Young children in group care settings catch and spread infections far more easily than older children or adults, simply because of how closely they interact, how often they put hands and objects in their mouths, and how much personal care, like nappy changing, they need throughout the day. Strong infection control childcare practices are one of the most important, and most achievable, ways an early years service protects the health of children, families and staff alike.
This guide covers what belongs in a written infection control policy, the practical hygiene routines that reduce transmission day to day, and how exclusion periods work when illness does occur.
Why Infection Control Matters in Early Years Settings
Children under three have immature immune systems and limited hygiene independence, which is exactly why creches and preschools see higher rates of certain infections, particularly gastrointestinal illnesses like norovirus and rotavirus, respiratory infections, and common childhood illnesses such as hand, foot and mouth disease. Good infection control is not about eliminating every illness, which is not realistic in any group setting, but about reducing transmission through consistent, well understood daily practice.
The benefits go beyond the children themselves. Consistent infection control also protects staff, reduces the disruption caused by outbreaks affecting whole rooms at once, and reflects directly on how your setting is assessed during a Tusla inspection.
The Regulatory Backbone: HSE Infection Guidelines Preschool Providers Should Know
Ireland's core reference document in this area is the Health Protection Surveillance Centre's Management of Infectious Disease in Childcare Facilities and Other Childcare Settings, developed with input from HSE public health specialists. These HSE infection guidelines preschool and creche providers rely on cover transmission routes, standard hygiene precautions, and the specific exclusion periods for common childhood illnesses.
The document sits alongside Tusla's Quality and Regulatory Framework, which expects every service to have a written infection control procedure covering hygiene practices, immunisation record keeping, and how non immunised or medically vulnerable children are managed, including for activities such as animal visits where infection risk is sometimes overlooked.
Writing an Infection Control Policy Creche Teams Can Actually Follow
A strong infection control policy creche settings can rely on day to day needs to go beyond a general statement of intent. At minimum it should cover:
- Standard hygiene practices, including hand hygiene, nappy changing and toileting procedures.
- Cleaning and disinfection routines for surfaces, toys and shared equipment.
- Management of children and staff with immunisation gaps or specific vulnerabilities.
- Clear exclusion periods for common infectious illnesses, in line with current HSE guidance.
- Procedures for outbreaks affecting multiple children in a room or the wider setting.
- Guidance on visiting animals or farm trips, which carry their own infection risks.
Writing the policy is only the first step. It needs to be trained into every member of staff, reviewed regularly, and updated whenever national guidance changes, such as during periods of heightened concern around specific illnesses.
Hand Hygiene Early Years Staff Should Practise (and Teach)
Handwashing remains the single most effective infection control measure available in a childcare setting, more effective than any product or piece of equipment. Good hand hygiene early years practice should be built into the daily routine at clear, predictable points:
- On arrival at the setting, and before and after eating or handling food.
- After using the toilet or assisting a child with toileting.
- After nappy changing, for both the child and the staff member.
- After handling animals, outdoor play, or cleaning up spills or bodily fluids.
- After wiping a child's nose or handling tissues.
Liquid soap, warm water and paper towels remain the gold standard. Alcohol hand gel has a role when handwashing facilities are not immediately available, but it is not effective against all organisms, including norovirus, so it should never fully replace proper handwashing.
Nappy Changing Hygiene: Getting the Highest Risk Task Right
Nappy changing happens more often than almost any other task in a creche day, and it is one of the highest risk moments for spreading infection if not handled consistently. Good nappy changing hygiene depends on a few non negotiable habits: never leaving a child unattended on the changing table, treating every wipe as single use, disposing of soiled nappies immediately in a hands free bin, and fully disinfecting the mat and surrounding surfaces after every single change, not just at the end of a shift.
We have covered this process in full detail, including a complete step by step procedure, in our guide on how to handle nappy changing safely, which is worth reading alongside this article if nappy changing forms part of your daily routine.
Understanding Exclusion Periods Childcare Ireland Settings Must Apply
Knowing when a child or staff member needs to stay home is one of the most practical parts of infection control, and one that parents often ask about directly. HSE guidance sets out specific exclusion periods childcare Ireland settings should follow for common illnesses, including:
- Diarrhoea and vomiting. Exclusion until at least 48 hours after symptoms have fully stopped, since this is when a person remains most infectious.
- Chickenpox. Exclusion until all blisters have dried and crusted over, which is usually around five to six days after the rash first appears.
- Conjunctivitis. Exclusion is not usually required unless there is a specific outbreak in the setting, though good hygiene around the affected eye is important regardless.
- Head lice, scabies and ringworm. Exclusion is not required before the end of the day once treatment has started.
Because exclusion advice can vary depending on the specific illness and any wider outbreak in your area, services should always refer to current HPSC and HSE guidance rather than relying on memory, and should communicate exclusion expectations clearly to parents when they enrol.
Cleaning and Disinfection Routines
A written cleaning schedule, covering high touch surfaces such as door handles, taps and toys throughout the day, alongside a deeper clean at the end of each session, is a core part of any infection control policy. Toys used by babies and toddlers who mouth objects should be cleaned more frequently than toys used only by older children, and any toy that cannot be effectively disinfected after contact with bodily fluids should be removed from use until it can be.
Managing an Outbreak
When several children in the same room develop similar symptoms within a short period, this may indicate an outbreak rather than isolated illness. Your policy should set out clear steps for this scenario: notifying parents promptly, increasing the frequency of cleaning and handwashing reminders, and where required, notifying the relevant HSE department of public health, particularly for illnesses that are subject to mandatory notification.
Common Mistakes to Avoid
Some infection control gaps show up repeatedly across settings. These include policies that have not been updated to reflect current HSE exclusion guidance, inconsistent nappy changing practice between staff members, hand sanitiser used as a substitute for handwashing rather than a backup, and cleaning schedules that exist on paper but are not actually followed during busy periods. Regular, informal spot checks alongside your written policy are often more effective than the policy document alone.
FAQ
How long should a child stay home after vomiting or diarrhoea?
Current guidance recommends exclusion until at least 48 hours after the last episode of vomiting or diarrhoea has passed.
Is hand sanitiser as effective as handwashing in a creche?
No. Liquid soap and water remain the most effective method, particularly against illnesses like norovirus where alcohol gel has limited effect.
Does every early years service need a written infection control policy?
Yes. It is a core expectation under Tusla's Quality and Regulatory Framework and something inspectors will look for directly.
How often should nappy changing mats be disinfected?
After every single change, not just periodically, along with the surrounding surfaces and bin contact points.
What should a service do if several children fall ill at once?
Treat it as a potential outbreak, increase hygiene measures immediately, notify parents, and contact the local HSE department of public health if the illness may require notification.
Final Thoughts
Infection control childcare practice is built from small, consistent daily habits far more than from any single product or policy document. Getting hand hygiene, nappy changing and exclusion periods right, and backing them up with a clear written policy that your whole team actually follows, does more to protect children and staff than anything else in your compliance toolkit. Our Infection Control Policy and full range of infection control supplies are designed to support exactly this kind of consistent, documented practice across your setting.
