• Dr. Kristen Mitteness

Guest Post: Guidelines for Safe Hand Sanitizer and Antibacterial Soap Use During Pregnancy

Here is another excellent post from Beth L'Arrivee! She is just so good at digging through the research to make the information useful and easy to comprehend. Wondering how hand sanitizer and anti bacterial soap might affect a pregnant woman and baby? Here's a ton of info to dig through so you can make an informed choice! I linked the citations throughout the article, but you can find them all at the bottom of the atricle, too. Want more of her research and writing? Find it here!

Your Safety During Pregnancy and COVID-19

We all watched the mad rush for hand sanitizer when the pandemic first hit. And when that ran out, you found yourself reaching for antibacterial soaps. If you’re pregnant, of course the first thing on your mind is safety — your own and your baby’s. But are hand sanitizers and antibacterial soaps safe during pregnancy?


Is Hand Sanitizer Effective Against COVID-19?

Hand washing with soap is one of the most powerful tools in our arsenal against COVID-19. Yup, plain old soap. Why? As Dr. Gregory Poland explains, “Your hand has oils on it, and viruses stick to that oil. They have an electrostatic charge to them. But when you're washing with soap, soap has things that decrease surface tension in them so you are physically rubbing by friction and washing away that virus. It is the most effective thing we know to do.” (1) This powerful illustration shows what happens when you add a drop of soap to pepper in water. It will convince even kids (including my own!) of the importance of washing their hands.

But say you’re getting back in your car after grocery shopping. Is hand sanitizer effective for when you’re stuck without a sink? According to the CDC, hand sanitizer can reduce germs, if the hand sanitizer is at least 60% alcohol. And only if you use it properly. (2) For hand sanitizer to be effective, the following conditions must be met:

  • A large enough amount is used (more than half a teaspoon)

  • Your hands must not be too dirty with visible grease or dirt

  • You must not wipe any off before it has dried.


Is Hand Sanitizer Safe During Pregnancy?

There are two kinds of hand sanitizers commonly available today with ingredients that may be unsafe for pregnant women: alcohol-based and those that use an antibacterial chemical called triclosan. Since there is no known safe threshold for fetal alcohol exposure, the FDA is concerned enough about alcohol-based hand sanitizers to call for further testing. (3) But is half a teaspoon of alcohol exposure through the skin a few times a day dangerous? According to available research, the answer is probably yes.

Testing performed on non-pregnant adults show that “‘moderate’ hand rub use led to a maximum systemic exposure equivalent to approximately 10% of the alcohol in a glass of wine or a bottle of beer. The implications of even this low exposure are unclear.”


*FOOTNOTE Hmmm. So using alcohol-based sanitizers is the same as drinking down a tenth of a glass of wine. Up to several times a day. Does this sound like something you would be comfortable doing while pregnant? If it were me, it would be a strong “Hell no!” Brands with alcohol concentrations of over 60% include Germ-X, Purell, and Dr. Bronner’s.*

By now you might be thinking of reaching for all those sanitizing products that don’t contain alcohol. Unfortunately, there are dangers to alcohol-free hand sanitizers as well.

Two toxic hand sanitizer ingredients are triclosan and triclocarban (to remember these while looking through labels, just think “tri”). And they’re hiding in places you wouldn’t expect, such as soaps (just when we thought soap was safe! — it is, just not when it has triclosan), toothpaste, deodorant, cosmetics, and fabrics that claim to be antimicrobial (like smell-resistant socks). Yikes! Triclosan is enough of a cause for concern that I’m going to give it its own heading…

The Dangers of Triclosan During Pregnancy

You know how everyone (even Michael Scott!) knows not to use Accutane during pregnancy? I wish the risks of alcohol-free hand sanitizers containing triclosan and triclocarban were equally well known. While potential danger to fetuses of these two chemicals compared to isotretinoin, the birth defect causing ingredient in Accutane, might be less straightforward, there are substantial reasons to avoid them.

The main problem with triclosan and triclocarban is that they are suspected to disrupt the endocrine system. (4) That’s right. Hormones. Which are more than a little bit important during pregnancy! Hormones are responsible for a baby’s normal growth and brain development, as well as male and female sex hormones. As far back as 2009 the Endocrine Society warned pregnant women and children to avoid triclosan if possible. In 2016 the FDA ruled that hand soap containing triclosan and triclocarban can no longer be marketed to consumers. But triclosan and triclocarban are still found in products such as dish soap, toothpaste, cosmetics, mouthwash, and, of course, hand sanitizers.

While there’s some evidence that triclosan in toothpaste can help prevent gingivitis, “there's no evidence that antibacterial soaps and body washes containing triclosan are more effective than plain soap and water in preventing illness and the spread of certain illnesses, according to the FDA.” (5) And of course, no antibacterials affect viruses.

