Proactivity on Peanut Allergies

"You have the potential to stop something in its tracks before it develops."
"[There appears to be] ...a window of time in which the body is more likely to tolerate a food than react to it, and if you can educate the body during that window, you're at [a] much lower likelihood of developing an allergy to that food."
"This [the new recommendations on early introduction] won't outright prevent every single case of peanut allergy -- there will still be some cases -- but the number could be significantly reduced by tens of thousands."
Dr. Matthew Greenhawt, chairman, American College of Allergy, Asthma and Immunology, food allergy committee

"If we can put this into practice over a period of several years, I would be surprised if we would not see a dramatic decrease in the incidence of peanut allergies."
Dr. Anthony Fauci, director, National Institute of Allergy and Infectious Diseases, U.S.

Babies who already have skin rash eczema or egg allergies should get a checkup before being exposed to peanut-containing foods, new guidelines say. Photograph: KidStock/Getty Images/Blend Images

New parental guidelines for the introduction of peanuts to children at an early date were released in January to the American public by the National Institute of Allergy and Infectious Diseases. Pureed food or finger food with peanut powder or extract are now to be offered before infants turn six months of age. Earlier yet, if it has been determined that a child is moderately prone to allergies. Parents should rest easy in doing so, since medical specialists have given this a green light.

They also caution that whole peanuts should be reserved for older children since they can represent a potential choking hazard to very young children.

There are more deaths attributable to peanut allergies resulting in anaphylaxis -- or constriction of the airways -- than for any other food allergy. Children who do develop a peanut allergy will not leave that allergy behind as they mature. With these children a strict avoidance of peanuts will permeate their consciousness for their entire lives. For them, it truly is a matter of life or death, should they falter in the need to be ever-vigilant.

Children determined to be at high risk while babies are to be referred to an allergy specialist who may proceed to order further allergy testing. The parental advice from the American Academy of Pediatrics renewed as recently as the year 2000 was that parents were to ensure children seen to be at high risk for allergies were never to be given peanuts until they reached three years of age. These precautions, however, did nothing to decrease the prevalence of peanut allergies.

The new guidelines have turned that advice around, not only in the United States but in the United Kingdom, Canada and Australia as well. Studies undertaken in more recent years have led to the formation of the guidelines which divide young children by their medically identified risk level, where infants at low risk who don't have eczema or an allergy to eggs, and for whom solid foods have been initiated, can be safely introduced to peanut-containing foods at about six months of age.

And the same is true for children identified as being at moderate risk, those with mild eczema. It is the high-risk infants who should be introduced to peanuts as early as four to six months, but under the supervision of a doctor's office, once they begin eating solid foods. Thereafter they should continue to be evaluated by a doctor. Tests showing positive for sensitivity to peanuts don't necessarily translate to allergies, and babies may benefit from eating peanut foods as long as no strong reaction to a skin test demonstrates an allergy in which case avoidance may be prescribed.

Mixing a few teaspoons of smooth peanut butter with an equal amount of warm water to a soupy consistency is recommended by Dr. J.Andrew Bird, a Dallas pediatric allergist. Still, Dr. Greenhawt cautions that foods containing peanuts should not be seen as appropriate for the first solid food given a baby. The peanut-containing food should be given regularly, roughly three times weekly, throughout childhood, for the pre-emptive allergic reaction to remain effective.

Parents and doctors are encouraged to proactively introduce peanut-based foods early. (iStock)