December 14, 2017

New Advice for Parents of Children at Risk for Peanut Allergies

A new qualified health claim from the government advises that some parents of babies who are at risk for developing a peanut allergy could introduce them to peanut butter at a young age. This seemingly contradictory advice comes after a clinical trail at the National Institutes of Health found this practice reduces the number of people who develop this serious allergy.

Peanuts in Bowl

Peanut allergy is one of the most common food allergies, and is one of the most dangerous. Reactions to peanuts is the leading cause of death related to food-induced anaphylaxis in this country. Most people who are allergic to peanuts develop the allergy early in life and never outgrow it. The prevalence of peanut allergies has more than doubled in children from 1997 to 2008. About 2% of all people in this country are allergic to peanuts.

The author of the study, Dr Gideon Lack of King’s College London said, “Parents of infants and young children with eczema or egg allergy should consult with an allergist, pediatrician, or their general practitioner prior to feeding them peanut products.”

Up to this year, guidelines stated that parents should not give any peanut-containing foods to children until they were three years old. This new landmark study, called Learning Early About Peanut Allergy (LEAP), which was conducted in 2015, found that early introduction of peanuts actually prevents peanut allergies in many children. Infants who are at high risk for developing a peanut allergy usually have an egg allergy and/or severe eczema, which is an inflammatory skin disorder.

In that study, more than 600 high-risk infants under the age of 1 were assigned either to avoid peanuts entirely or regularly include at least 6 grams of peanut protein per week. These regimens were continued until the children reached the age of 5. Researchers found an overall 81% reduction of peanut allergy in the children who ate peanuts.

The National Institutes of Health then issued Addendum Guidelines for the Prevention of Peanut Allergy. The first addendum is that infants who have severe eczema and/or an egg allergy should first be evaluated with peanut-specific IgE measurement using skin prick testing before peanuts are introduced to their diet. Depending on the results, peanuts may be added into the child’s diet. Some of these children should only have a supervised peanut feeding at a specialist’s office. And the addendum states that children who have a wheal diameter 8 mm or greater should be evaluated and managed by an allergy specialist rather than be introduced to peanuts.

Addendum 2 addresses infants who have mild or moderate eczema. Since the trial didn’t target those children, the study’s authors concluded that infant with mild-to-moderate eczema would “likely benefit from early peanut introduction,” but the confidence in this statement was low.

Finally, the Addendum 3 guidelines suggest that infants without eczema or any food allergy should have age-appropriate peanut-containing foods “freely introduced in the diet together with other solid foods.” The NIH says that “No evidence exists for restricting allergenic foods in infants without known risks for food allergy.”

However, 14% of children with peanut allergies at ages 12 to 18 did not have any known risk factors. Experts think that the early introduction of dietary peanut in children without risk factors for a peanut allergy is “generally anticipated to be safe.”

Of course, before you do anything that may affect your child’s health, you should ALWAYS consult with your pediatrician and an allergy specialist. They will determine whether feeding your child peanuts is beneficial, and whether an allergy test and a doctor’s supervision are needed.

FDA Commissioner Scott Gottlieb says that new labels on foods that contain ground peanuts and are suitable for infants will contain advice about this issue. The qualified health claim on the labels will state, “For most infants with severe eczema and/or egg allergy who are already eating solid foods, introducing foods containing ground peanuts between 4 and 10 months of age and continuing consumption may reduce the risk of developing peanut allergy by 5 years of age.” This is the first time the FDA has recognized a qualified health claim to prevent a food allergy.

The label will also say that parents should check with their infant’s healthcare provider before introducing these foods. And it will note that this new qualified health claim is based on one study.

 

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