New Peanut Recommendations to Reduce Infant Food Allergy

[dropcap]A[/dropcap]s a new parent, there are so many “Do’s” and “Don’ts”, it can be mind boggling. Especially when the recommendations trickling down from our pediatricians and medical experts seem to change every few years. But hey, they’re just people too, right? Now, in response to our growing food allergy epidemic, and the particular severity that peanut allergies can pose, the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), and the American Academy of Allergy, Asthma & Immunology (AAAAI), are recommending parents start introducing peanut foods to their infants as early as 4-6 months of age to induce tolerance. Four months sounds early, but generally after you begin solids.

A food allergy is an abnormal immune response to food. Some of the signs of an allergy are itchiness, swelling of the tongue, vomiting, diarrhea, hives, trouble breathing, or low blood pressure, and when these symptoms are severe, it is known as anaphylaxis. The foods that cause over 90% of food allergies are proteins in tree nuts, peanuts, milk, eggs, fish, shellfish, wheat, and soy. When someone has a food allergy, they are more likely to also eczema and asthma, and vice versa.

Some food-allergic children can out-grow their allergies and become tolerant to some foods, such as milk, egg, soybean and wheat allergies. In contrast, peanut allergy is much more persistent, with only about 20% of peanut-allergic children outgrowing peanut allergy by adulthood. Over 90% of food allergy fatalities due to anaphylaxis is caused by accidental peanut ingestion in children and adults who also have asthma.

The study found that infants at high risk of developing a peanut allergy (they have severe eczema or an egg allergy), who were fed peanut proteins as early as 4 months, had an overall 81% reduction in the development of peanut allergy over infants who were not given peanut-containing foods.

“More than 600 high-risk infants between 4 and 11 months of age were assigned randomly either to avoid peanut entirely or to regularly include at least 6 grams of peanut protein per week in their diets. The avoidance and consumption regimens were continued until 5 years of age. Participants were monitored throughout this period with recurring visits with health care professionals, in addition to completing dietary surveys by telephone.

The researchers assessed peanut allergy at 5 years of age with a supervised, oral food challenge with peanut. They found an overall 81 percent reduction of peanut allergy in children who began early, continuous consumption of peanut compared to those who avoided peanut.”

Because peanuts are a choking hazard, and peanut butter is very thick, they are recommending small amounts of the food mixed in with pureed fruits or vegetables.

The National Institute of Health recommends parents of high risk children should check with their infant’s health care provider to see if an allergy blood test, a skin prick test or an oral food challenge should be performed before consuming peanut products. The results of these tests will help decide if and how peanut should be safely introduced into the infant’s diet.

If you are pregnant or nursing, studies suggest continuing to eat food that contains peanuts to lower your offspring’s risk of allergy.

The AAP’s stance on peanuts has drastically changed over the last 20 years in response to the growing food allergy epidemic. According to the CDC, the average number of food allergy hospital discharges from 1998-2000 for children under 18 averaged around 2,615. In 2000, pregnant and nursing mothers were advised to completely avoid eating peanuts. The number of food allergy-related hospital discharges rose to 4,135 for years 2001-2003, and then in 2004-2006 jumped to 9,537. Learning from their mistakes, (complete avoidance can actually make an allergy more severe), the next recommendation from the AAP came in 2008, when they instructed pregnant women to eat peanuts, but to not give peanut containing foods to children under aged 2. However, total food allergies continued to rise. From 1997 to 2011 food allergies increased by 50%, in spite of the AAP’s recommendations. Today, the Centers for Disease Control estimates up to 6% of kids and 4% of adults have food allergies. About 1% of the total population has a peanut allergy.

If you are like me, then we both have this question: But where are these food allergies coming from?