The Right Way to Help Your Child Avoid a Peanut Allergy (Premium)
It’s a serious concern for new parents: What if my child has a peanut allergy? This allergy is the most frequent cause of a severe food reaction. For some, even a tiny exposure can be life-threatening. While heart-breaking stories of a child dying from a peanut exposure are rare, tragically they do happen–and the constant fear lingers for families who have to deal with this.
Reactions develop quickly after exposure, and caregivers need to watch for classic food allergy reactions such as itching in the mouth or throat, redness or swelling on the skin around the mouth, hives, digestive issues, shortness of breath, or a tight throat or wheezing. More severe, life-threatening reactions with symptoms such as trouble breathing, a rapid pulse, a drop in blood pressure, or dizziness require a 911 call, an immediate ER visit, and/or the use of an EpiPen, with physician follow-up.
While there are no promises or complete answers, recent guidelines offer a hopeful approach to lessen the severity or avoid a peanut allergy. Reportedly, most parents aren’t educated by their pediatrician on how to follow the approach.
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Are the new guidelines being ignored?
Four years ago, the National Institute of Allergy and Infectious Diseases released guidelines to help parents introduce peanut products to their infants. A new study being presented at this year’s American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting reveals:
Although 58% of those surveyed reported their primary care physician (PCP) discussed early peanut introduction, only 40% of the parents said they received a recommendation to introduce peanut by 11 months of age.
“We now know that the earlier peanut is introduced, as early as when a child begins solid foods, the better the chance that peanut allergy can be prevented,” said Christopher Warren, PhD.
Parents should know that most infants are either moderate- or low-risk for developing peanut allergies, and most can have peanut-containing foods introduced at home. Whole peanuts should never be given to infants as they are a choking hazard.
Read these important excerpts from the guidelines:
The same approach is not for everyone
“If your child is determined to be high risk, the new guidelines recommend evaluation by an allergy specialist, which may involve peanut allergy testing, followed by trying peanut for the first time in the specialist’s office,” says allergist Matthew Greenhawt, MD, MBA, MSc, ACAAI Food Allergy Committee chair, and a co-author of the guidelines. “If a child is tested and found to have peanut sensitization, meaning they have a positive allergy test to peanut, from that positive test alone we still don’t know if they’re truly allergic. Peanut allergy is only diagnosed if there is both a positive test and a history of developing symptoms after eating peanut-containing foods.”
A positive test alone is a poor indicator of allergy, and studies have shown infants who have a peanut sensitivity aren’t necessarily allergic. “In fact in the LEAP study, infants sensitized to peanuts showed the most benefit from early introduction of peanut-containing foods,” says Dr. Greenhawt.
The updated guidelines recommend that infants with a positive peanut skin test have peanut fed to them the first time in the specialist’s office. Some infants may have a large reaction to the skin test (8 mm or larger) which could indicate they are already peanut allergic. “An allergist may decide not to have the child try peanut at all if they have a very large reaction to the skin test. Instead, they might advise that the child avoid peanuts completely due to the strong chance of a pre-existing peanut allergy. Other allergists may still proceed with a peanut challenge after explaining the risks and benefits to the parents.”
Moderate risk children – those with mild to moderate eczema who have already started solid foods – do not need an evaluation. These infants can have peanut-containing foods introduced at home by their parents starting around six months of age. Parents can always consult with their primary health care provider if they have questions on how to proceed. Low risk children with no eczema or egg allergy can be introduced to peanut-containing foods according to the family’s preference, also around 6 months.
Video recommended by ACAAI
See the ACAAI video featuring Dr. Gupta, “Introducing peanut-containing foods to prevent peanut allergy.”
More information can be found here
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