Boil Water Order: What Parents Need to Know

As if life with an infant or toddler isn’t busy enough, right? During a Boil Water Order, we need to take some extra steps to ensure that the water we’re using is safe for everyday use.

In preparing for this blog, I’ve waded through some contradictory information about what parents should do to keep their homes, selves and babies safe. With research and a fact-checking phone call to an expert at MA Health and Human Services, I’m sharing some practical suggestions. As always, check with your health care provider for recommendations specific to your situation.

Some definitions I’m using below:

Tap water: This is untreated water directly from your faucet. This water is not currently considered clean or safe for drinking, cleaning or food preparation – some of this water is essentially open-air pond water treated with chlorine. However, the risk of illness for healthy adults is very low, even if there has been some accidental ingestion. Infants and immune-compromised people are at greater risk. Learn more about this tap water.

Clean Water: I’m using this term to refer to bottled spring water, or, water treated from your tap. To treat tap water, bring your largest pots of water to a full, rolling boil for 2 minutes and then cover and allow to cool. This water is now considered safe to use for drinking, tooth-brushing, food preparation, making baby formula, or sponge-bathing a baby. Do not boil longer than 2-3 minutes. It’s not necessary, and boiling down the water may concentrate any heavy metals in the water.

Disinfecting Soak: Add one teaspoon of household bleach to two gallons of water (use a large pot), or, one tablespoon of bleach to a sink-full of water (about 4-6 gallons). This dilute bleach solution may now be used as a soak to for dishes, baby bottles, collars and bottle nipples, breastpump parts, teething toys, etc. After soaking for 5 minutes, remove and allow to air dry. No further rinse is necessary.

How to keep yourself, your children and your household goods clean.

Handwashing
Adults should wash hands as usual with soap and tap water but finish off with a squirt of hand sanitizer.
For babies and toddlers, wash hands with a diaper wipe or a paper towel and Clean Water (bottled or boiled then cooled). Little hands go right into the mouth, so don’t use untreated tap water or hand sanitizer on your child’s hands.

Showers & Bathing
Adults can shower as usual, but avoid allowing water into your mouth. Nursing moms can breastfeed after showering and drying off. There is no need to disinfect your skin.
Because babies and toddlers like to lap at bath water and eat their tub toys, avoid tub baths until the boil-water order is lifted. For our little ones, it’s safer to do a sponge bath with a wet washcloth and a bowl of Clean Water.

Cleaning baby items including bottles, nipples, sippy cups, teethers, etc.

Wash your bottles, sippy cups and pump parts as usual, with tap water, dish soap and a bottle brush to get into the nooks and crannies. Then, soak items in Disinfecting Solution for five minutes (as above), remove and allow to air dry. OR, bring a large pot of boiled water to a rolling boil for two minutes, then add items. Allow to boil for 2 more minutes then carefully remove and air dry.

For breastpump parts:

With the boil-water order in effect, use only Clean Water (pre-boiled & cooled, or bottled) to wash your pump parts, OR, after washing with soap and tap water, soak items in the Disinfecting Solution for 2 minutes, remove and air dry.

Easier options and helpful for home or the workplace include using Medela’s Quick Clean Wipes to clean pump parts, then allow to air dry. Quick Clean Wipes are antibacterial, food-safe disinfecting wipes that are also great for hard surfaces like highchair trays and plastic toys. Medela’s Microwave Steam Clean Bags to steam clean bottles and pump parts are also effective. Use only Clean Water in the Quick Clean Bags.

For moms pumping at work, you may refrigerate your pump parts rather than washing in between uses, then on arrival home, use one of the above methods to clean and/or disinfect your pump parts. Current research indicates that refrigerating breastpump parts may effectively prevent short term growth of bacteria. (Note: these suggestions are for women expressing for healthy, term babies in the community. Special precautions may apply for premature or immunocompromised infants – check with your baby’s health care provider).

Is using the dishwasher safe or sufficient?
In a word, yes. If your dishwasher has a sanitizing feature, secure pump parts, toys, sippy cups, bottles etc in a dishwasher cage and run the sanitizer program. This final rinse uses water hot enough to destroy bacteria present.

