What is immunosuppression?
The immune system is the part of the human body that is programmed to fight infections. Some medications or diseases can weaken the immune system. This is called immunosuppression. When the immune system is weak, a child is more vulnerable to infection and may also have severe symptoms and a difficult time recovering.
Children on medications designed to affect the immune system, chemotherapy and children born with diseases that affect their immune system may all experience immunosuppression, but some are more severe than others. Talk to your child’s health-care team to understand which precautions to take.
What can you do to protect your child?
If your child has a condition or is on a medication that weakens their immune system, it is important to protect against infection as much as possible. You may not be able to prevent your child from getting an infection. However, following these steps may reduce the risk.
Practice and promote good hand washing
Hand washing is the most important step in preventing the spread of infections. Hand washing is especially important after:
- using the toilet
- changing diapers
- handling garbage
- using a cleaning cloth or soiled dishcloth
- handling raw food (meat, eggs)
- touching a pet
- blowing or touching the nose
- contact with other body fluids such as vomit or blood
As soon as someone enters your home, ask them to immediately wash their hands or use a hand sanitizer. Anyone who has diarrhea should thoroughly wash their hands with soap and water. Always wash your hands before:
- touching your child
- preparing food
- eating
Keep your home clean
- Wash your child's bed linens, bathroom towels and pajamas at least once a week.
- Wash all dishes and utensils in hot water or in the dishwasher.
- Wash surfaces in common areas such as the bathroom, kitchen and living room with a disinfectant. Pay particular attention to surfaces that are touched frequently such as handles on doors, the refrigerator, the oven, cupboards, sink taps, toilet handles and seat, telephones and computers. Clean these surfaces regularly.
- Clean toys before your child touches them.
Limit contact with those who have an infection
The following suggestions are for children with severe immunosuppression. These are not required for all children receiving immunosuppressive treatment. Talk to your child's health-care team and ask if you need to take these precautions:
- Keep your child away from crowds. Try to avoid stores, markets, parties, etc.
- Have your child wear a mask when they go out.
- Keep your child out of daycare and group play activities during the treatment period.
- Avoid communal play areas such as play parks, sandboxes and public swimming pools.
- Limit sharing of household items such as toys, towels, drinking glasses and eating utensils.
- If you are comfortable doing so, share your concerns about your child’s immunosuppression with others. This may help them understand the limitations that you must set to keep your child healthy.
- All visitors should be screened for illness. They should not visit if they are sick or have recently been directly exposed to someone who is sick.
- If you must be in a public place, use a plastic cover on the stroller and choose times when there is less likely to be crowds. An older child may wear a mask.
- When at a clinic, doctor's office or medical lab, advise them of your child's lowered immune system and request to be put in a room right away or ask for an appointment at the beginning or end of the day. Avoid waiting rooms as much as possible.
Ensure family members are immunized
Immunizations reduce the risk of many serious infections. Family members you live with should update their immunizations. This includes having annual flu and COVID vaccines. Immunizations make it less likely they will get sick and expose your child to one of these serious infections.
In general, it is safe for family members you live with to be vaccinated during your child's treatment period. Still, it is recommended that you check with your child’s health-care team if family members require live vaccines, such as the rotavirus, measles-mumps-rubella or varicella (chickenpox) vaccines.
Try to have your child's vaccinations updated four to six weeks before starting treatment. It is safe for your child to have 'inactivated' vaccines while immunosuppressed. However, they may not work well. The vaccine may need to be repeated at a later date. Talk to your child's health-care team before your child has any vaccinations.
For more information, see Immunizations for Children and Teens with Suppressed Immune Systems.
Avoid contact with pets
Do not allow your child to touch your pet. Pets carry bacteria, viruses and fungus that may harm your child. Keep your child away from surfaces where pets may have been such as the floor or furniture. If it is difficult to keep your child away from pets, you may choose to remove pets from your home during the treatment period. To prevent illness due to animal contact:
- Always wash your hands thoroughly with soap and running water after contact with animals and their feces.
- Avoid rough play with cats and dogs to prevent scratches and bites.
- If you are at higher risk of getting sick from animals, you should avoid contact with cat litter boxes, reptiles, baby chicks, ducklings, puppies and kittens less than 6 months old, and pets with diarrhea. You should also be extra cautious around young calves and other farm animals.
Do not smoke around your child
Second-hand smoke increases the frequency and severity of respiratory infections, ear infections, wheezing and asthma.
Prepare and store food safely
When preparing food for your child:
- always wash your hands before and after preparing food or handling raw meats
- wash all fruits and vegetables before eating
- keep all meat, poultry and fish separate from cooked food and at the bottom of the refrigerator.
- thaw frozen meat in the refrigerator (not on the counter) away from other foods.
- use a plastic cutting board. Clean cutting boards and utensils immediately after use. Have a separate cutting board for meat only.
- cook meat thoroughly
- avoid deli meats
- keep dairy products such as milk, cheese and yogurt in the fridge
- all dairy products must be pasteurized
Your child should not eat food:
- that is usually refrigerated if left at room temperature for more than two hours
- containing raw eggs
- that has expired
What do I do if my child is immunosuppressed and gets an infection?
If your child has any of the following, contact their health-care provider.