Preventing Peanut Allergy

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You are starting a family, and you’re worried your baby will be allergic to peanuts. If he or she is deemed to have a high risk for peanut allergy after birth, feeding him or her peanut products early on may prevent it.

Western countries have seen rates of peanut allergy double during the past decade, according to studies, leading many daycares and schools to ban peanut products. A peanut allergy can be life-threatening: In its most severe form, it can cause a potentially deadly immune response from the entire body rather than localized symptoms.

Once, conventional wisdom held that avoiding peanuts in infancy and toddlerhood was the most effective way to prevent peanut allergy. Now, new research supported by the National Institute of Allergy and Infectious Diseases published in February 2015 is turning that logic on its head, at least for high-risk children.

Researchers in the United Kingdom studied more than 600 babies between 4 and 11 months of age whose skin prick tests and severe eczema or egg allergy indicated they had a high risk for peanut allergy. The infants were randomly sorted into two groups: one group that avoided peanut products and another that received six grams of peanut products per week. The groups followed their assigned protocols until the children were 5 years old.

Among children with negative skin prick test results, approximately 14 percent of those who did not eat peanut products had peanut allergy at age 5, compared with approximately 2 percent who ate peanut products. Approximately 35 percent of children with positive skin prick test results who avoided peanuts had peanut allergy at age 5; approximately 10 percent who consumed peanut products were allergic at this age. The study found that early introduction of peanuts to high-risk children may reduce the likelihood of developing peanut allergy by as much as 80 percent.

Following the study’s publication, the American Academy of Pediatrics (AAP) endorsed a consensus statement developed by several American and international medical organizations intended to serve as interim guidance to physicians in applying the study’s findings to their patients; final guidelines are under development. The AAP recommends giving peanut products to high-risk infants between 4 and 11 months old with physician guidance. If your baby meets these criteria, speak with your pediatrician about the safest ways to introduce peanut products—not whole peanuts, which can be choking hazards—into your child’s diet.

Reacting to a Reaction

The sight of your child having a reaction to food, such as peanuts or shellfish, is terrifying, but it can be even more frightening if you’re unsure how to respond. First, learn what a food allergy reaction looks like. Symptoms may include:

  • Difficulty swallowing
  • Itchiness
  • Nausea
  • Skin rash or inflammation
  • Stomach cramps
  • Wheezing or trouble breathing

An oral antihistamine may be enough to treat a mild reaction to food. Anaphylaxis—the most severe type of reaction—can send your child into shock and may be fatal. Signs of anaphylaxis typically appear faster than symptoms of mild reactions and often are more intense versions of the aforementioned symptoms. In addition, anaphylaxis may cause palpitations and unconsciousness. If you suspect anaphylaxis, give your child an epinephrine injection immediately, if possible, and call 911.

Did You Know?

> Among food allergies, peanut allergy is the most dangerous—it accounts for the most food allergy-related deaths in the United States.

> Most food allergy symptoms appear within two hours after eating, according to the National Institutes of Health.

> A second anaphylactic reaction that occurs several hours after the initial episode is called a biphasic reaction.

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