Children don’t come with user’s manuals. But every mom comes home from hospital knowing that she should sterilise things that go into her baby’s mouth, and get people to wash their hands before touching her baby.
Everyone agrees that this is a good starting point. But it’s the next steps – slowly starting to expose babies to an unsterile world – that cause a lot of confusion and concern. We’ve all heard of the hygiene hypothesis: the idea that as we live in cleaner environments, our immune systems target harmless substances because they’re not fighting viruses, bacteria and parasites.
The argument is that the more ‘good dirt’ children are exposed to, the better for their lifelong health. So when and how to start this? “The hygiene hypothesis is debated in medical circles, but there seems to be some truth to it – if the immune system is not busy fighting off bacteria, it switches to allergens,” says Dr Deon Smith, a Cape Town paediatrician.
He suggests that when babies start to crawl and put things into their mouths, let them – obviously within reason. This slow exposure to dirt will help them to build up stronger immune systems that target the right infections later in life.
“Babies are born with a healthy dose of their mothers’ antibodies. But because these aren’t their own, they slowly leave the body, until at about six months, they’re gone,” says Dr Smith.
From this point, your baby must start to build her own immunity through controlled exposure to her environment. However, Dr Smith advises that sick people still be kept away from your child. If possible, the child should be kept away from a playschool or crèche until she’s two years old when her immune system is more mature.
“Obviously, this isn’t always possible, but as a best-case scenario, this is what’s best for the child,” he says. “They’re most vulnerable to infection between six months, when they no longer have their mother’s immunity and 18 months, when their own systems start to mature,” Dr Smith explains.
Keeping them at home can help prevent ‘crèche syndrome’, where babies constantly have runny noses, as their immune systems battle to deal with the host of infections with which they are being bombarded.
Dr Smith also points out that the younger the child, the worse she copes with an infection. “If children that are under a year old have a snotty nose, it will have a big impact on their lives – their sleep; their ability to eat. They’ll battle to clear secretions in the chest and nose and are more likely to end up at a doctor or physio,” he says. “The same infection in a two-year-old will have minimal impact. So, aside from worrying about their immune systems, consider how a small baby is going to manage being ill.”
A timeline of cleanliness
Babies born before 34 weeks of gestation haven’t received the load of antibodies from their moms. They’re particularly vulnerable to infection. Parents should be diligent about hand washing, sterilisation and banning visits from small children or sick adults.
0 to 6 months
6 to 12 months
12 to 18 months
18 to 24 months
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