Why Children Are Sick And How We Can Help Them

By Dr. Indrė Plėštytė-Alminė

Every day, while counseling children and their parents, I hear a lot of questions and requests for advice. How to strengthen a child's immunity? Why do some children get sick often and others only once a year? How do chronic diseases develop, and how can we help children develop their immune systems properly? The development of immunity can be compared to a constant, uninterrupted, and ever-improving process of studying and checking homework.

This book is a short story about the children's immune system: what it is made of, how it develops, and what challenges await it. The language of science is not easy, so I tried very hard to visually explain why particular diseases attack, what the immune system does at that time, and how to help a child with diseases typical of his age. Only by understanding why children are sick can we avoid medical errors and help the little ones grow up healthy. After all, a good start in life is half the battle.
 

Dr. Indre Plestyte - Almine

• Language: English
• Publisher: Doctor of littles
• Release date: Dec 1, 2023
• ISBN: 9786094547577

Book preview

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DR. Indrė Plėštytė-Alminė

WHY CHILDREN GET SICK

and how we can help them

English translation by Ieva Barakauskaitė

Išleido ir spausdino

UAB Vitae Litera,

Savanorių pr. 137, Kaunas 44146

Bibliografinė informacija pateikiama Lietuvos integralios bibliotekų informacinės sistemos (LIBIS) portale ibiblioteka.lt.

ISBN 978-609-454-757-7

eISBN 978-609-454-758-4

© Indrė Plėštytė-Alminė, 2023

© UAB Vitae Litera, 2023

I dedicate this book to my family, without whose support I would not have found the strength to write it, and to all my little patients, who have taught me to look at life with a childlike curiosity.

1. Where Does Immunity Begin, or Does the Apple Really Never Fall Far from the

Tree?7

2. The First Working Days of the Immune System13

3. Breast Milk19

4. A Good Start in Life is Only Half the Battle?27

5. Mister Immunity34

6. Home of the Immune System40

7. What Do We Bring at Birth? Innate Immunity47

8. The Cellular Mosaic of the Immune System - Cell-Mediated Immunity55

9. The Mysterious Humoral Immunity63

10. How and Where Our Immune Memory Is Recorded71

11. What Is Inflammation and What Is its Purpose?78

12. What Does Cause Infectious Diseases? Viruses, the Villains86

13. Gorgeous Bacteria95

14. Will Cleanliness Save Our Children? The Hygiene Hypothesis103

15. Is the Environment to Blame?110

16. What Does Protect Mucous Membranes?118

17. The Invaluable Work of the Digestive Tract126

18. Why Does a Child Want to Be Sick?134

19. When a Runny Nose is an Unwelcome Visitor141

20. Is It Always Necessary to Be Afraid of Cough?149

21. Does Food Heal Us or Make Us Sick?156

22. Atopic Dermatitis or Eczema163

23. Allergy to Oranges and Candy172

24. Allergies - the Scourge of the Age. Why Are So Many Children Allergic?178

25. When the Bronchi Get Angry186

26. Why the Gut Is So Important195

27. Tummy Ache? Let’s Rush to the Hospital!203

28. Are We Afraid of Vaccines or Diseases?210

29. More Medicine - Less Disease?219

30. How to Toughen Up Your Body227

31. Do the Tests Tell the Whole Story?234

32. What the Future Holds241

TABLE OF CONTENTS

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1.

WHERE DOES IMMUNITY BEGIN, OR DOES THE APPLE REALLY NEVER FALL FAR FROM THE TREE?

Protruding ears like dad’s? Eyes like mom’s? When future parents see their baby’s ultrasound picture for the first time, they start to speculate whether he will be smart, musical or creative. Who will he look like? What will his temperament be like? Of course, we hope that our kids will inherit only our best traits, that they will be the most good-looking and happy children in the world. For us parents, our own children are always like that because we see them through loving eyes. Unfortunately, we cannot change the way the gene mosaic is arranged during conception. We can play the guessing game, but no one can predict how a child will look like and be like. The little one will inherit some traits from dad and some from mom. We even see traits of our parents or grandparents. However, we often wonder why two siblings do not look alike, even though they share the same parental genes. Why is one child healthy and another often unwell? We are constantly comparing our children and marveling why they are so different…

