Just nuts: On second thought, not giving peanuts to young children may cause allergy

Peanut background



QUICKREAD

PEANUTS AT SCHOOL

Peanuts are rare on airplanes these days, and many schools have nut-free areas for students who are allergic to peanuts, which are technically legumes, or tree nuts.

In School District 51, policy directs schools to make “reasonable accommodations” to reduce a student’s exposure to substances that could cause them to have an allergic reaction. This includes having nut-free classrooms, nut-free tables in cafeterias — there are at least nine schools with nut-free tables — and even posting signs for nut-free hallways in some schools, according to spokeswoman Emily Shockley.

Accommodations depend on if students attending a school have the allergy, and parents have made the school aware of the danger.

Students also are taught to avoid sharing food to minimize the chance of allergic reactions from items in lunches or snacks brought from home.



Doctors have warned for years that parents should keep peanuts away from infants, but a recent study has changed that recommendation.

Early exposure to peanuts might actually prevent kids from being allergic to them, the study found.

It might seem counterintuitive, but science has shown that kids who eat peanuts early are less likely to develop a sensitivity to them.

The medical community is still trying to develop recommendations, brought forth by the results of the “Learning Early About Peanut Allergy” (LEAP) trial results published earlier this year.

In the United States, the prevalence of peanut allergies has more than quadrupled in the past 13 years, and it’s now the leading cause of death related to food allergies in the country, according to The New England Journal of Medicine.

It appears that avoiding peanuts may have exacerbated the problem, according to the study.

“This completely reverses all of the recommendations that have been made for the past 10 or 15 years,” said Dr. David Scott, an allergist with the Allergy and Asthma Center of Western Colorado.

Although the American Association of Pediatrics advised in 2000 that parents should avoid giving their children potentially allergenic foods until age 3, it appears that advice was wrong, and a new trend has appeared with health professionals recommending that infants as young as 4 months be introduced to peanut protein, the potential allergen.

The LEAP study arose from an observation that Jewish children living in Israel had 10 times less the rate of peanut allergies as Jewish children living in the United Kingdom.

It turns out, peanut introduction at a young age is common in Israel, and a peanut cracker called “Bamba” is often used as a teething biscuit, so children around 7 months in age commonly eat the peanut snack.

The study examined 640 infants already determined to have food sensitivities, who all started the study when they were younger than a year old. The results showed that children who consumed peanuts regularly until they turned 5 reduced their chances of developing peanut allergies significantly.

While the study clearly showed eating peanut products helps infants avoid allergies to peanuts, Scott cautioned that if parents introduce a food containing peanut protein and notice their child has any reaction, such as rashes, hives or breathing difficulties, they should consult their health professional and not continue exposing the child to peanuts.

“If you notice any type of reaction to peanut, stop,” Scott said. “The goal here is to prevent peanut allergy, not to treat early peanut allergy.”

Another concern is that peanuts are a choking hazard, and health officials recommend exposing children to peanut butter or other products, such as the biscuits used in the study.

“Peanuts just happen to be the perfect shape and size for children to choke on, so we do not recommend that parents give them to children before the age of 4,” Scott said.

Another complicating factor most people might be surprised to discover is that studies have shown that children who are exposed to peanuts in their environment, but are not allowed to eat them, are most at risk for developing the allergy.

This corroborates evidence that peanut allergies increased statistically since 2000, when health professionals started advising parents to avoid feeding their children peanuts until age 3.

“There’s good evidence out there that showed that chronic cutaneous — skin — exposure to allergenic foods may increase the risk of allergy,” Scott said.

That means putting potentially allergenic food on your child, but not allowing the child to ingest that food, makes it more likely the child will develop an allergy to that food.

“If mom and dad eat peanuts and that causes peanut protein to be on their fingers, the counter top, everywhere else in the house, there’s signs that being exposed to that protein may be sensitizing to the child,” Scott said.

Though the study had strict parameters about the amount of peanut protein fed to the children and how often, “We don’t know what dose of peanut is the right dose for preventing the allergy, yet,” Scott said.

Authorities also don’t know if this early exposure rule could apply to other allergenic foods — shellfish is one such food — or if preventing exposure to other foods could potentially cause sensitivities.

“We, as allergists, are pretty sure that the peanut early introduction data is going to hold true for other nuts, tree nuts in particular, but we aren’t sure about shellfish,” Scott said.

Another uncertainty is whether specialty diets imposed by parents, such as gluten-free or dairy-free diets, could cause children to develop sensitivities to foods.

Health officials caution that one food in particular, honey, still shouldn’t be given to infants, but that has nothing to do with allergies.

“That recommendation to withhold that until age 1 is still standing, because of botulism toxin,” Scott said.


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