Hemby Children's Hospital
Go



What's a parent to do?

To give or not to give kids peanuts early in life


boyWhen Jake Everett was 18 months old, he took one bite of a peanut butter-and-jelly sandwich at day care and his body reacted immediately. He turned dark red, became bloated and vomited repeatedly.

Even though it wasn’t life-threatening, his reaction was considered extremely severe for a first exposure.

“I was lucky that I didn’t see him until four hours later,” said Jake’s mother, Kati Everett of Huntersville, North Carolina. “Even then, I walked in the room and immediately had to walk away because he looked so scary.”

His left eye was swollen shut for several days, and his toes were so swollen and red that they looked deformed. “You couldn’t recognize him,” his mom recalled.

When Jake was young, Everett and her husband, Todd, went to extreme lengths to ensure that their son stayed out of danger. Now as a teenager, Jake has learned how to manage his peanut allergy.

"The American Academy of Allergy, Asthma and Immunology says food allergies affect more than 4 million children. In fact, the prevalence of food allergies among children increased 50% from 1997 to 2011, according to the Centers for Disease Control and Prevention.

For years, experts have recommended avoiding giving children peanuts until their third birthday for fear of triggering an allergy. A study published in The New England Journal of Medicine suggests that practice could be adding to the problem.

In the London-based study, infants 4 to 11 months old who were deemed at high risk of developing a peanut allergy were randomly assigned either to be regularly fed food that contained peanuts or asked to avoid contact with peanut products entirely. It found that those who consumed the foods with peanuts in them were far less likely to be allergic to peanuts when they turned 5.

Dr. Elizabeth Koonce of Novant Health Eastover Pediatrics in Charlotte, North Carolina, said that before this study, there was no strong research to back up the conventional recommendations.

While the latest research supports that early exposure to peanuts might help kids avoid developing allergies down the road, a previous study suggested probiotics might help prevent food allergies.

That study, released in August 2014 by The University of Chicago, found that common gut bacteria called clostridia helps keep immune response triggers to allergens at bay. The researchers also concluded that antibiotic overuse, high-fat diets and even baby formula have over time altered the body’s natural mix of gut bacteria, which could be why kids are more susceptible to developing food allergies these days.

Koonce cautioned, however, that mice were used for the study and the findings may not necessarily have broad implications.

“It’s premature to say that an animal study shows cause and effect regarding the rising incidence of allergies in the human population, but certainly the adverse effect of antibiotics on ‘good’ bacteria is a reason to use antibiotics only when appropriate,” she said.

What’s a parent to do?

Considering the recent research, parents may opt to give their children food containing peanuts within reason.

To avoid choking hazards, parents may want to introduce small amounts of peanut butter mixed in with other foods, Koonce suggested. She also noted that most children’s reactions to peanuts are mild, but if a child could be having an allergic reaction, it’s always better to be safe than sorry and to use an epinephrine injection, such as an EpiPen, if your child’s been prescribed one. “You should never hesitate to use an EpiPen – it can’t hurt,” Koonce said.

Everett will never forget her son’s upsetting allergic reaction years ago.

“New studies seem to come out every few years or so trying to pinpoint the cause of peanut allergies. I hope they find out for sure, but mostly I hope they find a cure,” she said.

There is no cure for children who do have confirmed food allergies. Strict avoidance of allergens and immediate management of reactions are critical in preventing serious anaphylactic episodes.

For the Everetts, what was once frightening is now just a way of life. “Sure, we have to be careful about what Jake eats, but otherwise, daily life is pretty much normal,” Todd Everett said.