In Sickness and In Health

It's only been about a month since I started taking Tori to various story times and other structured play groups. While the benefits have been tremendous--Tori is getting socialized and is learning to play well with others, and is getting taught lots of cool new songs and stuff--there have been some side effects. Like the croup (which Tori is finally starting to get over).

Since we first went to our first story time only 35 days ago, Tori has had a nearly non-stop runny nose, at least one seriously bad cold, and now the croup. Charlie and I have both been sick as well, and I developed a bronchitis serious enough that it took two rounds of antibiotics to beat it back (I'm prone to lung stuff, being a lifelong asthmatic and a former smoker. Lung bacteria lurves me).

I realize this is pretty run-of-the-mill stuff for most people, especially those who have kids in daycare. Because Tori was pretty much sequestered from other kids until recently, she is only now starting to get sick (prior to this last month, she had one stomach bug, and one cold, in over a year). But since it's all new to me, I'm finding that I have a bunch of questions. First, is being sick actually good for her--does fighting off these minor illnesses help build her immune system (as I've been led to believe)? Secondly, is there any thing more I can do to protect her (other than keeping her home)? Third, what (if any) impact is her continuing breast feeding having on these illnesses?

I've always been pretty relaxed about her bacteria and germ exposure because I firmly believe that American society has become germ obsessed. Bacteria exist for a reason, and our obsession with killing them is causing major environmental problems. Bacteria are, after all, alive--and they want to stay that way. So when we beat them back with antibiotics, they fight back and become "super bugs" that are resistant to most antibiotics. Persistent use of antibacterial products in the home has the same affect. A study in 2004 by the Annals of Internal Medicine found that using those products in the home did NOTHING to decrease the number of illnesses the folks in the house had (think of all the money wasted on these antibacterial products--sheesh).

There is also a little something called the Hygiene Hypothesis. This theory holds that the massive increase in diseases like asthma are due to humanity becoming a bit too clean; that our immune systems don't have to work very hard anymore and we are therefore becoming ill more easily. This makes a lot of sense to me, based on personal experience.

When I was an infant, I had asthma. This wasn't all THAT long ago (not quite forty years)--and asthma was so incredibly rare then that no one was willing to diagnose me with it. Even though I started suffering asthma attacks when I was not much younger than Tori is now, I didn't actually receive the label of "asthmatic" until I was five. In school, my asthma was ignored and dismissed by nearly everyone--even my teachers--until I would wheeze so hard that I couldn't stand up. It was a new disease--and that was in the 1970s. Now, nearly 5% of all Americans are now diagnosed with asthma. 

I don't know about you, but that's pretty overwhelming information right there.

Hygiene Hypothesis suggests that children, in particular, benefit from exposure to both bacteria and allergens. Farm children are far less likely to have hay fever and other allergies than city kids. In a wild touch of irony, kids in countries that routinely get intestinal parasites NEVER get irritable bowel disease or Crone's disease. Younger children in large families tend to develop fewer allergies than other kids, possibly because of the bacteria exposure they get from their older siblings.

So if you buy into the Hygiene Hypothesis, Tori is going to ultimately benefit from being sick now, even if I hate it, and she is uncomfortable. Truth is, Tori doesn't get all that sick when she's ill, and never stays sick for very long. The virus that gave me the bronchitis only lasted two days for Tori. The stomach flu that caused Charlie to vomit over 70 times in three days made her throw up only once. Personally, I believe that breastfeeding is one of the reasons why Tori is able to combat these illnesses so easily, and this article here agrees with me (in fact, that article claims that "premature" termination of nursing can make kids sicker, which could explain my asthma since my mother--like so many moms--was only able to nurse me for a few weeks. I mention this not to make moms feel bad--I promise--I just found it interesting personally). However, Tori's buddy Sam who lives two doors down from us is also still nursing (at two) and he's been chronically ill with various ear and respiratory ailments his whole life (and his mom is vegan and pretty healthy herself). So, basically, who fucking knows? It seems like a crap shoot.

The last point I want to consider is this: how can I help Tori's immune system more? I hope to keep nursing her until she's at least two (I'm going to try--my constant migraine battle may interfere), but what else can I do?

