For years my patients have heard me say it. My advice has been helping patient families for years. Finally, a scientific study shows that I was on the right track!
The National Institute of Allergy and Infectious Diseases (NIAID) announced that parents should give their children foods containing peanuts. The process should begin early and should be done often.
The new guidelines: Low-risk infants (those who don’t have family history, eczema or an egg allergy) who have already started solid foods, can be introduced to peanut-containing foods around 6 months of age. Parents can add peanut powder or extract to foods. This is even okay with moderate risk children. The new guidelines say even high-risk infants, (those with severe eczema or an egg allergy) can be introduced to peanut-containing foods after they start other solid foods. Importantly you should have your pediatrician evaluate your baby for risk and safety.
And just a reminder: never give whole peanuts or peanut bits to a baby because they can be a choking hazard!
What’s this all about—why the change? Peanut allergies have become ubiquitous (though it is rare that a child dies from a peanut allergic reaction) and are rarely outgrown, which means the person has to deal with this for their whole lives.
This protocol has “the potential to stop something in its tracks before it develops,” says Dr. Matthew Greenhawt, chair of the American Academy of Allergy, Asthma and Immunology’s food committee and one of the authors of the new guidelines. It appears that there’s “a window of time in which the body is more likely to tolerate food than react to it, and if you can educate the body during that window, you’re at much lower likelihood of developing an allergy to that food,” Dr. Greenhawt adds.
This is a big change. (but not for our patients!)
For years, experts said that the best way to fight peanut allergy was to avoid peanut products in the first years of life. The American Academy of Pediatrics (AAP) recommended in 2000 that any child a risk of a peanut allergy (such as those with a family history of peanut allergy or other food allergies or eczema) not eat any before 3 years of age. However, avoidance did nothing to arrest peanut allergies. If anything, more peanut allergies were diagnosed. That’s why in 2008 the AAP stopped recommending it.
These new guidelines have grown out of several studies conducted over the last decade. Some were motivated by anecdotes that Jewish children in Israel rarely suffered from peanut allergies. Dr. Gideon Lack, the senior author of the study and professor of pediatric allergy at London’s King’s College, studied the allergy rates of Israeli Jewish children with those of Jewish children in Britain. He found that the British group was 10 times more likely to have peanut allergies than their Israeli counterparts. This disparity could not be explained through differences in genetic background, socioeconomic class or tendencies to other food allergies.
The big difference: Israeli children, starting in infancy, eat foods containing peanuts, most famously, Bamba, a corn puff made with peanut butter. This peanut food introduces babies and their digestive systems to peanuts. Bamba is less sticky than peanut butter and can encourages exploration and improves hand-mouth coordination.
Dr. Lack and his colleagues wondered: Could this be the important difference—that the Israeli children ate peanut products from an early age?
So they tested it. They conducted a study on about 600 babies who had severe eczema or egg allergy, which are known to increase the risk of peanut allergies. They divided them up into two groups: one was given Bamba to eat regularly (if they didn’t like Bamba, they could eat smooth peanut butter), and the other was told to stay away from foods containing peanuts. They did this until the children were 5 years old.
What did they find?
- 3% of the kids who ate peanut products were allergic to them at age 5.
- 17% of the no-peanut product kids were allergic to them at age 5.
This included children who tested positive for a peanut allergy as infants. (Children with strong positive tests, however, were not included in the study.)
Now this doesn’t necessarily mean that everyone should run out and buy peanut butter—or that doing so will guarantee that the child never has a peanut allergy. There are questions that still need answers, like how much peanut exposure will prevent an allergy? How long it needs to be eaten? Is it okay to eat it a few times and stop? Should families keep giving it?
Further, peanut food should not be the first solids introduced into a baby’s diet. You should work with your pediatrician to develop a protocol appropriate to your baby.
This report is promising, and reinforces our experience at Total Family Care: if more parents follow these rules, maybe it will be okay for kids to revert to the old peanut butter-and-jelly sandwich as a lunchroom staple. STAY UP TO DATE with Total FAmily Care News Here!
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