He was one of the authors of a well-known 2016 study in The New England Journal of Medicine which compared the immune profiles of Amish children, growing up on small single-family farms, and Hutterite children, who are similar genetically but grow up on large, industrialized farms. вЂњThe built environment is the place in which our children grow up,вЂќ said Jack Gilbert, the director of the Microbiome Center and a professor of surgery at the University of Chicago. WeвЂ™re talking about living in a world of relatively clean and controlled surfaces, where even small children who are constantly picking things up and putting them in their mouths are not going to come into contact with a very wide variety of exposures. When we talk about the hygiene hypothesis, the collection of theories that address the possible problems that can be associated with growing up less exposed to germs and dirt, we are essentially talking about growing up indoors. A 2013 Swedish study, for example, showed that children whose parents just sucked their pacifiers clean had a lower risk of developing eczema. But many have also heard in recent years of the вЂњhygiene hypothesis,вЂќ which holds that some exposure to germs and microorganisms in early childhood is actually good for us because it helps develop the immune system.

Many parents, quite reasonably, worry about germs and dirt finding their way into a childвЂ™s mouth. When a toddlerвЂ™s pacifier falls out of his mouth and onto the ground, does it get confiscated and boiled by anxious parents or just licked off and reinserted by the more casually inclined?

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