Ironically, lately we Americans have come to embrace some bacteria--the bacteria that lives in yogurt. Of course, no one calls that bacteria; we call it "live cultures" and "probiotics." But no matter how you slice it, it IS bacteria--but good bacteria. This bacteria actually helps your intestinal track provide you with immunity. There are lots of new products out there capitalizing on this trend, and even Moxie agrees that probiotics can help a number of ailments and overall health (and we all know that Moxie's word is law). We do try to give Tori yogurt daily (she likes the "tubes" which I can cut a teeny tiny hole in and she can toddle around sucking on), but she doesn't always want it. Moxie suggests using unsweetened Kefir, and I might try adding some of that to Tori's milk.

What about vitamins? We haven't been giving Tori vitamins. It appears that the experts don't agree on the vitamin issue, but most agree that as long as they aren't too high-test they can't hurt. What about herbs? Sites like this one suggest that herbs such as echinaceia and others can help boost Tori's immunity, but I don't know. I use herbs personally, but since they aren't very well regulated and some herbs have been found to have both much higher and much lower chemical elements in them than the bottles claim, I'm not sure how safe it is (I know there will be plenty of you that know of some brand of herbs that is really! truly! safe! but still).

One lucky stroke of fate that may help Tori's immunity in the long run is that she has not yet been exposed to antibiotics (other than what may have filtered in through my breast milk). That's not due to any line in the sand we drew or anything, it's merely the luck of the draw and the fact that Tori has not been sick enough--yet--to need them. That's apparently good news, though, since recently a link between antibiotic use and asthma has been found. There is also little doubt now that antibiotics also kill off the "good" bacteria in our systems (that's why we women always get a yeast infection when we take antibiotics--I've always been able to fight this off by eating yogurt every day I take any antibiotics), and the lack of "good" flora and fauna in our intestines can decrease our resistance to viruses.

Ultimately, I have no more answers after reading through all of the links I provided above than I did before. I do feel like my basic instincts are correct, and I can list things in good and bad categories. "Good" being probiotics, extended breastfeeding, vitamins, and basic hand washing in soap and water. "Bad" is (unnecessary) antibiotics and anti-bacterial products*.

So I guess I will mostly continue to go on as I have been. The only things I plan to change is to put more effort into keeping things out of Tori's mouth (the toys at the library--yikes), washing her hands more, and adding in a daily vitamin and more probiotics. Other than that, I guess Tori is just going to have to spend some time being sick.

Next, working on my own immunity issues so that I don't need two courses of antibiotics to get over a serious bronchial infection. Sigh.

*You will note that I did not bring up vaccines. That's because I don't want to talk about them here. If you feel like you must discuss them, do it kindly and without judgment. I do not want a vaccine war here, please, I'm begging you. If we can be civil about abortion, surely we can be civil about the whole vaccine issue. And if you are wondering, yes, we vaccinate. But I have no feelings WHATSOEVER about whatever decision you've made on that issue. M'kay?

Comments

[Jenni]

My theory - the immune system - us it or lose it. And if she didn't get the stuff now she will eventually. She can't live in a bubble. On the bright side things slow down after a while one she gets better at fighting it. And then you'll have it over with!

It is a crap shoot. A crap shoot with lots of blame that can be thrown at the mom, something I am sure you'd be talking about if Tori was in daycare.

I am on the same page with you about the hygeine hypothesis. But that hasn't stopped my little man from having allergies to something and some asthma symptoms, no doubt inherited from the husband and I.

After we debate vaccines can we debate circumcision?! Just kidding :)

[Maria]

We just do the basics--hand washing with soap and warm water (sing Happy Birthday 2x while you scrub). I avoid hand sanitizers unless I've got no other option. Nurse as long as you both want, I'd say. Doesn't the WHO say 2 yrs? My son just started preschool, and he's been sick much less so far than the year he started daycare.

[ellemenope]

From my own personal experience, my kids have grown up around livestock: we have horses, used to have goats, have chickens, etc. And they were always eating dirt and I am sure in some way shape or form some gross stuff ended up in their mouths after horseback riding or goat milking, gardening or egg collecting. The result? My kids are almost never sick. My brother's kids on the other hand are the product of my SIL's obsession with making sure everything is spotless -- almost Howard Hughes like. She scrubs everything, all the time. Their result? Their kids are always sick -- once even to the point of hospitalization with ecoli. To me that shows the "build up the immunity by eating dirt" theory :-)

[jax]

My mum, a retired nurse, always says that air is the best healer!!!! She does tend to exaggerate a wee bit BUT on many levels it's true (although probably not if you live in a highly polluted environment) What I do suspect though is that air conditioning and on the other side poor ventilation in homes attributes to poor health.

