New peanut allergy prevention guidelines

<a href="http://www.cdc.gov/healthcommunication/toolstemplates/entertainmented/tips/allergies.html" target="_blank">More than 50 million people</a> in the United States suffer allergies each year, according to the Centers for Disease Control and Prevention. <br /><br />Snacking on nuts during the first year of life may reduce the risk of a nut allergy in children, studies show. Previously, parents of high-risk children had been advised to delay their introduction of peanuts.

More than 50 million people in the United States suffer allergies each year, according to the Centers for Disease Control and Prevention.

Snacking on nuts during the first year of life may reduce the risk of a nut allergy in children, studies show. Previously, parents of high-risk children had been advised to delay their introduction of peanuts.
Hide Caption
1 of 6
Some studies have linked certain objects or behaviors to the possible reduction of allergy risk. One new paper, for instance, suggests that children who <a href="http://www.cnn.com/2016/07/11/health/allergies-thumb-sucking-nail-biting-children/">suck their thumbs or bite their nails</a> may have reduced risk of developing allergies.
Photos: Six ways to reduce allergy risk in kids
Some studies have linked certain objects or behaviors to the possible reduction of allergy risk. One new paper, for instance, suggests that children who suck their thumbs or bite their nails may have reduced risk of developing allergies.
Hide Caption
2 of 6
Many medical authorities, such as the American Academy of Allergy, Asthma & Immunology, <a href="https://www.aaaai.org/conditions-and-treatments/library/at-a-glance/prevention-of-allergies-and-asthma-in-children" target="_blank">recommend breast-feeding</a>, as breast milk provides important vitamins and nutrients to an infant. Some research shows that breastfeeding for at least four to six months may strengthen a baby's immune system and, as a result, be helpful in avoiding allergies.
Photos: Six ways to reduce allergy risk in kids
Many medical authorities, such as the American Academy of Allergy, Asthma & Immunology, recommend breast-feeding, as breast milk provides important vitamins and nutrients to an infant. Some research shows that breastfeeding for at least four to six months may strengthen a baby's immune system and, as a result, be helpful in avoiding allergies.
Hide Caption
3 of 6
Children's risk for developing allergies and asthma may be reduced when they are exposed to a pet, such as a dog or cat, in the household <a href="http://www.cnn.com/2011/HEALTH/06/13/pets.infants.allergies/">early in infancy</a>. Researchers suspect that early exposure to certain pet allergens or bacteria might strengthen the immune system.
Photos: Six ways to reduce allergy risk in kids
Children's risk for developing allergies and asthma may be reduced when they are exposed to a pet, such as a dog or cat, in the household early in infancy. Researchers suspect that early exposure to certain pet allergens or bacteria might strengthen the immune system.
Hide Caption
4 of 6
Research suggests that exposure to air pollution during the first year of a child's life increases the risk of developing allergies to food, mold, pets and pests. Therefore, fresh air might help in avoiding sensitivity to allergens.
Photos: Six ways to reduce allergy risk in kids
Research suggests that exposure to air pollution during the first year of a child's life increases the risk of developing allergies to food, mold, pets and pests. Therefore, fresh air might help in avoiding sensitivity to allergens.
Hide Caption
5 of 6
What a woman eats during pregnancy may reduce allergy risk in her child. Some studies show that a diet rich in vitamin D, such as milk, eggs or mushrooms, is associated with a reduced risk of the baby developing allergies.
Photos: Six ways to reduce allergy risk in kids
What a woman eats during pregnancy may reduce allergy risk in her child. Some studies show that a diet rich in vitamin D, such as milk, eggs or mushrooms, is associated with a reduced risk of the baby developing allergies.
Hide Caption
6 of 6
06 Reduce Allergies01 Reduce Allergies02 Reduce Allergies03 Reduce Allergies04 Reduce Allergies05 Reduce Allergies



A serious peanut allergy can lead to anaphylaxis and, rarely, even death, which means some parents avoided introducing peanuts to their children.

But on Thursday, an expert panel published new guidelines about when to introduce some infants to peanut-containing foods as a way to prevent food allergies, a technique validated by the Learning Early About Peanut allergy, or LEAP, study.

