Handwashing and germs: surviving daycare illnesses

Why bother fighting over handwashing?

It's easy to feel like reminding a squirmy toddler to wash their hands for the tenth time in a day is a losing battle. But the evidence behind it is strong. The CDC estimates that handwashing can prevent about 30% of diarrhea-related illnesses and about 20% of respiratory infections like colds. Those are exactly the two types of illness that tend to sweep through daycare classrooms. That's not a small effect for something this simple.

This also helps explain why illness spreads through group care so fast. A single gram of human waste — about the weight of a paper clip — can contain one trillion germs, according to the CDC. Toddlers are still learning independent toilet habits. Diaper changes happen constantly at this age. And little hands touch faces, toys, and each other all day long. That combination is exactly why handwashing after diaper changes and bathroom use matters so much for stopping illness from spreading between kids.

Does handwashing really cut down on sick days?

This isn't just theoretical. The CDC notes that schools and daycares that actively promote hand hygiene see less stomach and respiratory illness among the children in their care, plus fewer missed days overall. If your child's daycare or preschool has a visible handwashing routine — after arrival, before meals, after outdoor play, after bathroom trips — that routine is doing real work, even on the days it feels repetitive.

The same logic applies at home. Reinforcing the same handwashing moments your child sees at daycare — instead of treating it as a school-only rule — helps make it a consistent habit, not something that only happens in one place.

How to make handwashing a habit that sticks

Toddlers thrive on predictable, repeated routines, and handwashing is no exception. Anchor it to the same moments every day — after using the potty or getting a diaper changed, before meals and snacks, after coming inside. This gives your child a consistent cue instead of an abstract rule to remember.

Language development plays a role too. By 19 to 24 months, most toddlers can follow two-step directions. That lines up well with a simple two-step handwashing routine: wet and soap, then rinse and dry. Narrate each step out loud as your child does it, instead of doing it for them. This gives them the repetition they need to eventually manage more of the process on their own.

How handwashing and potty training go together

Handwashing and toilet training tend to arrive in the same general window of toddlerhood, and they support each other well. According to the AAP and HealthyChildren.org, toddlers typically start showing signs of bladder and bowel control between 18 and 24 months. The average age toilet training actually begins in the U.S. is between 2 and 3 years. So there's no need to rush either skill ahead of your child's own readiness.

Instead of watching the calendar, look for the readiness signs the AAP describes: your child staying dry for at least 2 hours at a time during the day or after naps, and showing physical cues like grunting, freezing, or squatting before urinating or having a bowel movement. When those signs show up, that's your natural moment to start adding handwashing into the bathroom routine from day one — building the habit right alongside the skill itself, instead of adding it on later.

Is bedwetting normal at this age?

Between the germs, the accidents, and the general unpredictability of toddlerhood, it's easy to worry that something's wrong when it usually isn't. Occasional bedwetting is a good example. Per the Cleveland Clinic, most children gradually stop wetting the bed on their own as they grow older. This typically resolves between ages 4 and 6. That means a toddler or preschooler who still wets the bed sometimes is well within the range of normal — not a cause for concern.

There's a clear line for when it's worth a conversation with a healthcare provider: when a child is over age 7 and having accidents at least twice a week for three months or more in a row. Below that age and frequency, it's simply part of how bladder control develops over time.

When should you call the pediatrician?

Most of what happens during this stretch — frequent colds, potty training accidents, occasional bedwetting — is expected and resolves on its own with time and a steady routine. But it's still worth knowing what a real warning sign looks like, separate from the day-to-day noise of daycare illness.

On the communication side, ASHA notes that by 19 to 24 months, children typically use and understand at least 50 words, put two or more words together (like "more water" or "go outside"), and follow two-step directions. If your child isn't reaching many of these milestones for their age, ASHA advises talking with your child's doctor. More broadly, the CDC is direct: don't wait if your toddler isn't meeting one or more developmental milestones, or has lost a skill they once had. Bring it up with your child's doctor and ask about a developmental screening. Catching things early is always easier than waiting to see if they resolve on their own.

Frequently asked questions

Sources

1. Handwashing can prevent about 30% of diarrhea-related illnesses and about 20% of respiratory infections such as colds, which is why frequent handwashing matters so much once a toddler starts daycare or preschool. — CDC
2. A single gram of human feces (about the weight of a paper clip) can contain one trillion germs, illustrating why handwashing after diaper changes and bathroom use is critical for stopping illness spread among toddlers. — CDC
3. School and early care/education programs that promote hand hygiene can result in less gastrointestinal and respiratory illness and fewer missed days, directly supporting the case for consistent handwashing routines at daycare and preschool. — CDC
4. Toddlers typically show signs of bladder and bowel control between 18 and 24 months of age, and the average age toilet training begins in the United States is between 2 and 3 years. — AAP / HealthyChildren.org
5. Readiness signs for potty training include a child being dry for at least 2 hours at a time during the day or after naps, and showing physical signals like grunting, freezing, or squatting before urinating or having a bowel movement. — AAP / HealthyChildren.org
6. Most children gradually stop wetting the bed on their own as they grow older, and this typically resolves between 4 and 6 years of age, so occasional bedwetting in a toddler or preschooler is not itself a medical concern. — Cleveland Clinic
7. A healthcare provider considers bedwetting an issue requiring evaluation when a child is over age 7 and has accidents at least twice per week for at least three months in a row. — Cleveland Clinic
8. By 19 to 24 months, expected communication milestones include using and understanding at least 50 different words, putting two or more words together (like "more water" or "go outside"), and following two-step directions. — ASHA
9. ASHA advises parents to talk with their child's doctor if the child does not reach many of the speech and language milestones expected within their age range, as a signal to seek a professional evaluation. — ASHA
10. The CDC advises parents not to wait if a toddler is not meeting one or more developmental milestones or has lost skills they once had, and to talk with the child's doctor and ask about developmental screening. — CDC