[Kermit]

In cleaning, I use the natural antibacterials -- good old tea tree oil, grapefruit seed extract, and lavender oil. The latter are pricey but each batch of cleaner needs very few drops, so it lasts quite a while.

We are very into handwashing -- and when I'm running around all day, we use hand sanitizer. I'm working through a developed phobia of vomit and vomiting, brought on by two hospital visits brought on by stomach flu. (Reading about Charlie vomiting SEVENTY TIMES is a horror story to me.) I've been using the products, hand-washing, and sanitizer for the past year, and it's been a healthier year for us (the hand-washing alone would account for most of that, I am sure).

The best I can do is expect a superbug, prepare the best I can, and take steps to make sure I don't contribute to others developing. I love these natural cleaning products, because they are cheap, smell great, and the worst thing in them is borax.

I also nurse for at least 18 months. My formula-fed son had more allergy and breathing problems than the breastfeeders. Anecdotal evidence again, but it's my own and it's what I witnessed.

[Celeste]

I think you are overthinking what you may actually be able to control.

Age 18 months to 3 years was when my daughter had her greatest amount of colds. I think it is because that age child is just a natural home for bugs--they put their hands on everything, they put their hands in their mouth, they don't cover when they sneeze or cough on each other, and they can't really tell you they are becoming ill so you can keep them away from other kids. You do develop an eye for it, though.

I know of no proof that it's good to encourage viral spreading or try to prevent it. With a child her age, it seems to be just a part of life.

I think you can drive yourself crazy in prevention methods. JMHO. I also know it's no fun when they are sick.

I'm not sure croup is contagious, though. I think it's just something some kids get. Mine was in daycare 50 hours a week and never once had it, for example.

[Greta]

When I was born I only had one vein and one artery in my umbilical cord. You are supposed to have two arteries. As a result I had almost no immune system as a child and was extremely prone to illness. I also had asthma until I was about 11 years old. My doctors told my mom that the best thing for me (once I was past infancy) was NOT to restrict my activities in any way - because being outside and being exposed to germs was the only way to strenghten my immune system.

[Geohde]

Ah,

No matter how good a kids immune system intriniscally is, this is the age at which they get exposed to everything for the first time. Kind of immunity school 101. The more bugs the better. Even children of school age get at least twelve seperate colds a year.

:)

Just stock up on the kleenex and be prepared for the lot of you get get more colds!

[Kayla]

My son was breastfed for 20 months, and was really overall pretty healthy until about month 9 or 10, and that's when the ear infections started. He has such SEVERE reactions to an infection of any kind, we're talking 105 fevers for a cold. His little immune system over reacts to everything, like mosquito bites cause huge, red, hot, welts the size of his fist to spring up. He has been on lots of antibiotics for the ears, and while I would rather avoid them if possible, he needed them. He's never had any that weren't warranted, and I want to keep it that way. I just have to wonder if his immune responses are due to the antibiotics given almost monthly from 9-15 months. Sigh.

[AmyinMotown]

I'm not really a firm believer in "get her all germed up, it's good for her!" after having a traumatic experience right before Christmas last year (high fever, truly awful urgent care visit, very sick little girl). Maggie had RSV at seven weeks old and that was one of the worst times of my whole life--I wish I'd been more vigilant about people touching her. It's a cold, somtimes a minor one, to adults but can be really serious in teeny tiny babies. We were lucky that she wasn't that sick, but she did have trouble breathing and it's very common for kids to get hospitalized for it.

That said, I don't think it's a good idea AT ALL to get too anal about germs especially after they are 1 year old. We enforce handwashing, but just use normal soap, and she kisses the dog on the mouth and so on. She was sick ALL THE TIME last fall--we spent the entire month of October either sick (both of us) or injured (me). So far this year it's been much better, I think because she has exposed to everything last year.

