New peanut allergy prevention guidelines start in infancy
Peanut allergy affects about 2% of the children in the United States, and those numbers appear to be growing.
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.
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.
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