It seems simple – an egg and a sperm fuse, the cells start to multiply and a human being is born. But heredity does not follow strict laws, laid down by someone from above. During each conception, genes mix randomly. Therefore, there can be a wide array of gene combinations. Human chromosomes contain 20-25 thousand genes and the variety of different gene combinations is unfathomable. Additionally, a child’s genes reflect not only his parents but his entire ancestral line. Whether a child will inherit blue eyes from his mom or brown eyes from his dad, whether he will be disposed to obesity like his maternal grandmother, or whether he will suffer from the chronic illnesses common in his father’s side of the family, depends on combinations of several genes and their sequences, not just one. Therefore, it is obvious: no two people will ever be genetically identical, except for the monozygotic twins.

We were taught at school that genes can be weak – recessive or dominant. The blue eye gene is weak (recessive), the brown eye gene is strong (dominant). So, if a baby receives the blue eye gene from one parent and the brown eye gene from another, it will have brown eyes. Blond hair is a recessive trait as well. If both mother and father are blond, their baby will be born blond. And if one parent is light-haired and the other is dark-haired, the baby’s hair will be dark or a slightly lighter shade, similar to the color of its dad and mom’s hair. Curly hair is also a dominant trait. If either parent has curly hair, there is a good chance that the baby will also have curly hair. If not, it will inherit at least wavy hair.

Therefore, it is obvious that parental genes will determine child’s growth and appearance, even his or her academic abilities. Recent research shows that human intelligence is about 40 percent genetically determined. The rest is determined by the environment (including playmates, siblings, significant events, experiences and, of course, upbringing). A person does not come into the world with a fully formed personality of which no facet can be changed. Abilities are not everything. There are countless factors that determine what the person will be like. We all must learn the art of life – while living, working, thinking… Each person lives in their own way – organizing their domestic routine, solving problems, pursuing goals, defending their values. We are all different, unique, inimitable, and gifted with a power to improve ourselves.

This applies to all areas of life, including the immune system. The body’s resistance to various diseases is also partly determined by parental genes. So, before starting a family, the future parents should sit down and discuss how they themselves coped with illnesses, even with the mildest infections, during their childhood – what diseases they had and how many times they had to be hospitalized. It would be helpful to involve their parents as well or even look at their medical records. Some parental genes may be suppressed, non-dominant, therefore, sometimes a particular disease does not manifest in parents for their entire life. But if two genes or sets of genes that cause the same immune disorder merge during the conception, the baby might be born sick or vulnerable to various environmental factors.

A family is made up of two individuals who come with different genetic material, life experiences and memories. So, how does nature decide which genes will be dominant – mom or dad’s? One of the simplest explanations is that it resembles our family life. While the new life is forming, male and female genes – some different, some similar – should amicably settle who will have the upper hand – who will take the lead in which area. Life experience, strength or persistence - i.e., dominance - is very important in decision-making. If the system operates well, maternal and paternal genes come to an understanding. But what will happen if they fail to reach an amicable agreement? Unfortunately, the child will be at risk of developing some disorder. Simply put, the child will simply not have the right way of dealing with the issue at hand...

As I said before: genes do not determine everything. An important role in the development and characteristics of living organisms is played not only by genes, but also by epigenes. Epigenetics is a relatively new field of science and continued research in this area is giving us more and more insights into various immune disorders and the manifestation of diseases.

Epigenes, in a way, tells the body which of its genes should be activated and which should be sent to sleep. In other words, they determine current needs of the cell or the organism. Although, all the genes are still present, some of them stop functioning because of influences on top of genetics. Therefore, this phenomenon was named epigenetics. Which gene will switch on largely depends on the environment, a wide range of factors, such as air, water and soil pollution, diet, various chemicals in our surroundings, medications and, of course, stress. Some epigenes even transmit information about their parents’ living conditions to the offspring. Whether they starved, whether they ate substantially, whether they were under a lot of stress or not, whether they ate a lot of meat or not, whether they drank a lot of water or not – all this information can have an impact on the health of the children. Therefore, parents’ lifestyles have quite a strong influence on their children's lives.

