Lindy Kato (Writer)

I shouldn’t let someone like Trump goad me, he should stay in his own lane.

The incidence of autism would appear to be on the rise but firstly, is it really? Secondly does paracetamol/acetaminophen /Tylenol/Panadol have anything at all to do with it?

Let’s take the first notion, is there any real rise in autism? Have you heard of children diagnosed with idiocy, imbecility, feeble-mindedness or as a moron? No, you haven’t. The incidence of infantile schizophrenia – which was fashionable during my nursing training has also fallen. I’m not saying there aren’t children with schizophrenia rather – a good number of them playing at Darenth Park Hospital in the 1980s would have autism. Autism was already a ‘thing’ in those days, I read about it in the New Scientist when I was in the school library in the 70s – avoiding class, or more precisely avoiding being thrown out of class, to stand outside the deputy principal’s office. Additionally, children and adults previously diagnosed with Asperger’s are now placed on the autism spectrum (since 2013).

This is before we even get started on the increased breadth of inclusion for the diagnosis, the increased interest in getting a diagnosis, and the realisation that girls are better at masking their autism but it doesn’t mean it doesn’t exist.

Of babies born alive – roughly 11% (in NZ) have a recognised disability defined by the World Health Organisation (1980) as a long-lasting physical, sensory, intellectual, or developmental difficulty that restricts a person’s ability to perform activities considered to be within the normal range for human beings. New Zealand doesn’t do too badly because world-wide the rate is 16%. New Zealand has quite a lot going for it environmentally and with nutrition and health and safety etc.

For Trump to wade into a debate he knows nothing about he should consider the dangers posed by infection and fever during pregnancy. Let’s look at the problems with a raised temperature for which paracetamol is most often used. There is some evidence that it increases the chance of miscarriage. Around 50% of fertilised eggs don’t make it to a live birth and mostly we never know why. Miscarriage can occur for many reasons and It may be an underlying illness or it may be the high temperature itself – recent research is looking at the mothers microbiome as well.

Some studies have found untreated fever during pregnancy could be linked with neurodiversity, autism, ADHD etc. Trump’s advice could theoretically result in an increase in autism. Nine months is a long while to avoid an infection, generally you will get a cold at least – but using medication to avoid a fever will limit the effect on the foetus although the actual effect is only moderate. Children with a fever need wet sponging, don’t rely on paracetamol alone.

Not only has America besmirched the value of vaccines proven NOT to have an effect on rates of autism but vaccine hesitancy increases the risk of common and entirely preventable problems that are very well documented. Note you cannot be vaccinated with measles, rubella or chicken pox during pregnancy, you have to plan ahead.

Measles – the Samoan outbreak resulted in more than 5,000 reported cases and the deaths of more than 81 babies under four years old. I had measles myself, before there was a vaccine and ended up in the ward on a ship along with many other children.

German measles (rubella) If a pregnant woman is not immune to rubella and catches it during the first five months of pregnancy, she usually passes the disease to her foetus, and the baby can face many problems e.g. eye and hearing problems and heart damage.

There is no treatment for rubella infection. The damage to the foetus will last for life. Getting vaccinated and staying away from sick people, especially in the first three months of pregnancy, is the best you can do, avoiding Tylenol / paracetamol won’t help at all.

Chicken pox I can remember being taken as a child to chicken pox parties.I don’t think it’s an ideal plan and if pregnant the danger to your foetus, though small, is foetal varicella syndrome (FVS), which can cause; skin scarring, small limbs, eye problems as well as neurological problems.

Rubella, influenza, and toxoplasmosis during pregnancy have been linked with increased chances of schizophrenia in later life. There is plenty of good Trump could have done for childhood development by recommending people keep up with vaccination schedules.

You should be vaccinated during pregnancy for Covid, whooping cough and flu because these pass on protective antibodies to your baby while they face an uncertain world and are too young for vaccinations themselves.

At an even more basic level, Trump could have told people not to eat rubbish food. Note – starvation might not mean lack of food but lack of nutrients!

Early pregnancy can be a dreadful time to try and balance your nutrition – even if you are horribly sick you need to try and get in some fruit and essential fatty acids as a minimum. Essential fatty acids are essential, and our body can’t make them.

They are needed for cell membranes, so that nerve cells are directed to the correct place, axon sheathing (this makes your nerves work fast and efficiently), and a variety of receptors, transmitters and hormones. Poor fatty acid intake can have global problems. Poor quality nutrition affects the immune system, resulting in increased risk of infection in the mother which is known to affect the foetus.

Don’t eat top of the food chain fish such a tuna because methyl mercury is likely to be concentrated in those. The foetus will often act as a mop taking up toxins and sparing the mother and it especially will mop up methyl mercury and carbon monoxide. Which brings me onto poorly ventilated homes.

Trump could have told people not to live in substandard housing. Poorer housing often has heating problems (hence the carbon monoxide comment) and pest problems. Pesticides can result in poor foetal growth, lower IQ and increased risk of obesity and diabetes.

Be wary of cheap old stuff that could have lead paint. Even if you can afford new stuff, it might not be the best idea. New carpets and furniture give off formaldehyde which is toxic.

Road pollution increases lead levels which are known to cause multiple problems in the foetus and in children. Poor air quality has also been linked to obesity and degenerative brain diseases. Ah, what is that Mr. Trump? You can’t fix people’s poor living conditions?

Charles Darwin said:

 “If the misery of the poor is caused not by the laws of nature but by our institutions, then great is our sin.”

Trump could have reiterated the importance of avoiding alcohol. The foetus is vulnerable before you know that you are pregnant. Some people detoxify alcohol slower than others and so the foetus has higher blood alcohol for longer in those mothers.

The baby cannot detoxify the alcohol and it seeps into the amniotic fluid. So the baby is swimming in it. Sometimes midwives can smell it in the fluid.

There may not be a noticeable impact from maternal alcohol and in other cases there are significant growth defects It is not only the early weeks of pregnancy but later in pregnancy alcohol can cause the developing neurones to self-destruct. The effects are lifelong and entirely preventable.

Foetal alcohol is known to affect 1 in 100 NZ children but the numbers could be much larger than that and they are over represented in our jails. America won’t be any different.

Neurodiversity isn’t a pestilence for Trump to eradicate. Don’t get me started.

I have very few superheroes, my dear Dad who would probably be diagnosed with ADHD if he were a child now. Dorothy Hodgkin who solved crystal structures despite being plagued with rheumatoid arthritis. Richard Feynman and Oliver Sacks, very different personalities, neither of whom would be described as normal (a setting on a dishwasher) and lastly Temple Grandin whose parents were told to put her in an institution because of her autism. The world would be dimmer without these people in it. I guess Trump might think it would make his light shine brighter. It wouldn’t.