On Call: Do Kids Need to Eat Dirt?

Is the idea correct that children have to “eat a little dirt” in order to build a strong immune system? Dr. Joshua Potter is looking at it in his column this week.

Growing up, my best friend was happy to tell me that the reason I was sick all the time and he never seemed to have a cold was because my parents didn’t just let me be a kid like him what apparently had to do with eating filth as a toddler. His argument was that it took constant immune system challenge to grow strong and healthy, and that over-education had robbed me of that opportunity.

Recently, this concept was unveiled in the context of the Covid-19 pandemic and our efforts to combat it with measures such as masks, hand washing and social distancing. The Centers for Disease Control reported last month that the number of influenza infections in the United States was just over 2,000 for the 2020-21 season – compared with over 38 million reported cases the previous year.

Certainly such a drastic drop is a good thing, but does this level of protection mean our children are missing out on necessary immune challenges in the form of everyday colds and common viruses that would help them develop some kind of sustainable development? Immunity and protection?

On the one hand, the thought is tempting and perhaps has some justification. A study by Hullegie et al. studied children in day care centers in the Netherlands and was published in Pediatrics, the journal of the American Academy of Pediatrics, in 2016, showed an association between daycare attendance in the first year and an increased number of acute gastroenteritis infections (stomach bugs, typically viral, causing vomiting and / or cause diarrhea).

It is important, however, that this group also seemed to have a relative protection against the pathogens of these diseases, and this lasted at least until the age of 6 on microorganisms waiting in the dirt of playgrounds and on the snot-covered tables in classrooms to find.

However, as in most aspects of medicine, the answer may not be that cut and dried. Note that in 1900 pneumonia and flu, tuberculosis, and enteritis with diarrhea were the leading causes of death in the United States. These are all infectious causes of disease caused by various viruses and bacteria, and at the time, children under the age of 5 accounted for about 40 percent of all deaths from these infections. In 1915, the first year such data was published, infant mortality was around 100 deaths per 1,000 live births, a staggering number that fortunately seems almost impossible to pin down in a First World country today.

What led to the dramatic, world-changing decline, of course, was the development of modern medicine: the knowledge of the germ theory and the simple meaning of hand washing, the ability to treat pneumonia and tuberculosis with antibiotics, and the ability to protect yourself from some of the more virulent forms of infectious diarrhea in childhood with things like vaccinations for rotavirus.

The recent Covid-19 pandemic puts this question in sharp context, as many have argued that the overall very low disease and death rate among children means they should be allowed to live their lives and should not be locked away for fear of contagion. This should be mitigated in light of the fact that some of the children who get sick get very, very sick with multisystem inflammatory syndrome and some of them die. When we venture our children into the world, we may not know which encounters with microorganisms are relatively harmless and lead to increased immunity and the potential to be devastating.

Fortunately, medicine has advanced to the point that health care providers can often distinguish between the two and therefore determine when the incredible human immune system is supposed to work its miracles and fight a disease, but there are times when it is so very difficult between the two distinguish the two, especially during a pandemic like the one we saw last year.

So I tend to be moderation and try to give my children the freedom to wallow in the dirt and play with snotty friends in most situations, but make up for that with regular medical checkups, routine vaccinations, and increased vigilance in times of outbreaks where the Knowing for a long time that masks and hand washing can help keep them alive dramatically increases the likelihood that I will no longer have to suffer the same concerns of a parent 100 years ago.

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Joshua Potter, DO, heads the Shelter Island office of the Meeting House Lane Medical Practice at Stony Brook Southampton Hospital. He specializes in family and neuromusculoskeletal medicine. The opinions expressed in this column are his personal and professional views and not necessarily those of his employer.

source https://dailyhealthynews.ca/on-call-do-kids-need-to-eat-dirt/