A slightly odd aspect of life these days is that despite the fact that we are in the middle of a viral pandemic, for many of us our kids have been much less sick in the last couple of months than usual. My kids are not seeing anyone else, so we have not had our usual complement of vomiting, fever, runny noses and the such. (We did have pinworms; apparently, they have a long incubation period. Also, they are SO GROSS. I digress.)
This is good in the sense that I think if I have to deal with vomiting it will push me over the edge, but a number of you have written to ask me whether this might be problematic. Is the lack of germ exposure hurting our kids?
There are a couple of sets of theory or data people are drawing on in developing this question. The first is what is called the hygiene hypothesis. This is the idea that exposure to dirt and microorganisms protects against allergic diseases through contributing to the immune system development. In practice, there is a lot of debate about whether this hypothesis is a myth or not.
But even if it is not a myth, this theory isn’t really about exposure to illness as much as exposure to dirt. And your kid can easily eat dirt alone. Trust me, I know. And our data on avoiding allergies — at least food allergies — increasingly suggests the value of early exposure to allergens (not to dirt) in avoiding them.
The other relevant piece of data here is on illness among young kids at day care versus home. I write about this some in Cribsheet. In discussing the choice between day care and home-based care (a nanny or parent) I note that kids who are in day care get sick more often (there is much data to support this; see one example here). However, they also seem to get sick less during elementary school. The higher illness burden at young ages seems to translate to less illness later.
In terms of relevance to our current situation, this evidence seems pertinent. If you have a toddler who would otherwise be in day care, they are likely “missing out” on some illnesses they would get and, yes, it is possible that this could translate to more illness later in childhood.
However, I think it would be a mistake to freak out about this. For one thing, although this feels like it has been and will be forever, it probably will not be. Kids will start to return to day care, if not in the next month then likely within the next year. It’s not avoidable. And even with the extra precautions, they’ll get some of the common colds they would have gotten anyway.
Second, the data which shows lower risk of illness in the elementary school years shows that illness rates equalize in middle school. So even if your child misses out on the toddler viruses, the elementary school viruses are coming. And to be completely honest, it is somewhat easier to deal with a sick eight year old than a sick 18 month old, mostly because they have a longer attention span for TV.
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