Biologists joke that epigenetics is the story of your parents’ sinful lives which affects you as well. Children of mothers who smoke are more likely to be of a smaller height, experience lung problems and be born with various defects. They suffer the consequences of their mothers’ smoking even in adulthood: asthma, lower nicotine tolerance or a tendency to use drugs. A long-term study of families in England revealed an interesting fact: men who admitted to smoking at an early age (before the age of 11) later had sons with a high propensity for obesity. Thus, adolescents who smoke before puberty endanger not only their own health. They are passing on effects of harmful substances to their offspring. It is also widely known that the conditions of pregnancy and the future mother’s diet have a long-term effect on the health of the child. For example, people whose mothers did not eat adequately during pregnancy are more likely to develop cardiovascular disease and diabetes as adults. Another study showed that people whose grandparents starved as teenagers died earlier on average, if they were of the same sex as the starving grandparents. This suggests that the experience of starvation altered the epigenome in such a way that the effect was passed down over two generations. Of course, science still has a lot of unanswered questions in this field. In any case, all the research and knowledge available cannot change one thing – each person is unique.

Where Does Immunity Begin, or Does the Apple Really Never Fall Far from the Tree?

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INTERESTING FACTS

Did you know that by 6-9 months your baby's eye color can change? The color of your baby's eyes is determined by the genes inherited from the parents. It is thought that as many as sixteen different genes influence the color of a person's eyes, which is why there is such a wide variety of eye colors and shades. Eye color depends on the concentration of melanin, the pigment that gives color to skin and hair. The bigger amount of melanin, the darker the eyes. Newborn babies are usually born with a low amount of melanin and it increases as they grow. So, babies born with low levels of melanin have blue eyes. If the melanin level in the eyes increases, the color will change to brown, light brown or green. If the level of melanin remains low, the eyes will remain blue.

2.

The First Working Days of the Immune System

The long-awaited baby is finally born. Parents and others around see how fragile and helpless it is. It seems that it would not survive a moment without its mother or father. The little one enters a complex world - teeming with microbes, various pathogens, chemicals, and physical factors. In the first days of life an infant has to adapt to a bright and noisy world and to learn to live next to his or her mother. The first hours are crucial for the baby’s future life and, of course, for the proper functioning of its immune system. I will look at a few factors, essential to baby’s health.

The immune system of a newborn child is put to a considerable test. It is perhaps the most important system – on its proper functioning depends not only the child’s life, but also his successful fight with various diseases in the future. A new life is still delicate. A newborn baby has only innate immunity (the body’s basic defenses). Later, acquired immunity develops. Parental gene dowry, environmental factors and our efforts will determine whether the baby will be resistant to viruses and bacteria. It is extremely important to pay attention to the baby and to trust nature. After all, childbirth is a natural process and the more it is disturbed by medical measures and interventions, the more difficult it may by for the immune system to cope with new challenges. For example, a cream-like substance covering the newborn’s skin, called vernix, waterproofs and protects the skin of the fetus during 9 months in the amniotic fluid. Recently, scientists established that this substance should not be wiped off immediately after birth – vernix contains not only fats, but also anti-inflammatory vitamin E and special proteins that fight bacteria, viruses and fungi. Therefore, by delaying a newborn’s bath, we will give it some protection until its immune system starts functioning. Also, mother’s first milk, or Colostrum, is of great value in the first hours of life – it is a bomb of immune cells and various chemical compounds. These first sips of milk provide priceless protection for the child in later life. Therefore, encouraging breastfeeding during the first hours, will not only provide a newborn with a multitude of other benefits, but will also help its immune system to take the first steps.

The baby was safe enough in its mother’s womb, where it was reliably protected from the outside world. Perhaps, the only way a fetus can get sick is if the mother is sick too. During pregnancy, immune memory cells of the mother, also known as immunoglobulin G (IgG), are transferred through the placenta to the fetus. These cells are called memory cells because they have been engineered to fight a wide range of infectious pathogens (viruses, bacteria, fungi) – but they can resist only particular pathogens the immune system engineered them to fight against. If the mother’s immunity is strong and enough immunoglobulins have been passed from the 14th week of pregnancy through the placenta into the body of the fetus, the newborn will be born resistant to disease. After all, a newborn baby has not yet been exposed to any infectious agents and does not have its own immune memory cells, i.e., it does not know yet which microorganisms are dangerous, and which are not. It was established that the mother’s body has the highest level of IgGs when the baby is due (on 37-40 week), and that the newborn has even more IgG antibodies – thus the mother tries to protect her baby from infections to the best of her ability.

