Q: I read that the National Institutes of Health has changed the recommendations about delaying the introduction of foods known to cause allergies. What do the experts say about the introduction of peanuts? K.C., Greenville
A: Theres been quite a bit of press given to the news that early exposure (in the first year of life) to peanuts might help keep some babies from developing peanut allergies. Researchers are finding that the trend for parents to avoid exposing their infant to peanuts, while well intentioned, might not have been the right way to avoid developing an allergy. Zachary Blom, a third-year Brody medical student, wants to explain this situation. Here is what he wants you to know.
People with food allergies must avoid certain foods and constantly check ingredients on anything they order. Failure to do so can result in rash, itching, stomach pain, vomiting, diarrhea and feelings of impending doom. It can also cause a life-threatening anaphylactic reaction where the throat and upper airways swell, the face may puff up and the person may have progressive difficulty breathing. It can progress to the point of death if the person is not treated quickly with something like an EpiPen injection to fight off the allergic reaction or a trip to the emergency department of the hospital.
Food allergies are very common in the United States, affecting up to 15 million Americans and 1 out of every 13 children. And they are becoming more and more common. Some experts suggest part of the increase is due to well-intentioned advice from specialists that may have contributed to the increase.
The Centers for Disease Control released a study in 2013 that showed food allergies have increased by around 50 percent from 1997 to 2011. The exact cause for the rise in food allergies has yet to be determined. Society has taken steps to make it easier for people with allergies to avoid their allergen. If a major allergen milk, egg, fish, crustacean shellfish, tree nuts, wheat, peanuts or soybeans is likely to be in a food product, it must be listed on the ingredient label. Peanut allergies have been particularly problematic due to the life-threatening potential, and actions have been taken like banning them from schools and airplanes.
Out of some of that research, new recommendations have come from the National Institutes of Health. These guidelines are based on recently conducted clinical trials named LEAP or Learning Early About Peanut Allergy. The results were published in the New England Journal of Medicine. The results show that early exposure can significantly reduce peanut allergies lifelong for up to four out of five kids.
Its important to talk with your childs doctor before introducing any peanut products into their diet. Based on the findings, your doctor may choose to conduct allergy testing in order to determine the best and safest way to introduce peanut products into your childs diet. If your child has eczema (a skin condition) or other allergies (such as egg allergy), it is particularly important to talk to your childs doctor first.
You can ask your doctor to explain these recommendations:
1) Children with severe eczema or egg allergies are recommended to start peanut-containing foods at 4-6 months old, and continue eating these products throughout early childhood.
2) Children with mild to moderate eczema are recommended to start peanut-containing foods around 6 months old, and continue eating these products throughout early childhood.
3) Children without eczema or food allergies should start peanut-containing foods soon after introduction of other solid foods into their diet, and continue eating these products throughout early childhood.
Your doctor can suggest easy ways to introduce peanuts to your childs diet safely.Although instructions for presenting peanuts to your infant and children can be found on the web, we do not recommend you do so without getting clear instructions from your child's pediatrician.
Professor emeritus Kathy Kolasa, a registered dietitian nutritionist and Ph.D., is an Affiliate Professor in the Brody School of Medicine at ECU. Contact her at kolasaka@ecu.edu.
