We may not know the cause of the peanut allergy, but we’re getting closer to determining how to prevent it in kids.
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Results of a study published today in the New England Journal of Medicine found that early introduction of peanuts in children at high risk for peanut allergy could decrease their risk of becoming intolerant to the nuts.
From 1997 to 2010, the prevalence of peanut allergy among children in the United States rose drastically from 0.4 percent to 1.4 percent. Peanut allergy reactions can be fatal, and may cause anaphylaxis, a severe, life-threatening allergic response, on first exposure.
Researchers don’t know for certain what is causing the rise in the number of cases. But children who are at high risk for peanut allergy include those whose parents have asthma, eczema, allergies to cats or dogs, outdoor pollens, or whose siblings already have severe eczema or food allergies.
Preventing peanut allergy
The new study, called the Learning Early About Peanut (LEAP) study, suggests a way to prevent the allergy: Introduce peanuts to your children during infancy.
The study involved 640 children between the ages of 4 months and 11 months who were at high risk for peanut allergy. Researchers randomly assigned infants to one of two groups: one group that consumed peanuts or one that avoided peanuts until age 5.
The prevalence of peanut allergy was greater among the children in the group that avoided peanuts.
The study results indicate that “the earlier you introduce peanuts, the more likely you are to become tolerant to peanuts,” says pediatric allergist Brian Schroer, MD. “Earlier introduction and continued peanut consumption did decrease peanut anaphylaxis very significantly.”
Dr. Schroer says the study answered a major question: What can be done to prevent a child from becoming allergic to peanuts?
“Tolerance is the goal. Tolerance is what everybody has who is not allergic,” he says. “Patients in the study, even though they were considered high-risk, developed that tolerance.”
In the past, doctors would recommend avoidance for kids who might be at high risk for a peanut allergy. This study provided hard evidence for what many allergists have recently begun to suspect — that early introduction might be the key to tolerance, Dr. Schroer says.
“It’s a new way to prevent a disease,” Dr. Schroer says.
So how can parents safely introduce peanuts to their children? Dr. Schroer says to start early.
“Most kids are low-risk,” Dr. Schroer says. “The earlier you can introduce peanuts to your kids, the better.”
To avoid a choking hazard, wait until your child can chew a peanut-based dissolvable snack, or give them a safe amount of peanut butter, Dr. Schroer says.
Despite the new research, Dr. Schroer says it’s best to be cautious and talk with your child’s pediatrician about peanut tolerance.
“If your child has had a food reaction before, talk to your pediatrician before you go ahead with this,” he says.
Hives, swelling, vomiting and trouble breathing are among the symptoms of a food allergy.
“Call a physician if any of these symptoms arise,” says Dr. Schroer. “But if your child hasn’t ever experienced a reaction before, introduce them to peanuts.”