Dr David Bratt
One feels for some modern mothers. Buffeted by advice from family, friends, tanties, nurses, milk companies, the old lady from down the street and that enemy of children, social media, she is encouraged to talk to the baby before birth but not to pick up after birth.
She wonders whether to “spoil” or not to “spoil”, to breastfeed or pump and “in case” give formula, let it cry, don't let it cry, sleep with the baby, do NOT sleep with the baby, put it in a crib, buy a monitor and stay up all night listening. The baby must sleep on its back, the baby must sleep on its side, no bumper pads allowed these days, the baby must sleep a daily total of 21 hours at six weeks, and 17 hours and 40 minutes at five months, don't let anyone near the baby until it's got its first shots, take the baby out in the sun if it jaundice, no, give it vervine, give the baby water, no, don't give the baby water and one of the worst, put it on the floor, no, never put it on the floor, it go get germs!
Given all that, and more, and the usual post-partum come down from the excitement of “I pregnant”, to the reality of living with a creature who, most of the time, seems quite uninterested in your feelings, added to the usual anxiety and stress of life in T&T (see last Sunday's Guardian editorial), is it any wonder that some mothers end up uncertain of their ability to care for a baby?
That germ thing is new. It wasn't around 40 years ago. Perhaps it's the influx of poorly trained doctors taking care of children these days that are responsible or at least their inability to soothe maternal concerns. Concerns that appear to predominate among local moms, not the occasional foreign ones I see. One of the pleasures of seeing foreign mothers is that their babies are never overclothed and as soon as they are put down they start crawling all over the office floor. They know about floors and germs.
It's been known for many years that the decrease in common infections in babies has been accompanied by a concomitant increase in allergies (eczema; allergic rhinitis or “sinus”, asthma; cow's milk protein allergy etc), in those babies. The “hygiene hypothesis” explains this. It suggests that a lack of early childhood exposure to infectious agents, common ordinary germs and worms and so on, increases susceptibility to allergic diseases by suppressing the natural development of the immune system. It seems that a young child's environment can be “too clean”. The baby's immune system needs to bounce up some germs so that it can learn how to respond appropriately during the time when the child's immune system is maturing. In other words, it needs to go to school early so that it learns how to behave in times of need, ie, develop an inflammatory reaction aimed at destroying the germ.
This need is so inbuilt and strong, the immune system will make its own efforts to develop, by locking onto allergens, instead of germs, and overreacting. This inflammatory overreaction is known as an allergic reaction and it causes disease.
More evidence of the need for germs in the life of a baby comes from the recently described “unified theory of leukaemia” by Prof Mel Greaves, of the Institute of Cancer Research in London. This claims that it's our modern germ-free lifestyle, particularly our high level of cleanliness, that contributes to childhood leukaemia. It appears that some children are born with a relativity unstoppable genetic anomaly that takes place inside the womb. A lack of exposure to germs in the first year of life fails to teach the immune system to handle threats properly. This sets the stage for an infection to come along in childhood, cause an immune malfunction and leukaemia.
A little illness might go a long way in preventing something more serious.