Plus, there’s a potential environmental fallout from washing triclosan and triclocarban down our drains. A recent study concluded, “Considering the worldwide application of personal care products containing TCS and inefficient removal and its toxic effects on aquatic organisms, the compound should be considered on the priority list of emerging contaminants and its utilization in all products should be regulated.” (6)

There’s also reason to believe that antibacterial products are contributing to the growth of superbugs (7), and that they can alter the microbiome. (8) Which is a problem, since a huge proportion of your immune system is actually in your gut. It’s taken decades for regulatory bodies to take action. But when are we consumers going to just say no to these kinds of antimicrobials?

Take a stand and avoid products containing triclosan or triclocarban (again, think “tri” to remember), and products that claim to be “antibacterial”. These products include many dish soaps, personal care products, and cosmetics.

What are Safe Alternatives to Hand Sanitizers While Pregnant?

Your best defense against germs is going to be regular hand washing. But what should you do in a pinch? There’s some evidence that a 10% solution of malt vinegar could be effective against Human Influenza A/H1N1. (9) Now COVID-19 isn’t the same virus, but why not make up a vinegar spray or some wipes?

Babyganics alcohol-free wipes are claimed to kill 99.9% of germs. Benzalkonium chloride is the ingredient used to replace alcohol, but available evidence suggests it’s less reliable against certain viruses and bacteria. (10) So for the moment, we just don’t know if they are effective. However, Babyganics might be better than nothing, and they’re handy and free of toxins to boot.

Wearing gloves is an easy and effective option, provided you follow guidelines for wearing and removing them properly. (11)

But again, your best bet is to follow social distancing guidelines. Don’t get within six feet of others, avoid touching your face and wash your hands as soon as you get a chance.

Pregnancy is hard enough. Pregnancy during a pandemic is even harder. Now that you’re armed with the latest available research, you can cross hand sanitizer safety off of your list of things to worry about.

And rest easy in the fact that our bodies are AMAZING — they are built to defend us from external threats like germs and viruses. Your immune system is fighting to protect you day and night. That’s it’s one job, literally!

In addition to choosing handwashing over sanitizers whenever you have the chance, boost your immune system today with these 5 easy tips:

  • Reach for whole foods instead of carb and sugar-laden junk food. Metabolic syndrome (which includes pre-diabetes and diabetes) has been a huge factor in whether COVID-19 sufferers need hospitalization. (12) Studies suggest you can lower your blood sugar levels in as little as 9 days through diet changes. (13)

  • Get outside in natural sunlight. Vitamin D is essential for immune health, and 32% of Canadians are deficient. (14) As little as 15 minutes a day with exposed arms can boost vitamin D levels.

  • Care for your mind and your body by reducing stress. Stress is well known to reduce immune system function. (15)

  • Turn off Netflix an hour earlier and get adequate sleep! If you’re pregnant with other little ones I know you crave that precious alone time in the evening. But you’ll be worse off fighting a virus with an immune system weakened by sleep deprivation.

  • Continue to seek health care. If you’re pregnant or postpartum receiving adequate support is no less essential now than it was before. Advocate for yourself and insist on receiving the care you deserve.

This last point is especially important. If you want to maintain or improve your health, reach out to your local physicians and health care service providers. Many are adapting to social distancing measures and you may be surprised at the options available for receiving care safely. Your brain, your body, and your baby will thank you.


Resources:

(1) https://newsnetwork.mayoclinic.org/discussion/COVID-19-expert-explains-what-soap-does-to-sars-cov-2-virus/

(2) https://www.cdc.gov/handwashing/show-me-the-science-hand-sanitizer.html

(3) https://www.reliasmedia.com/articles/136142-fda-concerned-with-alcohol-exposures-to-pregnant-breast-feeding-healthcare-workers

(4) https://www.reliasmedia.com/articles/136142-fda-concerned-with-alcohol-exposures-to-pregnant-breast-feeding-healthcare-workers

(5) https://www.mayoclinic.org/healthy-lifestyle/adult-health/expert-answers/triclosan/faq-20057861

(6) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4454990/

(7) https://www.sciencedaily.com/releases/2018/06/180619122955.htm

(8) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6126357/

(9) https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0008987

(10) https://www.cdc.gov/coronavirus/2019-ncov/hcp/hand-hygiene.html

(11) https://www.cdc.gov/vhf/ebola/pdf/poster-how-to-remove-gloves.pdf

(12) https://www.touchendocrinology.com/insight/novel-coronavirus-disease-2019-COVID-19-and-metabolic-syndrome-an-association-too-difficult-to-ignore/

(13) https://www.today.com/health/cutting-processed-sugar-just-9-days-has-striking-effect-health-t52516

(14) https://www.ncbi.nlm.nih.gov/pubmed/20413135

(15) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465119/


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Dr. Kristen Mitteness

Lifemark Nature Park Way

76 Nature Park Way

Winnipeg, MB R3P 0X8

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Tel: 204-478-6480

dr.kmitteness@gmail.com

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