Talk to pediatrician before introducing children to peanuts

Dear Doctor: When it’s our turn to bring team snacks to the kids’ weekend soccer games, the most challenging part is accommodating so many allergies, especially to peanuts. Is it true that there’s now a way to keep children from getting a peanut allergy in the first place?

Dear Reader: Food allergies among kids are a fact of life. In fact, the number of children who are allergic to one or more foods has increased by close to 50 percent in recent years. According to the Centers for Disease Control and Prevention, food allergies affect 6 percent of American children.

An allergy occurs when the immune system flags a certain food as harmful, which sets off a physical reaction to that food. The most common triggers are milk, eggs, soy, wheat, fish, shellfish, tree nuts and, as you point out, peanuts. Children with siblings who have a food allergy, or who have eczema or asthma, are at higher risk of developing a food allergy.

For a child with an allergy, even a trace of the problem food can cause reactions that range from mild to severe. These include hives, rash, stomach and digestive upset, headache, nasal congestion, itchy eyes and breathing problems. In some cases, reactions can be so extreme as to be life-threatening.

The reasons for the recent surge in food allergies aren’t entirely clear. But several new studies into peanut allergies in children have both overturned accepted wisdom and offered parents new hope.

In the past, parents had been told to avoid feeding peanuts, or anything containing peanuts, to children at risk of developing an allergy until they reached the age of 3. But some researchers questioned that approach. Instead, they began to investigate whether early exposure to peanuts could actually prevent an allergy from developing.

In a landmark study, infants at high risk of developing a peanut allergy were divided into two groups. One group was given a snack that contained peanuts starting between the ages of 4 and 11 months, and until they turned 5. The children in the other group avoided peanuts. At the end of the study, the children who ate peanuts were more than 80 percent less likely to have a peanut allergy than those whose diet was peanut-free.

The upshot is that the National Institute of Allergy and Infectious Diseases has issued new guidelines. The institute now proposes that children who are at risk of a peanut allergy can eat products that contain peanuts beginning when they are between 4 and 6 months of age. But – and this is crucial – only after they have been first tested to make sure they don’t already have a peanut allergy.

Our position, as always, is that you should first discuss this issue with your pediatrician or primary care physician. With your doctor as both partner and guide, you have the best chance at a good and safe outcome.

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(Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health.)

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(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095.)