shower, change their clothes, have their hair cut, cut their nails and so on as necessary. Where body odor is a problem, a deodorant may help. In cases of excessive sweating, consult a doctor.

One of the most widespread and troublesome problems of puberty is acne. The first step in treating acne is to keep the face clean and to wash it with tepid water a couple of times of day. Do not touch the infected areas. If the problem is particularly troublesome a doctor can recommend suitable treatment.

A Clean Mouth

Keeping the body clean applies not only to the exterior but also to the interior. Cleanliness of the mouth is of primary importance, since the mouth is one of the main channels through which microbes can enter the body. The dangers are particularly serious in the case of small children, whose understanding of what is good for them and what can harm them is still limited.

Little children have little or no sense of the boundaries they must maintain in their interaction with the environment. They do not distinguish between what they may touch and what is dangerous, what they may put in their mouths and what can harm them. Little children naturally tend to put everything they find in their mouths - their fingers, toys, and then, when they begin to crawl, whatever they find on the floor, including pieces of food, buttons, pins and worse.

As parents who want to keep our children from danger at any price, we must constantly watch them to see that they do not put anything harmful in their mouths. There are some things that everyone knows to be dangerous, but there are other hazards that not everyone is aware of:

1. Food and candies that have fallen on the floor are dirty and should not be put in the mouth unless they can be washed properly.

2. Anything that has touched one person's mouth should not be put in someone else's mouth. Food, candies, drinking bottles etc. should not be passed from mouth to mouth.

3. Children have a tendency to touch their shoes, socks, feet, head, dirty nose and worse. They must learn not to put their hands in their mouth or touch food without first washing their hands.

The sages prohibited eating and drinking anything that most people would find disgusting.. They also prohibited eating with dirty hands and on dirty utensils, for all these things come under the rule, "Do not make your souls loathsome." Everyone who is careful in these matters brings extra holiness and purity to his soul and cleanses his soul in honor of the Holy One blessed be He, as it is said, "And you shall sanctify yourselves and be holy, for I am holy" (Leviticus 11:44).

Rambam, Hilchos Maachalos Asuros (Forbidden Foods) 17:29-32

Care of teeth

Healthy teeth are an important part of bodily health. Healthy teeth enable us to chew our food well, which is the start of good digestion. Good teeth also help us speak clearly as well as contributing to a pleasing appearance.

The effort which parents put into keeping their children's teeth healthy and teaching them to take proper care of them is a sound investment that can save a lot of suffering and heavy expenses later on. One of the main causes of tooth decay today is the high quantity of sugar in the average daily diet. When remains of our food stay in the mouth for extended periods, a thin layer of sugars (plaque) forms on the teeth, which encourages increased activity by bacteria, leading to tooth decay, cavities, infections, retreating gums and severe pain. Keeping the mouth and the teeth clean, especially after eating, is the main way to avoid these problems.

Parents should pay attention to their children's teeth from the moment they begin to sprout and perhaps even before. Some parents clean their child's gums with a soft, damp cloth after meals even before their teeth appear. Unfortunately parents sometimes bear a heavy share of responsibility for severe teeth problems among children. For some reason, many feel obligatto feed their child with a bottle whose contents are usually sweetened. The bottle remains in the child's mouth for long periods, and not infrequently, the child falls asleep with the bottle in his mouth. Extended contact of the teeth with the sugars in the food causes increased bacterial activity that can cause "bottle caries", deformation and premature falling of the milk teeth, and poor development of second teeth. Long before we start teaching our children to keep their teeth clean, we should do what we can to make sure their teeth are healthy in the first place!

Brushing the teeth

The first habit to teach our children to care for their teeth is regular cleaning. In order to instill this habit, it is good to early, even from the age of two or three, though initially the gains in cleanliness may be limited. To encourage the child, one can purchase a soft toothbrush and "tasty" children's toothpaste. Later on, it is worthwhile to take the child for a dental examination - hopefully before he has any pain in his teeth. Thank G-d today there are dentists who specialize in treating children and are sensitive to their needs. The dentist (or assistant) will explain to the child the importance of cleaning our teeth and give him a practical demonstration.

Children should be taught to clean their teeth at least twice a day, in the morning and especially before they go to sleep at night. They should be taught that whenever possible, it is good to rinse their mouths with water after each meal, and especially after eating sweets.

Parents should reinforce the dentist's message by giving their children practical training in how to brush their teeth. Every tooth has three exposed surfaces - outside, inside and top. One should systematically brush all the teeth in each jaw, the upper and the lower, those in front and those at the sides and back, on the right and on the left. Brushing the teeth should continue for about three minutes. One should teach children that the purpose is not so much to polish as to clean the teeth, as well as to clean between them and where they are attached to the gums.

Caring for children's teeth is a constant process in which both parents and children have a share: The parents' part is to make sure the children play their part by regularly brushing their teeth! Parents must find ways of encouraging their children to take proper care of teeth, such as with prizes - as long as they aren't sweets! A dental examination is recommended twice a year.

Chapter 6: Safety

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