My friends who are teachers tell me they get sick like crazy the first two years and then hardly ever again--same with kids in daycare.

[Kate]

One more way anti-bacterial products suck:
Last year when buying a house, our home inspector pointed this out, and I'm not sure why I hadn't connected it before, but septic tank problems have become extremely prevalent since the increase in popularity of anti-bacterial products.
He urged us to never use anti-bac hand soap because it kills good bacteria as well as bad, and it doesn't stop once you wash it down the drain. Since the septic tank system operates on keeping bacteria happily decomposing the waste, when you kill them off, suddenly your tank can no longer contain the, uh, "products" of your household. Ick (an expensive ick).

Your post just made me think of that, and I thought I'd share...

[Spacemom]

Quick repsonse-

Both kids went/go to daycare.
One ended up in hospital with dehydration from a rotavirus.

HOWEVER, once they hit their second birthday, they have rarely been ill.

Our pediatrician says "I either see them young, or when they start kindergarten"

We live on the eat dirt theory. If they eat dirt and live, eh, they'll be fine!

[Michelle]

Parenting is tough!

I don't really have any advice...my kids have always been in daycare and they rarely get sick. I think we're just lucky when it comes to that.

I hope your little one gets to feeling better soon.

[jeanie]

Okay - just reading the comments triggered one of my all time phobias - NEVER LET A DOG LICK YOUR FACE OR MOUTH - there have been epidemics of hydatids in the past.

While the "get em germed up" theory works great, there are some real nasties out there, so don't go out of your way to find them.

At this age there are more colds as someone above said - as you have less control over their hand/mouth thing anyway.

Just keep a close eye on any colds and make sure that she doesn't get too stuffy - and if she does, invest in a vapouriser - because ear infections are truly yucky!

If you thought croup was bad (from another veteran of the "my child is dying, get to emergency" brigade here), ear infections will make you believe your child wants to die from the pain. Go the pink medicine - and yoghurt. Oh - BTW - some "kids" yoghurts - fairly high in sugar. Just saying.

[Natalee]

I'm having to try and build and immune system as an adult, since as a child I was perpetually ill and on antibiodics. Part of this problem is/was my asthma. The steroids that are in my inhalor, and that I have to occasionally take orally (usually during a bronchial infection, just to breathe), are immuno-suppressors. Compounding my problem is my genetic issues-I have both rhumetoid arthritis and endometriosis, both of which are auto-immune disorders. Oh, and I'm (deadly) allergic to penecillan.

Once all of this data regarding antibacterial use contributing to the "superbugs" out there came out, I made a conscious effort to try and curb what I could. I do use anti-bacterial soap in the home, but I'm not the obsessive germ-freak handwasher I once was. I also don't run to the Dr. at the first sign of a cold. I try to ride everything out as long as possible, before seeking medical treatment. Thus far, my experiment seems to be working. In the past month, both a cold and stomach flu have circulated at work and to various family members. I was the only one who did not fall ill.

[RainbowW]

all i'll tell you to do is clean your nipples regularly.

or, if you want to be family-oriented about it, let charlie do it. that might be fun.

[Julie]

According to my SIL (who is a pediatrician) and my own ped - it's either now or later. Kids are going to either build their immune system very early through interaction with other children (usually in day care) or later - in kindergarten.

I agree completely that we have become overly concerned with germs and bacteria. Hell, Dylan hides pretzels under the sofa/chairs, etc. and munches away whenever he finds something. First time I almost died but my house is clean - if he doesn't mind a few cat hairs - why should I.

Oh, and studies have also shown that children who live with pets have less allergies :)

I don't think giving herbs is a good idea. Her immune system should develop naturally. Just because something is "herbal" doesn't mean it's safe.

Dylan's first year in day care - I was sick all the time. I've noticed my immune system has improved right along side of his.

[Jo-Ann]

You know how often the kids were sick in daycare. A only went to daycare for 2 months! I have to say as a 4 year old R is RARELY ever sick. I think it is a combination of exposure and the fact he nursed till be was almost 2.5. The kid has not had antibiotics in almost 1.5 years. When A had foot and mouth disease R hardly got any symptoms.

