Biting in child care

Biting in child care: What are the risks?

 

:: Highlights

• Most bites are harmless and don’t break the skin.
• Wounds from human bites, especially by young children, don’t usually become infected with bacteria.

No parent wants to hear that their child has been bitten while in child care (or that their child has bitten a playmate). However, biting is normal behavior for young children and is a common problem.
The good news is that most bites are harmless and don’t break the skin.  Those that that do break the skin don’t usually go deep enough to draw blood. If there is blood, infection is rare.

How can I prevent biting?

• Teach your child not to bite. When your child is old enough to understand, teach her that biting hurts and can be dangerous to her and to the person she bites.
• Do not pretend to bite your child or let your child bite you in play. Do not bite your child back if they bite. This will not teach them not to bite.
• Reinforce a “no biting” rule at all times.
• Young children are still learning self-control. Show your child how to express anger with words like “no” or “I don’t like that” instead of with biting.
• Redirect or distract your child if you see a problem developing with a playmate.

Can a bite wound from another child become infected?

Wounds from human bites, especially by young children, don’t usually become infected with bacteria.
Still, some parents are concerned about some of the more serious infections that are transmitted through blood, such as hepatitis B or C, and HIV (human immunodeficiency virus, the virus that causes AIDS).

Infection	How it spreads	What is the risk and what should I do?
Hepatitis B	Passed from person to person through blood and other body fluids. It can be passed through sexual intercourse, from mother to baby, and by sharing needles and syringes.The virus is not passed by contact of saliva with normal skin. Only a bite that breaks the skin can pass hepatitis B and even then, spread is rare.	A child with hepatitis B who bites another child and breaks the skin may expose the bitten child to hepatitis B infection. A child who bites a child who has hepatitis B may be exposed to the virus if blood from the bitten child enters the biter’s mouth. If you are told: that your child bit another child, or that your child was bitten, AND the skin was broken, and your child has not received hepatitis B vaccine,  Contact your local public health unit or a doctor right away.
Hepatitis C	Hepatitis C is also passed from person to person through blood or other body fluids.	Hepatitis C infection is rare in young children. Hepatitis C infection from a bite by a young child is extremely unlikely and has never been reported.
Human immunodeficiency virus (HIV)	HIV is passed through sexual intercourse, from mother to baby before or during delivery, or through blood when needles and syringes are shared.	The chance of transmitting HIV through the bite of a child, even when the skin is broken, is extremely unlikely and has never been reported. Giving a child anti-HIV drugs after a bite is not recommended.

How should I care for a wound if my child is bitten?

If a child is bitten while in child care or at play, here’s what you should do:

• If the skin is not broken, clean the wound with soap and water. Apply a cold compress and soothe the child.
• If the skin is broken:
  • Let the wound bleed gently. Do not squeeze it.
  • Clean the wound carefully with soap and water.
  • Apply a mild antiseptic such as hydrogen peroxide.
  • Inform the child’s parents (the bitten and the biter).
  • Check to see whether the bitten child has been vaccinated against tetanus and if he has had all of the recommended doses. If not, refer to a doctor or clinic for tetanus vaccine.
  • If either child has not received 3 doses of hepatitis B vaccine, the public health unit or a doctor should be notified. Hepatitis B vaccine will usually be recommended right away for that child.
  • Watch the wound over the next few days. If it gets red or begins to swell, the child should be seen by a doctor.

How can I keep my child safe?

• Have your child vaccinated for hepatitis B. In some provinces this vaccine is given to all babies, while in others it is given to all children in elementary school. Ask your doctor if your child should receive hepatitis B vaccine early because your child is in child care.