Four days after we arrived in India, Maya came down with what seemed like a cold. She had a little fever on the first day, but not after that. Two weeks later, she continues to have a unabated runny nose. During the night, her breathing is a little ragged sometimes, especially if the fan is on, but quite normal at other times. We suspect what she has is more an allergic reaction than a cold, though friends here have colds that seem to last a month. We’ve been careful about boiling filtered water before giving it to her and so far she has not suffered any stomach disorders. One of my fears about bringing her to India was her developing breathing problems or skin conditions as an allergic reaction to the more polluted and dusty air. One of our friends had to hospitalize their child after she developed severe allergic reactions. When I had to cancel a social engagement because she seemed to be bothered more than usual by her cold, they commented that this was common, that their grandchildren all went through some allergic reaction or caught cold when they came to India from the US. One of them was even being treated with Ayurveda as the western counterpart was considered to be non-conducive.

One common folk wisdom is that children growing up in US’s sterile climate are less prepared to deal with the plethora of allergens and microbes that populate India. Shanthala pointed out an article in today’s New York Times titled “Babies Know: A Little Dirt Is Good for You”. The article alludes to what is called the “hygiene hypothesis”, a hypothesis first formulated in 1989 by a British professor of epidemiology, a hypothesis with a comprehensive entry in the Wikipedia. According to this hypothesis, now considered to be well supported by data, a lack of exposure to infectious microbes and symbiotic microorganisms in early childhood leads to a compromised immune system, a system that can’t differentiate between harmless agents such as pollen and harmful ones such as mycobacteria and so reacts to pollen producing an allergic reaction.

People of the new world were wiped out by diseases carried by the old world invaders, diseases to which they had no immunity. White settlers to the US deliberately and systematically sold small pox infected blankets and clothes to the native Americans, thereby wiping out broad swaths without firing a single bullet. Jared Diamond explored and exposited the reasons why Spaniards invaded North and South America and not the other way in his Pulitzer Prize winning book “Guns, Germs and Steel” (Paul Shepard walked similar ground but with a more incisive and unwavering commentary, see his Paul Shepard Reader for example). One of the theories he espoused is that with greater domestication of animals in the old world, people there developed better immunity and to more diseases compared to the new world where domesticable animals were far fewer.

Senses in infants is equal to the adult counterparts between three to six months. As adults, sight is our most advanced and used sense. So why do infants put things in their mouth ? The NYT article also postulates that infants and toddlers explore the world by putting things in their mouth because it provides an evolutionary advantage, by training the immune system. From the article:

“What a child is doing when he puts things in his mouth is allowing his immune response to explore his environment,” Mary Ruebush, a microbiology and immunology instructor, wrote in her new book, “Why Dirt Is Good” (Kaplan). “Not only does this allow for ‘practice’ of immune responses, which will be necessary for protection, but it also plays a critical role in teaching the immature immune response what is best ignored.”

The article quotes another researcher, David Elliot, as saying intestinal worms may be the most significant player in training the immune system. Therapies based on injecting these worms into humans has shown to alleviate the symptoms of patients with autoimmune disorders such as multiple sclerosis. Another researcher, Dr. Joel Weinstock says:

“Children should be allowed to go barefoot in the dirt, play in the dirt, and not have to wash their hands when they come in to eat,” he said. He and Dr. Elliott pointed out that children who grow up on farms and are frequently exposed to worms and other organisms from farm animals are much less likely to develop allergies and autoimmune diseases.

This advice has practical consequences for people such as us, visiting homeland for a few weeks, trying to cram social engagements and valuable time with grandparents, close friends and relatives into a short span. A sick child with a runny nose and a runnier stomach is not likely to permit too much cramming. And I wonder if infrequent exposures help much. There is no dearth of pathogens here. Shanthala was down all of yesterday with a badly upset stomach. Today, she has a sore throat. Sigh. The dilemma of parenthood. Sometimes, I think our parents had it a lot easier.

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