If you have an older dishwasher without the Sanitize option, you may still use your dishwasher to wash your dishes, bottles, sippy cups, breastpump parts and teether toys: be sure to select a dishwashing detergent containing bleach (as stated on the label) to serve as a disinfectant. (Per MA Health & Human Services recommendation).

Preparing baby formula, food, coffee/tea, ice cubes and/or rinsing fruits and vegetables.

To mix formula (powdered or concentrate), only use tap water that has been boiled for two minutes and cooled, or use bottled spring water. For infants under one month of age, some experts recommend using only ready-to-feed formula which is a sterile product.

For food preparation (rice, oatmeal, pasta, etc), bring water to a rolling boil for two minutes, and then it is safe to use for cooking. Allow water to cool, and use it to make ice cubes, coffee or tea, or for washing fruits and vegetables.

As inconvenient as these additional steps are, it makes me thankful that 360 days out of the year, I take it for granted that I can turn on my tap and have fresh, clean and safe water readily available. It makes me think about how many million people on this planet never have that option, getting sick from contaminated water, or needing to make a trek of several miles each day to collect water to use for washing or drinking.

About Nancy Holtzman RN IBCLC CPN

Nancy is a Vice President at Isis Parenting and leads Clinical Content. As one of the original co-founders, she was instrumental in the creation of many prenatal and new parent programs at Isis Parenting, helping to develop the Isis vision in its earliest stages. Nancy has over 25 years of clinical nursing experience including ten years at Boston’s Beth Israel Hospital, and is a mother/baby nurse educator, a board certified lactation consultant and board certified pediatric nurse. She is the founder of the Great Beginnings New Mothers Group series which has now reached over 10,000 Boston-area mothers. She speaks and writes for a national audience about breastfeeding and infant development, and has served on the board of MLCA, the Massachusetts Lactation Consultants Association. She received a BS from Northeastern University College of Nursing, and a Certificate in Advanced Pediatric Assessment from Boston College. Nancy lives in Boston with her husband, two teens and a rescued Bichon. Find her tweeting about all about babies at @nancyholtzman

6 Responses to Boil Water Order: What Parents Need to Know
  1. Suzi
    May 3, 2010 | 12:48 pm

    This is helpful, thank you!

  2. Nancy
    May 3, 2010 | 1:12 pm

    With a three year old and a nine month old I was not excited to hear about the water ban. But boiling water turns out not to be that big of a deal. What drives me insane is the bleach soak after washing dishes. First, I am not big on chemicals, so there is the discomfort factor. But second, it is just a royal pain to have to set up the sink with a bleach bath and soak the dishes. We are cramming our dishwasher full and hoping that the ban is lifted before we need to run it!

    Also, having not previously been a bottled water family, it’s disheartening to see the recycling build up with the water bottles we are going through.

  3. Kim
    May 3, 2010 | 1:59 pm

    For me, It’s a big pain. We cloth diaper and although I have read that it is fine to wash the diapers in the water, I feel iffy taking a chance, which means we switched to disposable diapers until the ban is lifted. My daughter has a super sensitive diaper area already and I don’t feel like taking any chances. Can’t bleach cloth diapers so it felt easier to switch and not risk it. :)

  4. Nancy
    May 3, 2010 | 2:03 pm

    @Nancy: According to my research, it should be safe to clean dishes and bottles in your dishwasher, either on the sanitizing program, or by using a dish-washing detergent containing bleach. This is what the spokesperson from Health & Human Services told me today when I called to clarify conflicting information.
    @Kim: I agree with what you were told. There is no risk from doing any laundry (cloth diapers or clothing for baby or adults) as usual with your water. The only risk is ingesting water that is contaminated with e-coli or giardella, neither of which have yet been found with testing and could not be ingested from clean laundry.
    You can contact Massachusetts Health & Human Services by calling 2-1-1 and waiting a really, really long time. – Nancy Holtzman

  5. Fay
    May 3, 2010 | 4:20 pm

    Thank you, Nancy! This is very helpful.

  6. cna training
    May 3, 2010 | 10:21 pm

    Terrific work! This is the type of information that should be shared around the web. Shame on the search engines for not positioning this post higher!

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