An update on Annika is coming, but meanwhile I have gotten caught up with some wonderfully provocative comments made on my seemingly innocuous (and badly titled) about rings and things
post below. First, Andrea
noted, "But--aren't those little antibacterial thingies supposed to be the tools of the devil or something?" That's exactly why I read her every, single day: she is absolutely unhesitatingly putting herself out there, and pulling no punches. I posted a longish reply to her comment, basically saying I had heard no such talk of satanic activity swirling around the Purell business, but that I would be sure to check the bottle for any sign of a moon and stars
. I did mention a study, though, and didn't give a link. So here's a report on the study showing hand sanitizer decreases incidence of tummy bugs
, an old college buddy and also an extremely smart and kind guy, questioned my unbridled enthusiasm at the proliferation of hand sanitizer in our world by bringing up the hygiene theory of allergies and asthma. Basically, this theory supposes that the noted increase in allergies and asthma in developing countries is due to our increased concern with hygiene and more frequent use of antibiotics to treat bacterial infections. Thus, the immune system is left with nothing to do and goes a little stir-crazy, eventually beginning to attack our own cells rather than those of harmful foreign intruders, leading to allergies and asthma. I posted a reply to his comment right away, but then couldn't stop thinking about what he had said. So I began to write another follow-up comment, which eventually became long enough that I decided to make it its own post instead.
The first thing that I neglected to say to Mike in my quick response was that I was sorry to hear about his as-yet unidentified allergy. Allergies are not to be trifled with, and I hope he is now armed with an epi-pen.
Let me also say up front that I do believe that messing about with the immune system is likely to lead to allergies. There is new work being done in the transplant community showing that kids on immuno-suppressive drugs tend to be much more prone to developing violent, life-threatening allergies. I know of one little boy in particular who seems to be allergic to damn near everything, and I do mean everything. It's a nightmare. So I don't want to pooh-pooh the role of allergies in people's lives. And it seems reasonable that cutting down on the immune system's work, either artificially by drugs or by simply living in a cleaner environment and giving antibiotics to treat bacterial infections, seems a good theory to account for higher rates of allergies.
But here's the thing:
Some of the countries with the lowest incidence of allergies/asthma are in the developing world, where infections and parasites during childhood are rampant. Now, I have no doubt that children who contract these parasites/infections and fight them off on their own come through with stronger immune systems and smarter immune systems (i.e. immune systems that know better than to attack themselves, as is the case with allergies). But, geez louise! The rate of childhood mortality in those countries? Pretty high.
It seems likely that if our children are exposed to many of these infections that we now shelter them from, that there will be quite a few children coming through with stronger, smarter immune systems. And there will also be a sizeable group who dies, either from a weaker immune system than the survivors or from the bad luck of being exposed to a more virulent strain.
I guess my view is biased because I am the mother of one of the acknowledged "weak ones." But I'm just not sure that this approach is one that we would want to take as a society ("let 'em get sick and the strong and lucky ones will survive and be stronger for it..."). Maybe I'm straw-manning the opposition here. I don't mean to. Feel free to make a compelling argument the other way. I'm truly interested in thinking about this a bit more.
Here are some other caveats to the hygiene theory that I came across in my quick reading:
1) The correlation between more infections and lower rates of allergies/asthma only
holds for the first 6 months of life
2) The hygiene theory does not explain why there has been a rise in allergies/asthma in poor, inner-city environments, where the hygiene theory predicts there should be lower rates
3) a new study
suggests that the observation that children born as second/third/later siblings show lower rates of allergies/asthma may be due to the mother's changing immune system with each successive pregnancy, rather than the supposition that later children are exposed to more bugs thus making them less likely to develop allergies (the hygiene theory)
4) Some of the earlier studies on the hygiene theory have been criticized as flawed as they often rely on self-reporting questionnaires and may suffer from faulty set-up. Here's one such report of a study
, along with the noted criticisms.
Also here is a general overview of allergies, the hygiene theory, and alternative hypotheses
I suppose that, as a parent of a post-transplant child, I am too used to looking at life as a series of gambles and trade-offs. So when I hear that washing hands frequently, which is certainly and demonstrably beneficial to one's health, may also lead to later allergies and asthma, I tend to fall on the side of choosing to take that risk in order to avoid what I see as the greater risk to my child's health (including Frankie, not just Annika).
I had heard of the hygiene theory before Mike mentioned it, but it's worth noting that I always read it in the context of "working moms shouldn't feel guilty for sending their children off to daycare, where they will be exposed to more germs than the infant of a stay-at-home mom." This, I think, is really the most useful approach to take on the hygiene theory. Decreased hand washing would be the wrong action to take in response to this theory.