You may have read last week that the National Institute of Allergy and Infectious Diseases (NIAID) has issued new guidance on children and peanut allergies – advice which completely upends what parents have been told in the past.
It used to be believed that the best way to prevent peanut allergies was to avoid exposing children to any peanut-containing products until age three. Now the NIAID is recommending the opposite approach, urging parents to expose their babies to this potential allergen before they’re six months old – and even earlier if they’re known to be prone to food allergies.
The new guidance is based in part on a study which found that Jewish children in Israel had fewer peanut allergies than Jewish children living in Britain. In Israel, a popular peanut snack called Bamba is frequently fed to babies as an early first solid food. (Bamba is basically the equivalent Veggie Booty – a popular infant snack here in America – but coated with peanut powder instead of veggie powder.)
Despite this new guidance, though, parents shouldn’t rush to feed their babies peanuts. For one thing, peanuts themselves are a choking hazard; exposure must come through safer forms of the food, like peanut powder or extract, or peanut butter thinned with water. Also, before exposing any child to peanuts, the NIAID advises that parents first find out if he or she is at a higher risk for food allergies, a determination that can be made by a pediatrician. And if a child’s risk appears to be high, the NIAID recommends that the first peanut exposures take place at a doctor’s office in case an allergic reaction does occur.
While allergy experts believe this new guidance could reduce the number of peanut allergies in this country “by tens of thousands,” some parents of kids already allergic to peanuts are very concerned about how the advice will be interpreted and applied. For an overview of those concerns, check out this recent Huffington Post piece by Lianne Mandelbaum, a prominent food allergy activist.
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Karen says
I remember when, as a pregnant and then nursing mom, reading advice to avoid peanuts myself if I or my child’s father had any allergies at all. It was thought that such exposure in ute to or through breastmilk would increase my baby’s risk of developing a peanut allergy. It seems like that was probably the exactly wrong advice. That was 17 years ago, not such a long time ago.
Bettina Elias Siegel says
I know – and I can only imagine the regret (or even anger) that some parents of peanut-allergic kids are feeling right now.
Lisa says
Have to say…parents like me, with peanut-allergic kids, are dubious about the new guidelines and the new risks they may present to our allergic kids. Many allergists in my community are telling patients to “stay tuned” as they are not fully prepared to guide their patients in this direction. And we are slightly bothered by the response from the National Peanut Board who shared their excitement that the new recommendations will inevitably allow peanuts to be plentiful in schools again, where avoidance is always a challenge. I’m certainly hopeful that this news will prevent kids from developing a life-threatening allergy. But for many, this new mindset is confusing and a bit of a threat to those whose lives are still in danger.
Sarah says
What I find amazing is that the Israeli link has been known for at least a decade, but it has taken this long for the NIAID to revise its guidelines, potentially causing many, many children to develop a nut allergy that may have been prevented.
How long will it take before nut free schools no longer exist? Substantive research already exists showing nut free schools (not early childhood, but mid elementary onwards) actually do more harm than good, to the extent that the official anaphylaxis prevention guidelines have been updated by the Australasian Society of Clinical Immunology and Allergy to explicitly state that food bans in upper primary and high schools do not work, and can actually cause problems. And yet, the majority of schools here in Australia continue to be nut free (while ignoring dairy, egg, kiwi etc allergies which can also be fatal).
The President of Allergy and Anaphylaxis Australia has stated many times that instead of trying to enforce bans that do not work, children with allergies need to learn how to manage allergy risks themselves, and as adults we need to look after our children until they can look after themselves.
I also wanted to comment on Lianne Mandelbaum’s implication that a peanut allergy can not be “fixed”. While perhaps that may be true specifically for her child her article implied that was the case for all children with an existing peanut allergy, when this is not the case. Oral Immunotherapy has been very successful for many children here in Australia, (basically using the same method the cameraman was using with his child) and from memory has success rates of over 85%. Obviously this is something that needs to be done under close medical supervision.