Press. voanews.com.
New
dietary guidelines say it’s ok to feed your infant small amounts of peanuts in
order to prevent a serious allergy later in life. The new guidelines from the
National Institute of Allergy and Infectious Diseases (NIAID), provide
information for how to introduce peanut-containing food for high, moderate and
high-risk infants.
"This
update to the peanut guidelines offers a lot of promise," says allergist
Stephen Tilles, MD, president of the American College of Allergy, Asthma and
Immunology (ACAAI). "Peanut allergy has literally become an epidemic in
recent years, and now we have a clear roadmap to prevent many new cases moving
forward. The Learning Early About Peanut allergy (LEAP) study, the study that
paved the way for the updated guidelines, has had a dramatic impact on
day-to-day patient care. In fact, during my career as an allergist I cannot
think of a single publication with more of an impact."
The new
guidelines state that for high-risk infants, those with severe eczema and or
egg allergies, parents can introduce peanut-containing foods as early as 4 to 6
months, after determining that it is safe to do so.
"If
your child is determined to be high risk, the new guidelines recommend
evaluation by an allergy specialist, which may involve peanut allergy testing,
followed by trying peanut for the first time in the specialist's office,"
says allergist Matthew Greenhawt, MD, a co-author of the guidelines. "If a
child is tested and found to have peanut sensitization, meaning they have a
positive allergy test to peanut, from that positive test alone we still don't
know if they're truly allergic. Peanut allergy is only diagnosed if there is
both a positive test and a history of developing symptoms after eating
peanut-containing foods."
A
reaction to the peanut skin test of 8 mm or larger could indicate an allergy, according
to the guidelines.
However,
researchers say a positive test for peanut allergies is actually a poor
indicator of allergy as “studies have shown infants who have a peanut
sensitivity aren't necessarily allergic.” "In fact," Dr. Greenhawt
notes, "in the LEAP study, infants sensitized to peanuts showed the most
benefit from early introduction of peanut-containing foods."
"An
allergist may decide not to have the child try peanut at all if they have a
very large reaction to the skin test. Instead, they might advise that the child
avoid peanuts completely due to the strong chance of a pre-existing peanut
allergy,” according to the news release. “Other allergists may still proceed
with a peanut challenge after explaining the risks and benefits to the parents."
Infants
with a moderate risk, who have moderate eczema, and have started solid food, do
not need to be evaluated, according to the guidelines. For these infants,
parents can give their infant peanut-containing food at home starting at 6
months.
Low risk
infants can also be given peanut-containing food at 6 months of age. Parents
should not give infants whole peanuts as they are a choking hazard, and
peanut-containing food should not be the first solid food given to your infant.
"The
guidelines are an important step toward changing how people view food allergy
prevention, particularly for peanut allergy," says Dr. Tilles. "They
offer a way for parents to introduce peanut-containing foods to reduce the risk
of developing peanut allergy."
The
guidelines were published in Annals of Allergy, Asthma and Immunology, the
ACAAI's scientific publication, as well as other scientific journals.
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