As parents with children with peanut allergies know, this increasingly common allergy can be a constant source of worry, causing parents to grow nervous in crowded situations in which snacks are being consumed, and prompting them to monitor the contents of foods served at daycare, preschool, parties, and play dates. If peanut allergies simply meant that kids broke out in a hive here or a bit of eczema there, parents might be able to dial down their concern. But peanut allergies can be fatal, causing anaphylaxis, which causes airways to close up, and leads to cardiac and respiratory arrest if not treated immediately.Parents of older kids may be in the clear, but many of our families are growing, and therefore are still reading up on the allergy that affects no less than 1.5 to 3 percent of children in Western countries.
As peanut allergies became more of a worry in the 90’s, the American Academy of Pediatrics(AAP) issued guidelines to parents and pediatricians to abstain from feeding their children peanut products until at least the age of 3. The AAP asked that parents wait until 1 year of age to introduce dairy, the age of 2 to introduce eggs, and the age of 3 to introduce peanuts, tree nuts, and shellfish. These are the guidelines that most parents stick to, but the adherence to these guidelines has not resulted in a reduction in peanut allergy cases.
In February 2015, The New England Journal of Medicine released a study that found that abstaining from peanut products has a degree of correlation with the eventual development of a peanut allergy. The study shocked parents and pediatricians when its results suggested that introducing peanut products to infants may actually decrease a child’s likelihood of developing a peanut allergy. The researchers studied a large group of children, including over 600 babies between the ages of four months and 11 months, some of whom were already believed to be susceptible to peanut allergies. It followed their trajectory for five years. One group of children was restricted from consuming peanut products during the time period of the study, while a second group was exposed to a moderate amount of peanut product consumption on an ongoing basis. After five years, both groups were tested for allergies. According to the study, “Among the children who started the trial with no sensitivity, nearly 14 percent who did not eat any peanut products developed an allergy, compared to less than 2 percent of those who did. Among the children who were already slightly sensitive to peanuts, but did not eat any peanuts as they grew, 35 percent developed an allergy, compared to almost 11 percent of the ones who ate the snack.” The vast difference in outcomes between the groups of children who were exposed to peanut products, and the groups who were not, has prompted the National Institute of Allergy and Infectious Diseases to meet with immunologists and pediatricians to discuss the results. Their goal is to create new guidelines for parents.
So, you know you want to protect your child from developing a peanut allergy. But you also want to do what is safe for her. What can you do as new guidelines are in the process of being developed? As your pediatrician for direction. Most pediatricians are very familiar with this groundbreaking new research, and have been consulting with parents about how to navigate allergenic foods. He may have advice that will help you to introduce your child to allergenic foods safely and within a reasonable timeframe.