Is It Good To Expose Your Child To Germs?

Every day, your child is exposed to several germs – be it at the playground, while playing with a dog, and even on the floor. But, this might actually be more of a good thing than bad.

By Dr. Chaitali Laddad

Is It Good To Expose Your Child To Germs?

Do you remember using sanitizers when you were younger or your parents carrying sanitizers everywhere for you? Me neither. At the time, we stuck to using just soap and water.

My mother tells me that she was careful about keeping me and my brother clean. She did so, through more baths and a clean set of clothes after our outdoor play, which seems fair, cause you don’t want your child to be dirty all the time. When I asked my mother about sanitizers, she simply answers that it wasn’t a trend at the time, so she didn’t bother.

However, these days there’s an increased scare about keeping your child and her environment as sanitized as possible to the extent of using really strong sanitizers.

As a parent, you might worry about the germs your child is exposed to. However, you don’t need to fret much since there is a silver lining to this. Did you know that dirt and germs may be beneficial to your kid’s immunity?

What is the hygiene hypothesis?

The hygiene hypothesis suggests that exposing children to some infections at a very young age can help their immune system become stronger and thus help them fight off worse illnesses as they grow up. It also suggests that children living in pristine conditions have lower immunity due to their lack of exposure to these germs.

According to WebMD, “exposing kids to a host of illnesses through dirt, exposing children and infants to germs may offer them greater protection from illnesses such as allergies and asthma later in life.”

In the article, ‘Expose your child to life with all its warts’, Thom McDade, PhD, associate professor and director of the Laboratory for Human Biology Research at Northwestern University said, “Just as a baby’s brain needs stimulation, input, and interaction to develop normally, the young immune system is strengthened by exposure to everyday germs so that it can learn, adapt and regulate itself.”

What evidence do we have for and against hygiene hypothesis?

There are many studies that say hygiene hypothesis works, and some that it doesn’t. And there are not many India-specific studies. Moreover, higher levels of sanitisation cannot be the only reason why allergies and asthma are increasing. Because if this were the case, asthma would increase at a higher rate in more developed countries, because their spaces are more sanitized than ours, which has not been observed yet.

What kind of infections and germs can boost a child’s immunity?

An average of 6-8 infections in the first 5 years of age is the normal. And most of them are usually viruses; kids catch respiratory infections, gastro infections, etc. Basic immunisation will protect them from the more dangerous infections later in life.

What is the ‘old friends’ hygiene hypothesis?

The hygiene hypothesis was first suggested in 1989 and has since then become a popular theory. But this idea that our immunity is going down simply because we are living in conditions that are way too hygienic has intrigued many scientists. This is where the ‘old friends’ hypothesis comes in. The ‘old friends’ hypothesis talks about microorganisms that have co-evolved with us. It suggests that it’s not our personal hygiene that is harming our immune system, but our lack of exposure to certain ‘friendly’ microbes. This is mentioned in the article ‘News Feature: Cleaning up the Hygiene Hypothesis’ by Megan Scudellari, published in the Proceedings of the National Academy of Sciences in 2017.

These microbes aren’t harmful for us and we aren’t harmful for them. They were in fact, part of our environment, especially in green spaces. We were more exposed to these spaces before, with people back then climbing trees, farming, going in the grass, etc. But now we are moving towards a more urban environment and an urban lifestyle, which reduces our exposure to these microbes. These are microorganisms that our bodies should ideally know to tolerate. But because of our lack of exposure to them in early childhood, our body thinks they are a threat to us and overreact to their presence. In this process we end up damaging our own body. As Sally Bloomfield, the Chairperson of the International Scientific Forum on Home Hygiene puts it: “It's not about just learning what to attack but learning what to tolerate.”

What about hygiene hypothesis and vaccines, auto immune diseases and asthma?

The existing vaccines combat few of the very harmful organisms. And it is not easy to develop vaccines. Parents often wonder whether to vaccinate their children or not, as it lowers the body’s immunity. However, the risk of your child contracting long-term health problems or dying is more probable without taking the recommended vaccines. The current vaccines that have been developed against diseases are those wherein where there have been a significant impact in terms of morbidity or mortality of children. So, these are not the germs that would help your child’s immunity. Hence, vaccines are still very beneficial.

Also, if your immune system is not challenged enough in the initial formation years, auto immune diseases are more likely to happen. But, there’s no direct evidence for this yet. Nor is there any direct evidence that asthma has anything to do with the hygiene hypothesis.

Can the hygiene hypothesis apply to our tolerance for pollution?

No, the hygiene hypothesis does not apply to our tolerance for pollution. Pollution is about gases and chemicals, not microbes. It is harmful to our bodies, but our biology is not going to change in order to get used to it. We cannot get used to pollution.

How does marketing influences perception about hygiene (in terms of usage of sanitizers)?

We observe both extremes. We see that the affluent class over-sanitize and the underprivileged sections live in unhygienic conditions due to lack of resources. Hence, the same marketing strategy is not going to work for both. So, while it’s okay to market soap as a way to keep clean, it’s not okay to scare consumers into constantly using sanitizers. Because that scare is harmful. We still have access to open water, and using simple soap and water is better than a sanitizer. As many of these sanitizers are unnecessarily harsh and at a similar level to those used in hospitals and ICUs. There is no added advantage to using such harsh disinfectants in place of simple soap. These harsh disinfectants not only kill good bacteria, but also harm your skin in the long run and skin is the largest organ in the human body.

Thus, hygiene hypothesis is not really about personal hygiene. In fact, it’s a misnomer. And while it’s still important to wash your hands after using the bathroom, we do not need to go overboard with constantly using sanitizers.

At what age should the children be exposed to germs?

Babies are exposed to some germs in the utero itself, through the mother. Nonetheless, the first five years are crucial for this exposure when the child’s immunity is in its developing stage. You might have noticed that once the children are older than five or six, they start falling less sick. This is because they have fallen sick earlier and that has helped boosts their immunity. They then become more and more stronger with each infection and are able to deal with it. 

What you can do as a parent:

Here are some ways to expose your child to some friendly germs and microbes under adult supervision:

Encourage your child to play barefoot outdoors in the dirt and grass. However, the playing area should be free from nails, shards of glass, or other sharp materials. Kids who play outdoors invariable return with dirt under their nails, mud all over and bits and pieces of weeds and grasses – all immune boosters.

Go easy on your use of antibacterial soaps. Constant usage of antibacterial soaps and sanitizers may inhibit immune development in your kids. Soap and water is enough to keep your kids clean.

Take a trip to the countryside or a farm. Take out time from your busy schedule and try to visit a farm where there are animals like sheep, horses and even fish. This will expose your child to germs and bacteria that they would not encounter in the city. Children who interact with pets like dogs and cats from a very young age are less likely to develop asthma or allergies.

Take your child hiking or on a walk outdoors regularly. If you keep your child in clean conditions all day long, she will have trouble building immunity to common allergens.

Give your child foods from different cultures. Foods such as kimchi, pickles, yogurt and kombucha, are made of varied ingredients from all parts of the country. Exposure to these foods will provide your child with nutrients that have health benefits. They are good for the digestive system and promote immunity against many illnesses.

So, the next time you are upset with your child for playing outdoors and getting her clothes and hands soiled, remember that exposure to germs may not be so unhealthy after all.

About the author:

Written by Dr. Chaitali Laddad on 11 August 2017.

The author is Founder & Director, The Pediatric Network.

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