NEW THINKING ON RESTRICTING PEANUTS
WHEN my husband and I had our first child seven years ago, the prevailing wisdom was that babies at risk of allergies should avoid peanuts or peanut products until age 3 or older. The idea behind this restriction – based on American Academy of Pediatrics (AAP) guidelines released in 2000 – was that feeding peanuts too early to little ones might risk severe, possibly life-threatening allergic reactions.
Over the years that thinking has done a 180. Now, scientists believe the exact opposite: Giving your baby peanuts earlier rather than later might prevent them from developing an allergy.
While many doctors and medical groups have come out over the past year to endorse this view, there has been a lot of confusion about which kids could benefit from early exposure, the optimal timing of the exposure, and how exactly one should feed peanuts (which, after all, are a choking hazard in their raw form) to babies.
The National Institute of Allergy and Infectious Diseases (NIAID) has released formal, detailed guidelines for pediatricians and allergists.
The document, published in six medical journals, includes three separate sets of recommendations based on the level of risk an infant has for developing a peanut allergy. Those at highest risk are defined as babies with severe eczema or egg allergy or both. Those in the middle group have mild-to-moderate eczema. And those in the lowest-risk group have no eczema or food allergies.
The guidelines come at a terrifying time for new parents in terms of allergies. The number of American children with nut allergies has quadrupled in the past 13 years, and peanut allergies are now estimated to affect 2% of them. Most schools now ban foods with peanuts, and manufacturers are required to label whether food contains peanuts or was manufactured in a facility that processes them.
The soaring price of EpiPens, used to treat a severe allergic reaction, has become a hot political topic.
Anthony S Fauci, NIAID director, said the new thinking on peanut exposure grew out of observations of Israeli children in Israel versus Israeli children in Britain. In the former, he said, parents as part of their culture often give various types of peanut preparations such as paste or nuggets in the very earliest days of a child’s life. Scientists noted that the incidence of peanut allergies in Israeli children in Israel is lower than in Israeli children in Britain and wondered whether the two things could be related.
That theory was put to a test in the much-praised Learning Early About Peanut Allergy (LEAP) study, a randomised trial led by Gideon Lack of King’s College London involving 640 infants considered at high risk of developing peanut allergies. The results, published in 2015 in the New England Journal of Medicine, showed that children at high risk who regularly consumed peanuts as infants had an 81% lower chance of developing a peanut allergy by age 5.
Fauci called the results “very striking” and estimated the guidelines could prevent thousands of children from developing peanut allergies. – The Washington Post
Study shows that children who regularly consumed peanuts as infants had an 81% lower chance of developing a peanut allergy by age 5.