AUTOIMMUNE
April 11, 2016

Rethinking Peanut Allergies

There is encouraging news for parents of children with peanut allergies. Exposure does help.

Parenthood is difficult enough in the best of circumstances, but when you are dealing with a child who has allergic reactions to a food, it can be a nightmare. Peanuts are one of the biggest concerns, and for years parents have been advised to delay introducing peanuts into their child’s diet until the second or third birthday.

That rule of thumb appears to be about to change.

A peanut allergy can be very serious because just a particle of peanut accidentally mixed into a non-peanut containing food can set off a life-threatening allergic reaction — anaphylactic shock — in which a person's airways swell, and it becomes difficult to breathe.

Even without allergies, there are some safety considerations parents should be aware of before feeding peanuts to their infants.

A growing body of research suggests, however, that rather than carefully avoiding exposure, exposing infants to peanuts early in life can provide protection against such allergic reactions, especially babies who have a strong family history of food allergies and those with eczema.

In a 2015 study of over 600 babies at high risk for peanut allergy, one group was fed a peanut butter mush starting between the ages of four and 11 months of age, and the other group avoided peanuts entirely. By the time the children were five years old, those who were fed peanuts were about 80 percent less likely to have developed a peanut allergy when compared to those who were not exposed to peanuts early on.

A follow-up study published recently in the New England Journal of Medicine tracked over 500 children from the original study for one more year. By the time the kids were six years old, their allergy rates had not changed, even among a group who stopped eating peanuts for a year.

This finding was significant because researchers didn’t know if the kids would need to continue eating peanuts to stave off the development of an allergy, but it seems as though the benefit of early exposure gave permanent results.

Exactly how much of the peanut butter mush babies can safely consume during the first year of life has not been established and is the work of more research, but some physicians are already beginning to change the advice they give to parents.

The American Academy of Pediatrics and other medical societies have put out new interim guidelines that health care providers should recommend the introduction of peanut products to high risk infants between the age of four and 11 months. Formal guidelines are expected to follow.

If your baby has any known or suspected food allergies, do not feed him or her peanut products without first talking to your pediatrician or an allergist. Eczema, blood in the stool, vomiting, a rash or fussiness after eating are all signs of a possible food allergy.

The question now is whether the peanut allergy protection will last if kids are allowed to eat peanuts as little or as much as they want. If it does, these findings could be a huge step in curtailing the epidemic of peanut allergy.

About one percent of the U.S. population has a peanut allergy, and only about 20 percent will outgrow it. It is the most common cause of food-related deaths.

Even without allergies, there are some safety considerations parents should be aware of before feeding peanuts to their infants. Never give infants or toddlers whole peanuts as they are choking hazards. The studies used a paste made from peanuts, not actual peanuts. If you and your pediatrician decide to introduce your infant to peanuts, make a mushy paste with smooth peanut butter and a fruit like bananas or applesauce.

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