Daily Local News (West Chester, PA)
New guidelines for food allergy prevention
Food allergies among children have increased 50 percent since the late 1990s, and peanut allergies have tripled during the same time.
Not only is peanut allergy among the most common food allergies, it can cause a severe allergic reaction that can be fatal, called anaphylaxis. In the past, pediatricians recommended that children, especially those at high risk for food allergies, wait until 2 to 3 years old to consume potentially risky foods such as peanuts.
During the past couple of years, experts have changed their thoughts on food allergy prevention, and recent science has led to a new and likely more successful approach.
The new National Institute of Allergy and Infectious Diseases guidelines, which were published this month in the Journal of Allergy and Clinical Immunology and endorsed by the American Academy of Pediatrics, lay out steps parents can take to introduce peanuts to their children. These new guidelines are based on more recent evidence, including a leading randomized trial that showed an 80 percent decreased risk of developing a peanut allergy in children at age 5 when given peanut-containing foods as infants.
As this method is for the prevention of an allergy, not the treatment, the study excluded children who had tested positive for a peanut allergy. In addition, peanuts and other nuts pose a serious choking hazard to infants and toddlers. Therefore, peanut butter or a peanut powder should be used in the introduction of peanuts instead of whole nuts or pieces of nuts.
Guideline one recommends that infants at the highest risk who have severe eczema and/or an egg allergy be given peanutcontaining foods at 4 to 6 months, following the successful introduction of other solid foods. Parents of high-risk children should discuss the feeding of peanuts with their physician before giving them to their infant.
Guideline two suggests that parents of children with mild to
moderate eczema should introduce peanut-containing foods to their infants at about6 months of age. Consulting with a physician beforehand is not suggested unless parents have
questions or concerns.
Guideline three pertains to infants who are at low risk for developing a peanut allergy and don’t have eczema or an egg allergy. These infants may have peanut-containing foods introduced to them at any time similarly to other ageappropriate foods.
The likelihood of having
a food allergy is greater in people who have a parent with an allergic disease such as asthma, eczema, and food or environmental allergies. Food allergies are managed by the avoidance of foods containing the allergen. It is recommended that those with serious food allergies, including peanut allergy,
have quick access to an epinephrine auto injector at all times in the event of accidental exposure.
Diagnosing and managing food allergies often takes a team approach through the consulting with the pediatrician, allergist, dermatologist and registered dietitian. Common signs of food allergies to
look for in children include hives, eczema, redness around the eyes or mouth, nausea, vomiting, diarrhea, wheezing, trouble swallowing and difficulty breathing, among others.
If you suspect your child may have a food allergy, including a peanut allergy, or if there is a family history of food allergies, it is best to
speak with your doctor before starting your child on solid foods.
LeeAnn Weintraub, a registered dietitian, provides nutrition counseling and consulting to individuals, families and businesses. She can be reached at RD@halfacup. com.