Germ truths
You’ve got to be strict about cleanliness, but sometimes a little ‘germ time’ can be a good thing, writes Georgina Guedes
A FRIEND OF mine once confessed that she had been “too relaxed” with her newborn. After the third or fourth visit to her paed to treat her son’s diarrhoea, the doctor sat her down and explained: “You do actually have to wash your hands and sterilise everything that might go into your baby’s mouth.”
After this tongue lashing, my friend set about doing all the things she should have been doing to keep her baby healthy. It was no surprise that his runny tummy never returned.
“All of us have germs on our hands, but not all of them cause disease,” explains professor Refiloe Masekela, a paediatric pulmonologist and head of department at the department of paediatrics and child health at the University of Kwazulu-natal.
“Many otherwise harmless germs can cause infection in small children, so parents should keep their hands clean. We all have some sort of colonisation from touching objects and other people,” she explains.
Babies’ immune systems are not equipped to deal with the germs in the world around them. We are all covered with millions upon millions of microorganisms, most of which are completely harmless to adults, but for babies they can cause tummy upsets or runny noses, as this new threat is just too much for their little systems.
“Our immune systems need to be stimulated to become resistant to viruses and bacteria,” prof. Masekela says. “Exposure builds resistance to that particular infection. When babies are born, their immune systems are less able to fight infection, and they then go through a process of getting better and better at doing so by simply maturing on their own and by learning
how to fight infection from exposure to different organisms.”
The best defence against infection is for anyone who might come into contact with your baby to wash their hands with warm water and soap. Fortunately, by six months, most babies have developed enough antibodies that this is no longer necessary – a good thing too, since crawling follows in short order, and gradual exposure to germs helps to build a baby’s immunity.
The other important way to limit exposure to germs is to sterilise everything that they might put in their mouths. This is a mammoth task; despite flailing arms and floppy necks, babies are very good at getting hold of and sucking on objects before their parents can say “gastrointestinal infection”. DECENT EXPOSURE It’s very important to keep small babies healthy, but it’s also vital for them to be gently exposed to microorganisms so that they can build their immunity.
A newborn’s first exposure to germs is from her mother’s body through the birth canal and her perineum. When a baby starts crawling and is chewing on everything she can get her hands on, wash everything well. You can let her sit on the grass or let her “play” with other children.
If you notice that sickness occurs after exposure, hold back on letting her run wild in the garden just yet.
“Some children get sick, others have no problems,” prof. Masekela says. “The basic message is, if your baby eats something that isn’t clean, take it away, but don’t panic. These things happen – babies eat sand – and it’s important not to be obsessive about what a child does or prevent them from being a child.”
At the same time, too much exposure can lead to chronic illness or secondary infections. If you notice that your baby is often ill, try to ramp up the preventative measures, and limit exposure for a time.
“Young babies are often bombarded with bacteria at crèche,” explains Sancia Breedveld, a Johannesburg-based homoeopath. “Because their immune systems aren’t ready, they get ‘crèche syndrome’, where they have constantly runny noses.” Many parents have no choice but to put their children in a crèche or daycare from a young age, but Sancia says the longer they can be kept away, the better. It allows them to gently build their immunity at home.
WHY BREAST MAKES A DIFFERENCE Breastmilk is a rich source of antibodies from the mother, which helps the baby fight infections. “Although formula milks are amazing these days, formulafed babies definitely have higher levels of allergies, mucous production and illnesses,” Sancia says.
“Breastfed babies borrow antibodies from their mothers, and their bodies retain the memory of those antibodies.”
Another benefit of breastfeeding is that if you fall ill, your baby will automatically get your antibodies to that illness from your milk and will be unlikely to get sick herself. Mothers with bottle-fed babies have to keep their distance when they come down with a cold or the flu and have to ramp up the hand washing.
THE GERM-EXPOSUREALLERGY LINK The connection between allergies and early exposure to germs is only beginning to be fully explored, but studies have shown that the greater a child’s exposure to “clean” dirt when they are small, the less likely they are to develop hay fever or food sensitivity.
There is increasing evidence to support the belief that this is because babies in environments that are too sterile aren’t exposed to enough germs for their immune systems to get the workout that they need to properly mature.
“One of the theories is that because people live in cleaner environments where their immune systems are not stimulated by bacteria or viruses, more and more allergies are presenting, because immune systems don’t have much to do,” prof. Masekela says. “Basically, if you are not exposed to bacteria, chances of an allergy are much higher – which is why babies with siblings [who expose them] are generally less prone to allergies.”
Some studies show that there is a marked reduction in allergies in children growing up on farms compared to their city slicker peers. Clean air and general healthy living of course play a part but so do the things – the substances and allergens – the farm children are exposed to.
Clearly everyone living in a city can’t have a cow in their kitchen, but they should try to expose their children to the outdoors and to animals after babyhood – or once they’re toddlers.
A BALANCING ACT
As with anything in life, keeping your baby safe from germs is about balance. You have to take into account what you know about your own baby, as well as general rules of cleanliness, and decide
THE GREATER A CHILD’S EXPOSURE TO ‘CLEAN’ DIRT WHEN THEY ARE SMALL, THE LESS LIKELY THEY ARE TO DEVELOP HAY FEVER OR FOOD SENSITIVITY
when and how much good exposure should take place.
Just remember that sometime in the first year, you will have to make the transition from the necessary hand washing to the acknowledgment that a little bit of dirt is certainly not a bad thing. THE DEVELOPING IMMUNE SYSTEM When is it safe to give your child at least some exposure to germs? 0 TO 6 MONTHS Your baby’s immune system is immature at this stage. Sterilise bottles, dummies and everything else that your baby might put in her mouth. Wash your hands frequently, especially after contact with foreign objects or other people. Keep her away from sick people.
6 TO 12 MONTHS Your baby’s immune system is starting to mature. Begin controlled exposure to different environments such as grass, shopping malls and other children. Ensure that all food is stored, frozen and defrosted properly. Bottles can be washed safely in the dishwater or with dish-washing liquid, water and a bottle brush.
12 TO 24 MONTHS Your child is well on the road to building her immune system. If she is still drinking from a bottle, a good clean with hot water is all it needs. You don’t need to worry as much about her dummies and toys – although you should still keep them clean, especially since she will be fairly indiscriminate with where she smears her food. She can play outside or with the family pet with no reservations, as long as you regularly deworm both pets and people in your household.
24+ MONTHS Your child, depending on her health, should have developed a stable supply of antibodies by now, but you still need to be on your guard when she is exposed to the general public and unknown sources of germs. YB