But what happens if the mom’s immunity is not strong and her IgG production is impaired? Maybe the woman did not eat properly or dealt with other harmful factors and did not have sufficient resources to produce an ample amount of IgG. Obviously, in that case the child will not get what is due – the less IgG it gets, the lower its resistance to disease in the first months of life. It should also be remembered that together with the immunoglobulins the fetus also receives a letter about his mom’s previous illnesses and dormant infections, which are not dangerous to the woman herself, but may lead to premature birth or congenital infections.

Unfortunately, these memory cells passed on by the mother cannot last a lifetime. The level of IgG in newborn’s body starts decreasing – in the first three weeks the level is two times lower than in the first hour of life. However, newborn’s immune system gradually takes over. First, it starts producing immunoglobulin M, then A and others, and finally - immunoglobulin G. But for the time being there is no lack because the amount the baby got from the mother suffices for quite a long time (I will elaborate on immunoglobulins in the subsequent chapters). IgGs from the mother usually last for about half a year – that’s why most babies get sick for the first time at that age. Often a fever, a runny nose or a cough are attributed to teething at this time, but usually the real reason is that the baby has to learn to fight infections by themself because mom’s given protection is gone. Even the three-day fever, perhaps the first viral childhood infection, is most common around this age, not to mention more serious illnesses such as bronchiolitis.

Nature made sure that both mom’s and baby’s behavior would make the first working day of the immune system as easy as possible. We are all carriers of various microorganisms. Their entirety, the so-called microbiota, is one of the most important parts of our immune system. The fetus is relatively sterile in the womb, and this part of the immune system is still inactive. As the newborn moves through the birth canal, it receives a variety of good bacteria from its mother – they are invisible to the naked eye but help to fight off microorganisms in the environment. However, such protection is not sufficient. Therefore, the newborn should be placed on its mother’s bare chest immediately after birth. The mom gives her baby some of her own good germs (from her skin and from the exhaled air) – this is the first gift from the mother to the baby’s immunity. This is how the baby’s immune system is programmed to what the right microbiota is and that other germs need to be fought. Since the newborn’s immune system is not fully formed at birth, it is believed that babies need to be exposed to different bacteria to stimulate this formation.

The gut flora of children, born after cesarean section, has been shown to be very different from those who passed through the birth canal. The levels of lactobacilli, bifidobacteria and bacteroids in their gut are three times lower than of those who were born naturally. The microflora of newborns delivered by C-section is mainly composed of the flora of the mother’s skin, such as actinobacteria, proteobacteria and bacilli. It has been found that such babies are less resistant to infections and allergies and have a higher risk for developing asthma, diabetes, obesity, celiac disease, cancer, mental illness or autism spectrum disorders in the future. Ways to help such newborns are already being explored. A study by the University of California School of Medicine has shown that a relatively simple transfer of bacteria from the mother’s vagina onto the baby’s skin after a cesarean section can have a very positive effect on the baby’s microbiota - making it similar to that of a naturally born baby.

There is a lot of research into the impact of birth on a child’s later life and health. A very interesting study has been published which shows that natural childbirth stresses the fetus and activates its immune system. During a cesarean section the fetus does not experience stress and epigenes do not switch on all the genes necessary for protection. As a result, babies delivered by C-section are more prone to immunological disorders: asthma, diabetes, obesity, digestive issues, gluten or nut allergy, etc.

It begs the question – why has nature arranged it so that a newborn baby cannot fight infections at all? It was established that the immunity of the fetus and the newborn is evenly suppressed to prevent fighting the microorganisms in the environment. However, answers to this question are not found yet. One explanation could be that the suppressed immunity lets the aforementioned microbiota to colonize baby’s skin and gut. After all, if the immune system was angry, agitated but also ignorant, it would attack good bacteria as well and the child would then be constantly ill. Therefore, mother’s closeness is essential – not only to comfort and reassure the baby itself, but also to make sure it survives in every possible way until it learns to fight the surrounding enemies on his own – even in the microscopic world.

The First Working Days of the Immune System

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INTERESTING FACTS

Maternal stress, anxiety and, finally, depression during pregnancy and after the birth of the baby have been shown