"Many, many people were asking their doctors, their pediatricians, 'We've heard about this wonderful information; what should we do?' " said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. "The professional societies -- such as the American Academy of Pediatrics, the American Academy of Family Physicians, the American Academy of Allergy, Asthma & Immunology, etc. -- all decided they needed to get together and sit down in a few meetings and put together some guidelines."
The institute sponsored the conference where the new "Addendum Guidelines for the Prevention of Peanut Allergy in the United States" was written to supplement the 2010 Guidelines for the Diagnosis and Management of Food Allergy in the United States.

Intended for pediatricians and other health care providers, the guidelines are published in the Journal of Allergy and Clinical Immunology.

But the real purpose of the guidelines is "to spread the word," said Fauci.
What are the guidelines?

The recommendations are "really simple and straightforward," Fauci said, explaining that the intention was to answer the typical questions of family physicians.
/2016/10/31/health/peanut-allergy-skin-patch/index.html Skin patches may help kids' peanut allergies, study says

Recommendations fall into three categories.


The first category includes children who are believed to be most likely to develop a peanut allergy: infants who have severe asthma, egg allergy or both. Parents can either introduce these children to peanut-containing food at 4 to 6 months or get a reference to an allergist who will give the child a skin prick test or a blood test to see whether the infant is allergic to peanuts.
If not allergic, parents should follow the recommendation of introducing peanut-containing foods at 4 to 6 months. However, if the infant is allergic, parents should refrain.

The second category includes children with mild to moderate eczema; less likely to have an allergy, these infants should be introduced to peanut-containing foods about 6 months of age.

Finally, the third category belongs to children with no eczema or food allergies and no family history of such. These children can either be fed peanut-containing foods or not at any age, based purely on family and cultural preference.
"So if it's severe, go to an allergist," summarized Fauci. "If it's not severe, give (peanut-containing foods), but give it at 6 months." For infants with no family history of allergy or no food allergies themselves, "don't worry," said Fauci: Just give them whatever foods the family prefers.

"Something as simple as that ... we think will go a long way in decreasing the incidence of peanut allergy in society," Fauci said.
A study to snack on

The LEAP trial is significant because it was "the first and only large, randomized prevention trial for peanut allergies," and so the results are considered "definitive," said Dr. Jerry Nepom, director of the Immune Tolerance Network. The network developed the LEAP trial, which was led by professor Gideon Lack.
/2016/04/07/health/feeding-to-prevent-food-allergy/index.html Is food the cure for a food allergy?

Is food the cure for a food allergy?

In a word, it was "rigorous," Fauci said.

In Israel, there's a custom of feeding infants a popular peanut butter snack "as soon as they possibly can," he said. "And they found out that the infants in Israel had a remarkably lower incidence of peanut allergy than infants in the UK -- even Jewish infants in the UK whose parents did not follow the custom" of giving infants the peanut snack.

From this largely unscientific observation, Nepom and his colleagues constructed a scientific study.
"We designed the trial and ran the trial because there was a clear public health need and there was a lot of rationale for it," Nepom said.

More than 600 children participated in the study, and each was randomly assigned to one of two groups. One group consumed low-dose peanut-containing food three times a week, starting in the first year of life and continuing to the age of 5. The other group abstained from peanuts for the first five years of life.

Nepom stressed that the parents did not give whole peanuts to babies: "That would be very dangerous. There's a choking hazard there."
/2016/05/05/aviation/peanut-allergy-denied-flight/index.html Family kicked off flight over peanut allergy
Instead, they had peanut butter or, more likely, Bamba, a peanut-flavored puff commercially produced in Israel.
All the children participating in the study were at high risk of peanut allergy due to family history or having eczema or egg allergy themselves, said Nepom.

At age 5, the children in both groups were given peanuts and observed, Nepom said: Eighteen percent of the children who had been avoiding peanuts had a peanut allergy at age 5, compared with only 1% of the children who had been introduced to peanut butter or Bamba early in life.

"This showed that early introduction of peanut flour had over 80% prevention effect," Nepom said.
Calling them back a year later and repeating the challenge, the researchers discovered that all the kids who did not have an allergy at age 5 still did not have peanut allergy at age 6.

"Of course, we're extremely gratified that the result came out so definitively," Nepom said, adding that he's also pleased the data were used to support the new guidelines.

Read Next

You just earned points!
Login to save points.
Earn your spot on the leaderboard.

You earned Ochen points!

You're on your way to the top of the leaderboard!