Parents take new approach on preventing peanut allergies

• Parents and health care providers have changed their tune on peanuts
• They used to guard against feeding children nuts
• Now they advise doing the opposite

For Swedish pediatric gastroenterologist Dr. Uma Pisharody, the realization came when she considered how many American children had food allergies.

Ten years ago, she says, “the AAP (American Academy of Pediatrics) had been adamant about not giving kids peanuts until they were three and milk when they were one.” But she saw that more American kids had developed food allergies than children in other countries. “Maybe the guidelines are causing this,” she thought.

Her insight was confirmed in 2015, when a London LEAP (Learning About Peanut Allergies) study determined that toddlers exposed to peanuts at a young age had a significantly lower risk of developing peanut allergies.

Now, health care providers advise parents to start feeding their children peanut-based foods before they are one. Dr. Pisharody thinks the golden window is in the range of four to seven months, when the immune system is being developed. She says that’s when the gastrointestinal system is “ripening.” “I believe infants should be exposed to many new foods (especially the allergenic ones) during this ‘window of opportunity.’”

Food allergies can be deadly

The new thinking about peanut allergies has high stakes. An allergy to foods such as peanuts means a person may be at risk of a severe and potentially deadly reaction. If an extremely allergic person is exposed to peanuts, Dr. Pisharody says, symptoms come on rapidly and “the throat may actually close up.”

The U.S. Centers for Disease Control and Prevention reports that food allergies affect 4 to 6 percent of American children. And the U.S. Food and Drug Administration says the allergy rate among Americans “at least doubled” between 1997 and 2008. For most, food allergies persist into adult life.

In the face of such trends, and in light of the LEAP study, health officials changed course. Last winter, experts sponsored by the National Institute of Allergy and Infectious Diseases issued new guidelines for the early introduction of peanut-based foods to young children to ward off peanut allergies. 

And last fall, the FDA endorsed a qualified health claim asserted by Assured Bites Inc., which makes peanut-based food kits, that feeding such foods to children from four to 10 months old “may reduce the risk of developing peanut allergy by 5 years of age.” That will allow manufacturers to include the information on their labels.

New patterns for parents

Kristen Shane, a Seattle nurse and three-time mother, says her practices have changed since her now-10-year-old was born. Her youngest child is 18 months old.

When the oldest child was young, she says, she was so worried about celiac disease that she didn’t introduce some foods until he was a year old. In contrast, following the emergence of the new information, her youngest was “eating everything we had on our plates as soon as he could sit up.”

“The guidelines completely changed from the 10-year-old to the one-year-old,” she says.

Dr. Pisharody, who was a medical resident in 2002 and joined Swedish in 2009, says the generational change is apparent in her practice.

“I met a family this week and was telling the parents about peanut allergies,” she said. “And the grandma said ‘This isn’t what I used to do.’”

You can find out more and get personalized advice by visiting a Swedish pediatric health care provider at any of 20 locations in the Puget Sound area. 

This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.