A only went to daycare for 2 months. He has gotten sicker more often these 2 past winters. He didn't have it all concentrated all at once. He gets things easier than R but is starting to enter the age where he is sick less. We have not been to the pediatrician for a sickness since June.

I think getting over the sickies at this age is easier. My sister always says that the more they are exposed young the less they are sick older. It has been true for her kids and it is true so far for mine.

I have been getting sick less since I started handling people's dirty glasses all night. When I used to work at the bar I was almost never sick. At the office I was sick more and now that I am back at the bar I am hardly sick again, and I get so little sleep.

Could Tori's runny nose be seasonal allergies? Pediatricians can tell looking in the nose and the color of the mucous membranes. I know for Aaron and I fall is the worst and he takes Claritin daily and does much better.

Good Luck in whatever decision you make

[-erica]

Yes, ditto what Julie said, there is a study that says that children who grow up with cats and/or dogs have less allergies. Which makes me feel good about my own dog/cat ownership. HOWEVER, I grew up with NO pets because my father has bad cat-induced asthma - the very same father who grew up with dogs around the house. He grew up with pets but is allergic; I grew up with none and I am fine. My family is a direct contradiction to that study! So I suppose the moral is, do what works for you...!

[Amy]

Yes its helping her. Stinks for you though.

[electriclady]

I don't have any advice to offer but just wanted to say that I've been thinking about this a lot lately--my husband (SAHD) has been wanting to go back to work part-time, so we've been talking about putting our 8-month-old in daycare two days a week...just in time for cold and flu season. Not sure how comfortable I am with that.

[Miss W]

Because my son was born at 29 weeks gestation, I have two minds on this. While on the one hand, I think Americans as a whole are over-medicated, overly cautious and generally causing themselves to be unable to survive in the world as it actually exists -- I also had to learn that even the most innocent of illnesses could spell huge danger. At nearly 2, it's not the danger it once was, but it's hard not to see monsters lurking in every corner, ya know?

Our rules are that we wash hands regularly, never share toys that have been in someone else's mouth (he can play with public toys, but not if I saw it in someone else's mouth and not anywhere near his mouth, hands washed immediately after), no accidental sips from someone else's cup, binkies don't go back in the mouth if they fall to the floor or the sucky part has touched a table in public. We also don't allow playdates with kids who have runny noses, cold symptoms, etc. (Adults with those symptoms have to exercise caution -- no holding, no sharing food/drinks, cover that cough, etc.)

And that's since we relaxed our standards!

[Laura]

one thing to keep in mind with the hand sanatizers are kids put their hands into their mouths. the hand sanatizers are mostly alcohol and a few kids have had to be rushed to the hospital with alcohol poisioning.

as for breast feeding my son lasted 6 months (he was a biter)my daughter 13 months and i got sick had pneumonia and the worry of crossing steroids to her caused my dr to force me to stop. Had i known then what i know now i would have pumped and dumped for a couple weeks as it was so traumatic for her.

we had bouts of daycare illnesses when they were young and i did many trips to the ER with my son for the croup it is very scarey so i totally understand. my kids are now 19 and 15( or almost 16 as she says) both are healthy and happy and we did not over protect them ever against bugs or normal childhood illnesses. of course we treated ones that were out of control but thank goodness i had a peditrician who absolutely used antibotics as a last resort.

keep on doing what you are doing you sound like a great mom and i do enjoy your blog
hugs Laura

[Lisa]

Not to get too graphic but since I started taking acidophilus and cranberry supplements depending on the occasion, I haven't gotten a yeast infection or a urinary tract infection (for about three years). If you think of things as a delicate balance, and you take acidophilus or cranberry depending on the symptom, it works way better than taking prescription medication which never really worked for me and always just ended up causing more problems.

[chrystal]

I am still breastfeeding at 23 months. My wee one has been in day care since 5 months. I don't think the bf has totally protected her from getting sick, but I believe it has minimized the illnesses she has had.

She got RSV and a couple of rotaviruses last year, but she wasn't an infant at that time so that may have played a part in her not being as affected as a 3m.o. would be. When she has been ill and stops eating solids, she has always breastfed. Some of her classmates have made trips to the hospital for oxygen or dehydration. But I never seriously worried since she has always taken the breast during her food strikes.

Maybe that's naive of me. I'm only working with a sample of one.