Can I Be Around Babies and Newborns During Chemo?

Most people can be around babies during chemotherapy. Time with a grandchild, a niece, or your own small child is worth protecting.

The concern runs in one main direction: from the child to you. Chemotherapy lowers your white blood cells, the cells that fight infection. NCI says there are times in each treatment cycle when the count of one type, called neutrophils, is particularly low. Your infection risk is highest then.

Babies and toddlers pick up colds and stomach bugs often. So NCI's plain advice applies here more than anywhere: stay away from people who are sick or have a cold. Wash your hands often and well, and ask the people around you to do the same.

That is the whole of it for ordinary chemotherapy. Cuddling, feeding, and rocking a baby are usually fine when nobody is ill. Ask your team whether your blood counts change that.

There is a second, smaller point that involves the drugs rather than germs.

For a short window, chemotherapy leaves the body in urine and other fluids. OSHA's hospital guidance says staff who handle urine from patients who received hazardous drugs in the previous 48 hours need protective gloves.

The American Cancer Society says it generally takes at least 48 hours for the body to clear most chemo. At home this mostly matters for bathroom cleanup and anything soiled with body fluids in the two days after a dose. ACS advises two pairs of throw-away gloves for anyone handling body fluids, and washing hands with soap and warm water afterward, even if gloves were worn. Ask someone else to take those jobs if you can.

ACS also lists semen and vaginal fluids among the places chemo waste can be found. NCI says condoms may be advised to protect a partner from chemotherapy that can remain in vaginal secretions. NCI gives no time frame, so use the window your own team gives you.

People often assume radiation makes them dangerous to a baby. For the common kind, it does not.

NCI is direct about this. External beam radiation therapy will not make you radioactive. You may safely be around other people, even pregnant women, babies, and young children.

Internal radiation is different, and this is where real rules appear:

• High-dose implants in hospital. Visitors may face limits. NCI lists visits of about 30 minutes or less, standing near the doorway, and no visits from pregnant women or children younger than a year old.
• Permanent implants. When the radiation source is first put in place, NCI says to limit time around other people and to be extra careful not to spend time with children or pregnant women.
• After a temporary implant is removed. NCI says there is no radiation left in your body, and it is safe for people to be near you — even young children and pregnant women.

If radiation is part of your plan, ask which of these applies to you. Most people on chemotherapy alone will not need any of it.

Ask your care team about any shot a child in your home is due for. A few vaccines use a weakened live germ, and those get a mention.

NCI advises avoiding people who have just had a live vaccine, naming chickenpox, polio, and measles as examples.

CDC adds one specific rule about the nasal-spray flu vaccine. People who care for someone severely immunocompromised who needs a protected environment should not get the nasal spray, or should avoid contact with that person for 7 days after getting it.

Most people in treatment are not in a protected environment. If you are, or you are not sure, ask before a child in the home is vaccinated.

A fever during treatment is not a wait-and-see problem.

CDC says a temperature of 100.4°F (38°C) or higher during chemotherapy means calling your doctor right away. Fever may be the only sign of an infection, and CDC warns that an infection during chemotherapy can be life-threatening. NCI's infection page uses 100.5°F (38°C). Sources word this threshold differently. Use the lower number, 100.4°F (CDC), unless your own team gives you a different one.

NCI says to talk with your doctor or nurse before you take any medicine for a fever, even aspirin, acetaminophen or ibuprofen.

Fever is not the only warning. NCI lists chills, cough, sore throat, mouth sores, swelling or redness at a catheter site, and painful or cloudy urination as signs of infection. Call your care team right away, day or night, for any of them. A normal temperature is not a reason to wait.

• What was my neutrophil count at the last blood draw?
• Which days in each cycle are my lowest, so I can plan visits around them?
• Which steps do you want me to follow at home for the 48 hours after a dose, or longer?
• Does any part of my treatment involve internal radiation with contact rules?
• Which fever number does this team use, and what number do I call at night?

This is general information. Your care team's specific instructions for your treatment always take priority.

• NCI — Infection and Neutropenia during Cancer Treatment
• NCI — External Beam Radiation Therapy
• NCI — Brachytherapy
• NCI — Sexual Health Issues in Women with Cancer
• OSHA — Administering Hazardous Drugs
• American Cancer Society — Chemotherapy Safety
• CDC — Nasal Spray Flu Vaccine
• CDC — Fever and Cancer Treatment