Avoidance of Peanut in Infants Now Questioned (Premium)

Typically, parents are taught to hold off on introducing peanut to infants in an effort to avoid future peanut allergy. Researchers from two new studies suggest just the opposite is advised.

Please check with your pediatrician or allergist on this to learn more about the best way to go about introduction of peanut and whether this approach is appropriate in your particular case.

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Discussion from a March 2015 New England Journal of Medicine article is summarized below

“Among infants with high-risk atopic disease, sustained peanut consumption beginning in the first 11 months of life, as compared with peanut avoidance, resulted in a significantly smaller proportion of children with peanut allergy at the age of 60 months. This intervention was safe, tolerated, and highly efficacious. In the intention-to-treat analysis, peanut consumption was associated with an 86% reduction in peanut allergy at 60 months of age among participants who had had negative results on a peanut-based skin-prick test at study entry and with a 70% reduction among those who had had positive test results at study entry.”

See the full discussion in the New England Journal of Medicine here.

A second study was released March 26, 2015 from Loyola University

Tips to potentially prevent peanut allergies from Gottlieb allergist

Newswise — Peanut butter and jelly sandwiches are a dietary staple for many children. But for others, peanut products can be life-threatening and are strictly taboo. A new study released at a meeting of the American Academy and Association of Allergies and Immunology (AAAAI) and published in the New England Journal of Medicine suggests that peanut allergies can be prevented through early exposure.

“The importance of this study will really change the way peanuts are introduced in children’s diets,” says Rachna Shah, MD, board-certified allergist at Gottlieb Memorial Hospital, part of Loyola University Health System. Often, peanut introduction is recommended when the child is between 2 and 3 years of age. Pregnant or lactating women may be told not to consume peanuts to prevent allergies.

More than 1.3 percent of children in America are allergic to peanuts. “Symptoms of peanut allergies are hives, vomiting, rash, shortness of breath, decline in blood pressure and even death,” says Dr. Shah, affiliate faculty member at Loyola University Chicago Stritch School of Medicine. “If a child eats or even is exposed to peanuts, a reaction could range from something as relatively simple to treat as hives to a life-threatening episode.”

Treatment for peanut allergies in children currently is limited to avoiding peanuts. Peanut allergies generally cannot be outgrown. If a child is allergic to peanuts, it is likely they will also be allergic to other tree nuts like almonds, cashews, hazelnuts, pecans, walnuts and pistachios.

Delayed exposure to peanuts did not decrease the development of peanut allergies. In fact, early introduction and regular consumption of peanuts led to a reduced likelihood of developing a peanut allergy after the age of 60 months.

“Bottom line, early introduction of peanuts decreases the frequency of developing a peanut allergy,” says Dr. Shah, who treats many children as well as adults with peanut allergies in her Gottlieb Memorial Hospital practice. “The estimated prevalence of peanut allergy in America is 1.4 to 3 percent and the numbers are growing so this news offers a potential real solution to prevention.”

Dr. Shah recommends these tips for introducing peanuts to a child’s diet:
Introduce peanuts in a controlled setting like your home. “The last thing you want, is for the introduction to happen in a restaurant or party where you might not be able to directly monitor the symptoms of a reaction.”

Allergists in Dr. Shah’s office at Gottlieb Memorial Hospital have the sole distinction of conducting the official allergy count for the Midwest during allergy reporting season. Gottlieb allergists are uniquely certified by The American Academy of Allergy, 
Asthma and Immunology to perform the Gottlieb Allergy Count.

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