Caring for Our Children (CFOC)

Chapter 3: Health Promotion and Protection

3.3 Cleaning, Sanitizing, and Disinfecting

3.3.0 Cleaning and Sanitizing Objects Intended for the Mouth

Content in the STANDARD was modified on 3/20/2023.

Thermometers, pacifiers, teething toys, and similar objects that are intended for the mouth should be cleaned, and reusable parts should be sanitized between uses. For more information on how to clean and sanitize mouthed objects, see CFOC Standard For thermometers, refer to the manufacturer’s instructions for cleaning.

Children should never share pacifiers. Pacifiers need to be sanitized if they look dirty or if another child has used them. Use a sanitizer safe for contact with food, or boil the pacifier for 1 minute in water that can be for drinking or meal preparation, and air-dry. Using a dishwasher to sanitize can also replace the need for chemical sanitizers. Using a dishwasher that has a “sanitizing cycle” or that is set to heat-dry is an acceptable way to save time and work when sanitizing pacifiers and objects that are dishwasher-safe ¾ as long as the dishwasher can wash and sanitize the surfaces, and it doesn’t wash dishes and cutlery at the same time. Use a dishwasher with a sanitizing cycle that is certified to meet the NSF/ANSI 184 standard. This standard helps confirm that a residential dishwasher can reduce bacteria by at least 99.999% when run on the sanitizing cycle.1

After you clean a pacifier, water often stays in the nipple. Be sure to squeeze any water through the nipple hole of the pacifier to be sure it is clean. Program staff should ensure their hands are thoroughly washed before squeezing the pacifier nipple. Squeeze the pacifier away from you, as water may still be hot. If water drops remain in the nipple, let the pacifier air-dry. Make sure the pacifier has cooled completely before giving it to the child.


Infectious diseases spread easily in early care and education programs, since children, staff, and families are all in close contact. Mouthed objects can carry germs and have spread diseases.24 Developing effective cleaning strategies and policies are important steps to reduce the risk of illness in early care and education programs.


Early care and education programs need to write up and follow a routine schedule of cleaning, sanitizing, and disinfecting. Refer to CFOC Appendix K: Routine Schedule for Cleaning, Sanitizing and Disinfecting.

For more information on selecting a cleaning, sanitizing, or disinfecting product, please refer to CFOC Appendix J: Selection and Use of a Cleaning, Sanitizing, or Disinfecting Product. Appendix J also has important information about the use of bleach products, how to prepare bleach solutions, and health and safety precautions. Never mix bleach with other household cleaners, especially those that have ammonia.

The use of products that have safer (less toxic) chemicals helps reduce health and environmental concerns. Manufacturers may claim that their products are “green,” “natural,” or “earth friendly,” but these claims are often misleading and might not be about a chemical’s safety. Organizations now certify and label products that meet certain health and environmental standards. These certifications can help you find less hazardous cleaning, sanitizing, and disinfecting products. CFOC Appendix J has more information on Third Party Certifications logos and these safer (less toxic) chemicals. Safer disinfectant choices can be found at Using the least hazardous products available will help protect the health of children, and early care and education program staff and custodial personnel.

Center, Early Head Start, Head Start, Large Family Child Care Home, Small Family Child Care Home
RELATED STANDARDS Pacifier Use Handwashing Procedure Routine Cleaning, Sanitizing, and Disinfecting Cleaning and Sanitizing Toys Guidelines for Taking Children’s Temperatures Dishwashing in Centers Dishwashing in Small and Large Family Child Care Homes Method for Washing Dishes by Hand
Appendix J: Selection and Use of a Cleaning, Sanitizing or Disinfecting Product
Appendix K: Routine Schedule for Cleaning, Sanitizing, and Disinfecting
  1. Western States Pediatric Environmental Health Specialty Unit. Green cleaning, sanitizing, and disinfecting: A tooklit for early care and education, 2nd ed. San Francisco, CA: University of California, San Francisco; 2021

  2. Ibfelt T, Engelund EH, Permin A, Madsen JS, Schultz AC, Andersen LP. Presence of pathogenic bacteria and viruses in the daycare environment. J Environ Health. 2015 Oct;78(3):24-29. PMID: 26591334

  3. Gerba CP, Chaidez C. Detection of pathogenic micro-organisms on children’s hands and toys during play. J Appl Microbiol. 2014 Jun;116(6):1668-1675. doi: 10.1111/jam.12473. Epub 2014 Mar 20. PMID: 24524673

  4. Bright KR, Boone SA, Gerba CP. Occurrence of bacteria and viruses on elementary classroom surfaces and the potential role of classroom hygiene in the spread of infectious diseases. J Sch Nurs. 2010 Feb;26(1):33-41. doi: 10.1177/1059840509354383. Epub 2009 Nov 10. PMID: 19903773


Content in the STANDARD was modified on 3/20/2023.