Why some germs may be good for
your child's health
By Jessica Snyder Sachs, as first appeared in PARENTING magazine
Emma Donahue, 2, enjoys life on
her family's farm. She loves to touch the menagerie of animals -- and pick
up the feathers and other "treasures" they leave behind. "I'm
not the type to get stressed out over dirt. That takes a lot of the fun out of
being a kid," says her mom, Stacey, of Lithia, FL. "I just tell Emma
not to put her hands in her mouth until we can wash up."
Emma's early exposure to
old-fashioned muck, with its cornucopia of germs, may be just what the doctor
ordered -- at least according to the "hygiene hypothesis" and a
growing number of studies that support it. The crux of the theory: The modern
war on germs may have gone too far, wiping out too many of the good guys along
with the culprits that cause diseases. Exposure to certain bacteria in the
first years of life is crucial for teaching the developing immune system to
recognize friend from foe. Without this early training, the imbalance within
the body's immune cells may predispose them to attack a host of harmless
substances, such as cat dander and pollen -- or even other cells in the
body.
That immune-system immaturity may
be a major contributor to one of the most perplexing public-health problems our
country faces: the increasing number of kids who are suffering from childhood
allergies, asthma, and eczema. "The hypothesis is a leading theory to
explain things like rising rates of these illnesses," says Richard
Johnston, M.D., a member of the Institute of Medicine and a pediatric
immunologist at the University of Colorado School of Medicine, in Denver. Many
experts are also investigating possible links to adult autoimmune diseases,
such as diabetes, multiple sclerosis, and lupus.
It's time to rethink our efforts to wipe out every microbe that comes near us.
Some of those germs might actually be good for our kids.
"Part of the problem comes
from our belief in the myth that we would want to live in a germ-free
world," says Graham Rook, M.D., an immunologist at the Royal Free and
University College Medical School, in London. "Lab animals raised in a
genuinely sterile environment develop abnormal immune systems." Indeed, a
typical adult human houses trillions of bacteria in his intestines. These
normal gut "flora" aid digestion, produce such nutrients as vitamin K
and certain B vitamins, and play a long-recognized but little-understood role
in the operation of the immune system.
Even our skin is replete with
harmless bacteria so deeply embedded you could never scrub or sanitize them
away. Nor would you want to: These skin germs serve as a barrier against
harmful stray bacteria that might otherwise take up residence there.
Of course, no one is claiming we
shouldn't protect ourselves against illness. Or return to the days before water
treatment, antibiotics, and vaccinations largely wiped out scourges like
cholera, tuberculosis, and polio. "Rather, we're recognizing that in the
process of sanitizing our modern environment, we've taken away something that
the immune system needs to program its early development," says Dr. Rook.
Scientists aren't yet certain how
the process works, but they believe specific microbes switch on cells that then
suppress a reaction against allergens and beneficial bacteria. They point to
numerous studies that show that allergies and asthma occur less frequently among
children who:
·
have older siblings (think walking germballs)
·
spend time in daycare in the first year or two of life
·
have early exposure to pets or farm animals
·
live in rural parts of the country or in areas of the world that lack modern
sanitation.
The good news: The organisms that
babies and toddlers need to encounter in daily life to develop healthy immune
systems aren't the kinds that make us sick. Instead, the common denominator
among older siblings, daycare, animals, and rural environments appears to be
the largely harmless bacteria found in dirt, mud, puddles, and ponds.
The hundreds of antibacterial
products flooding the market each year -- in everything from hand gel and
soap to toys and even sneakers -- may be making the problem worse. "If
our past experience with overuse of antibiotics is any guide, these items could
do more than eliminate good germs," says Tufts University microbiologist
Stuart Levy, M.D., author of The Antibiotic Paradox. "They're likely to
encourage bacterial resistance to these products -- and to
antibiotics." Some of those newly resistant bacteria could cause illness.
Echoing Dr. Levy's concerns, the
American Medical Association recently urged government regulators to speed
their review of antimicrobial agents in consumer products to determine whether
they actually pose a threat. (Manufacturers of these products defend them as
beneficial, pointing out that they can kill or inhibit the growth of bacteria,
including salmonella and E. coli, that cause intestinal illnesses, skin
infections, and other unpleasant -- and in some cases fatal --
diseases.)
The alarm first sounded in 1998,
when researchers at Tufts University discovered that triclosan, the active
ingredient in most antibacterial cleansers, works more like an antibiotic drug
than a disinfectant. Instead of obliterating bacteria and then evaporating
(like bleach), triclosan blocks a specific enzyme that germs need to survive.
The trouble is, microbes are infamous for developing ways around such narrow
modes of attack. Triclosan also lingers on such surfaces as tubs and kitchen
counters for days, even weeks, which gives bacteria plenty of time to develop
resistance.
While critics counter that no one knows whether any of this poses a real
problem, many microbiologists believe that it's not worth taking the risk,
especially given that the only place triclosan and other similar products have
been proven to reduce the spread of illness is in hospitals, where workers
scrub their hands and douse surfaces for 5 to 20 minutes -- not the mere
seconds most people spend on such activities.
So what should you do to give
your child's immune system a head start, without going overboard?
Experts -- even those who aren't sold on the hygiene hypothesis yet --
agree that taking the following easy steps is wise:
Widen your circle:
If your child's not in daycare and doesn't have an older sibling, make sure she
still has lots of contact with other kids -- and their germs. You might
join a playgroup or sign her up for Mommy and Me classes once or twice a week.
But don't purposely expose her to people who are sick -- those are not the
type of bacteria she needs.
Don't relegate your pet to the
backyard It's fine to have a gentle pet in the same room with your baby. (But
not if your child's already developed an allergy to animals -- in that
case, isolating the pet from bedrooms, or even finding it a new home, may be
called for. Once an allergy develops, exposing a child to the allergen only
makes things worse.)
Head outdoors:
Because good bacteria are found in soil and natural bodies of water, families
who enjoy gardening, camping, a day at the lake, or trips to the country
shouldn't be shy about including their youngest one in the fun.
Stick with your tried-and-true cleaners The best antibacterials are the
old-fashioned ones, says Dr. Levy. That includes bleach water (one cup chlorine
bleach to one gallon water), cleansers (like Comet or Bon Ami), alcohol (either
isopropyl or ethyl alcohol), or hydrogen peroxide. It's also smart to open
windows to bring in fresh, clean air.
Recent warnings about the dangers
of triclosan have spurred new antibacterial cleaners and lotions labeled
"alcohol- and triclosan-free." But take care: These often use
triclosan's close cousin, triclocarban, a compound that is thought to work in
essentially the same way, so check the ingredients. If you must use these or
other antimicrobial products, do so sparingly -- only when cleaning up
after cutting raw meat or poultry, for example, or if someone living in the
house has a medical condition that leaves him susceptible to infection.
Don't encourage germaphobia: Of course, parents mean well when they disinfect
playground equipment or insist that kids stay away from yucky, dirty mud. But
doing so may pass on some unnecessarily scary ideas about the world. Instead,
try to give your child the freedom to explore his environment, then
matter-of-factly tell him when it's time to wash up. If he starts refusing to
touch things, washing excessively, or asking fearful questions about dirt and
grime, look hard at the message you're sending. It may be that in the end, the
best way to give our kids a healthy attitude about germs -- as well as a
strong immune system -- is by trying not to protect them too much.
Writer Jessica Snyder Sachs is the author of Good
Germs, Bad Germs: Health & Survival in a Bacterial World
(Hill&Wang/FSG) and Corpse: Nature, Forensics, and the Struggle to Pinpoint
Time of Death (Perseus/Basic Books).
