Go Nuts

News from the wellness beat: New guidelines suggest infants benefit from early exposure to the allergen.

The percentage of children diagnosed with peanut allergies has been on the rise over the past 20 years, leading to proliferations of EpiPens and school-wide bans. Though there is no concensus regarding the cause—are we too clean, or are we using too many antibiotics?—new guidelines put forth in January by the National Institutes of Allergy and Infectious Diseases, part of the National Institutes of Health, could help turn the tide.

Instead of isolating children from peanuts—another theory to try and explain the increase—the guidelines suggest that early exposure to the potential allergen might actually be helpful. The NIAID, in an addendum to guidelines published in 2010, recommends offering peanuts (in crushed or powdered form, to avoid a choking hazard) to infants as young as four to six months of age. The previous guidelines recommended no exposure to peanut products before age 3. 

“This is a really big change that parents are hearing. So understandably, there have been a lot of questions,” says Darlene Mansoor, M.D., a pediatric allergist-immunologist affiliated with Inova Fairfax Hospital.

Mansoor says the addendum resulted from the study, Learning Early About Peanut (LEAP) allergies, conducted two years ago, which showed that peanut allergies may be prevented by the early introduction of peanuts to children at high-risk—those with eczema and/or egg allergies. Published in the New England Journal of Medicine, the study divided high-risk infants into two groups: The first group was introduced to peanuts; the second was not.

“In the group that did not eat the peanuts, there was a significant amount of children who later developed a peanut allergy,” she says. Meanwhile, the other group reduced their allergy risk by 81 percent.

The addendum offers three different recommendations depending upon the degree of the infant’s eczema and food allergy. The first is for infants with severe eczema and/or egg allergy and offers a process for introducing peanuts by 4-6 months of age. (Parents should check with a health provider to see if an allergy blood test or skin prick test is needed first to determine if the introduction is safe.) The second is for those with mild to moderate eczema and recommends peanut consumption around six months. The third is for patients with no eczema or food allergies and suggests that peanuts can be introduced at any age to beneficial effect. NIAID.NIH.gov

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