A new take on babies, peanuts

A recent study determined that babies at-risk for peanut allergies can benefit from controlled exposure to peanut containing foods while their immune systems are still malleable or able to adapt

Dr Cliff Mihail, Daily Item, Jan 31, 2017

Peanut allergy is the most common and severe of all food allergies. And, it's on the rise. For someone with a peanut allergy, exposure to small amounts of peanut oil or dust can be life threatening, with reactions ranging from an itchy tongue to anaphylactic shock, and even death. Unlike other allergies, it is rare to outgrow a peanut allergy. Throughout their lifetime, individuals with this allergy must carefully avoid peanut products. Because exposure can occur unexpectedly, those with this allergy must carry an EpiPen in case of a reaction.

For years, parents were told to withhold peanut products from infants in an effort to avoid causing a peanut allergy. However, a recent study determined that babies at-risk for peanut allergies can benefit from controlled exposure to peanut containing foods while their immune systems are still malleable or able to adapt. In the study, fewer at-risk babies developed peanut allergies by age five after they were exposed to peanut containing foods in infancy. To share this information, a panel of experts sponsored by the National Institutes of Health created guidelines that were published in the Jan. 5, 2017, edition of The Journal of Allergy and Clinical Immunology.

Here are some key points:

Determine your baby's risk for peanut allergy with help from your pediatrician. Signs that your baby could develop a peanut allergy include a history of skin rashes or severe eczema, consistent runny nose and/or an egg allergy. Your pediatrician can conduct a blood test for peanut allergies during a well-baby visit, but these tests are not always conclusive for children under the age of five. Positive results are firm, but there is a risk for false negative results.

Another indication for peanut allergy is family history. A baby with one parent who is allergic to peanuts has a 50-percent chance of developing a peanut allergy. If both parents are allergic, the baby has a 90 percent chance.

Absent any family history or the signs of allergy above, the guidelines recommend that you introduce food containing peanuts to your child at any time that fits with traditions for your family and culture. There is no need to wait, nor is there a need to rush.

If your child is considered at-risk, your doctor can help you determine when to introduce peanut containing foods - at four months, for those at the highest risk level, or at six months. For babies over six months of age and under five years, controlled exposure may also have benefits.* The first introduction is a "challenge test," which is best when conducted in a clinical environment for safety. During a challenge test, the baby receives a very small sample of diluted peanut butter and is then observed for signs of a reaction for the next hour to an hour-and-a-half.

It's ideal to try other foods before testing peanut products. For infants ages four months and up, make a peanut butter paste, with the aim to serve about one teaspoon. Mix a teaspoon of peanut butter with hot water to make a digestible paste. Whole peanuts and even regular, undiluted peanut butter can pose a choking hazard.

Know the signs of an allergic reaction to any products. Always have Benadryl on hand, and call 9-1-1 should an allergy occur. Symptoms may include an itchy tongue, runny nose, nausea, vomiting, diarrhea, tightening of the throat, shortness of breath or wheezing.

Experts hope publishing new guidelines will help reverse the trend toward peanut allergies. *Always consult your infant or child's pediatrician who is familiar with his or her family history and risks before introducing peanut products.

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