- Title: Feed peanut products to babies to cut allergy risk, doctors say
- Date: 16th January 2017
- Summary: UNIDENTIFIED LOCATION (FILE) (REUTERS) BAG OF PEANUTS BEING POURED ONTO DESK VARIOUS OF PEANUTS
- Embargoed: 30th January 2017 13:37
- Keywords: peanuts peanut allergy babies National Institute of Allergy and Infectious Diseases NIAID peanut butter
- Location: LONDON, ENGLAND, UK / WASHINGTON D.C., UNITED STATES / FILE LOCATIONS
- City: LONDON, ENGLAND, UK / WASHINGTON D.C., UNITED STATES / FILE LOCATIONS
- Country: USA
- Topics: Health/Medicine
- Reuters ID: LVA0025ZBZFIZ
- Aspect Ratio: 16:9
- Story Text: Parents should feed babies creamy peanut butter or purÃ©ed food with nut powder when infants are 4 to 6 months old to help lower the risk of life-threatening allergies, new U.S. guidelines urge.
For most babies -- kids without severe eczema or egg allergies that make peanut allergies more likely -- new guidelines from the National Institute of Allergy and Infectious Diseases (NIAID) recommend introducing foods containing peanuts as soon as babies are able to tolerate other solid foods.
"When you give by mouth, expose it through the gastro-intestinal tract, an antigen early on before the child's immune system is fully developed, you what we call 'tolerise' the child to not make a bad response against the peanuts. They become, quote, 'tolerant' to the peanuts," NIAID Director Anthony S. Fauci, M.D. told Reuters.
Whole peanuts should never be given to any child under the age of 4, as it they are a choking hazard, the guidelines stress.
A shift in thinking about peanuts came courtesy of a study of 640 babies in the UK who were already at high risk for nut allergies because they had eczema or an egg allergy already, researchers note.
The British experiment compared the effects of giving some babies a 6-gram dose of peanut each week to strict peanut avoidance in children over a five-year period. All of the infants in the study had skin tests to determine if they developed a peanut allergy.
Aged 5, about 14 percent of the kids who avoided nuts had a peanut allergy compared with roughly 2 percent of the children who got an early taste of the food.
The new guidelines are a radical departure from recommendations in 2000 that advised against giving babies peanuts before age 3. Revised recommendations in 2008 had suggested no food be delayed past 4 to 6 months but failed to offer specific guidance on when to feed babies peanuts.
Peanut allergies are a leading cause of death from food allergies in the U.S. and the new guidelines aim to alter this statistic by helping babies get an early taste that will make severe allergic reactions less likely.
Some allergic reactions can be mild, with symptoms like hives or nausea, but more serious reactions can lead to anaphylaxis, when the airways tighten to the point where it's impossible to breathe. People with anaphylaxis can die if they don't get immediate medical help.
"When you get an allergic reaction to peanut it could be severe, it could be anaphylactic, it could even lead to hospitalisation and death. So that's the reason we're feeling very good about the study that showed you might be able to prevent a significant proportion of the peanut allergies by this approach," added Fauci.
As doctors and parents change their approach to peanuts to follow the new guidelines, early exposure should help dramatically curb the number of children who develop severe allergies, say doctors.
Under the new guidelines, most babies can have peanuts introduced at home by parents or caregivers, but infants with severe eczema or egg allergies should see an allergist first. A specialist can test for peanut allergies and if necessary, give babies their first taste of peanuts during a doctor visit.
These precautions are for infants with severe eczema that doesn't respond to treatment with moisturizer or corticosteroid creams or ointments, not babies with temporary rashes.
"The earlier you go, the more likelihood you have of 'tolerising' the child. So if you have a much greater chance [of developing peanut allergy], you go from four to six [months old]. If you do it at a time when it's very unlikely that you're going to have a peanut allergy because you don't have severe eczema, you have just eczema, just moderate eczema; then they figure six months is about the time that you start feeding the child the kinds of foods that you could put peanut-based food in," said Fauci.
In infants without eczema or any food allergies, parents should feel comfortable giving babies a taste of peanuts after they are accustomed to eating other solid foods, doctors say.
The new advice follows trial results reported in February 2015 that showed regular peanut consumption begun in infancy and continued until 5 years of age led to an 81 percent reduction in development of peanut allergy in infants deemed at high risk because they already had severe eczema, egg allergy or both.
Fauci added that the success of this study points to similar trials into other higher risk foods.
"If the mechanism holds true, it is conceivable but not yet proven that you could do the same thing with allergies to other types of foods. And so what will be happening over the next few years is that there will be studies with the same design of early of exposure versus avoidance with other food to which a child may or may not have a propensity for an allergic reaction to," he said.
The guidelines are being published simultaneously in several journals including the Annals of Allergy, Asthma and Immunology.
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