How to prevent a peanut allergy

Parents have grown increasingly leery of foods that contain peanut-based ingredients. Concerns are valid, though, as a growing number of U.S. children deal with peanut allergies each day. To raise awareness, people like Dr. Neil Gershman, who is board-certified in allergy and immunology and a Fellow of the American Academy of Allergy, Asthma and Immunology, work to educate the public and pediatricians on the importance of peanut-allergy prevention.

“For school age children, peanut allergy is by far the most common among all foods, affecting about two percent of the population,” Gershman says. “Reactions can be as mild as itching and swelling of the face and mouth, but they can progress to diffuse hives and swelling of the tongue and throat, as well as asthma-like symptoms of wheezing and coughing.”

Severe cases can even result in shock or death.

According to Gershman, infants with a high risk of developing a peanut allergy include those with eczema or other known food allergies, such as milk and eggs.

Until recently, pediatricians often recommended that parents introduce peanut-based products into their children’s diets at the age of two. However, new research shows that exposure to peanuts during infancy might serve as a more effective preventative method.

Earlier this year, the Division of Allergy, Immunology and Transplantation at the National Institute of Allergy and Infectious Diseases sponsored a panel that released new guidelines for the prevention of peanut allergies. The guidelines are based on findings taken from the Learning Early About Allergy Prevention (LEAP) study conducted by the Immune Tolerant Network.

“The LEAP study clearly showed that introduction of peanut early in life significantly lowered the risk of developing peanut allergy by age 5,” says Dr. Daniel Rotrosen, director of the Division of Allergy, Immunology and Transplantation at NIAID.

The NIAID’s guidelines include three core directives aimed at reducing the risk of peanut allergies. The first encourages infants with severe eczema, egg allergy or both be introduced to age-appropriate peanut-containing foods as early as four to six months of age. The second guideline suggests that infants with mild to moderate eczema be introduced to age-appropriate peanut-containing foods around six months. The third guideline suggests infants without eczema or any food allergy have age-appropriate peanut-containing foods introduced freely in the diet, together with other solid foods.

“It is kind of counter-intuitive, but that is how the immune system works,” Gershman says. “Early infant exposure to certain foods does lead to a less chance of food allergies.”

Some suggestions for making the introduction of peanuts into an infant’s diet include adding peanut protein powder to baby foods or dissolving snacks that are made with peanuts.

Before implementing the new NIAID guidelines, Gershman advises parents to talk to a pediatrician.

“There are some complicating factors, in that it is possible that a child could be allergic to a food without the parent knowing,” Gershman says. “I recommend parents, especially of those children who are at high risk for food allergies, do some type of allergy testing prior to the introduction of the peanuts.”