By Tamara Katy, MD, FAAP, MedStar Georgetown Emergency Department Pediatrician

(Washington, DC) - The number of children with peanut allergies is rising rapidly. A 2010 study noted that the rate of peanut allergies in children had more than tripled between 1997 and 2008. According to the American College of Allergy, Asthma and Immunology, an estimated 400,000 school-aged children in the United States are affected.

As a result, many schools have declared their campuses “nut-free,” banning nut products to avoid causing what can be a life-threatening reaction in some children.

Serious Health Risk

To those allergic, peanuts can pose a serious health risk. The most severe reaction can cause anaphylaxis, a sudden and potentially deadly condition that impairs breathing and requires immediate treatment.

Although eating peanuts is the most common way to trigger an allergic reaction, in some cases inhaling peanut powder or dust, or even coming in contact with peanut oil, can cause a reaction.

Allergy Prevention?

Hope may be on the way for parents of some children, however. Results  from a study, Learning Early About Peanut Allergy (LEAP), published in the New England Journal of Medicine in 2015, showed the early introduction of dietary peanuts may prevent peanut allergy among children at high risk.

The study showed that feeding a small amount of peanut products regularly to children between 4 months and 11 months of age reduced their risk of developing the peanut allergy by 80 percent.

My colleagues in pediatric allergy and immunology are understandably excited about this news.

“This is the first large, prospective study on a possible therapy to prevent the onset of peanut allergy in high-risk infants,” says Sally Joo Bailey, MD, MedStar Georgetown Assistant Professor of Pediatrics, Division of Allergy and Immunology. “Until now, there were only observational studies suggesting that this may work.”

While the news excites those of us in the medical field, we still advise a cautious approach for parents.

“Parents of young children with a known sensitivity should consult with an allergist, pediatrician or general practitioner prior to beginning therapy with peanut products,” cautions Talal M. Nsouli, MD, Clinical Professor of Pediatrics and Allergy and Immunology at the Georgetown University School of Medicine. 

“I advise parents not to introduce peanuts into the diet before having children properly tested for food allergies,” he says.

Tips for Parents

1) Know the signs and symptoms of food allergies.

The most common reactions occur within several minutes and up to two hours after eating. 

Symptoms of Food Allergies

• Hives
• Vomiting
• Diarrhea
• Red lips
• Itchy skin
• Swelling of the lips, tongue or mouth

Symptoms of Severe Anaphylaxis

• Wheezing
• Difficulty breathing or swallowing
• Drop in blood pressure

If your child has any of these symptoms, call your doctor or go to the emergency room for evaluation. If the reaction is mild, your doctor may advise you to treat symptoms with an antihistamine.

Some children may have anaphylactic or severe reactions, which can be fatal. If you suspect a severe reaction, treat with injectable epinephrine (EpiPen) if available, then call 911.

2) Identify the food trigger.

Have your child’s physician diagnose possible food allergies by examining a complete family history, allergy skin testing and blood work. Your child’s physician will devise a treatment plan, including avoiding the food or similar foods that cause the allergy and other first-line treatments, such as an antihistamine, to relieve symptoms.

3) Be prepared and don’t wait.

Children with a peanut or other food allergy should always have an epinephrine injector, such as an EpiPen or AUVI-Q, accessible anywhere they go. Encourage learning proper and safe use with practice kits. Autoinjectors administer life-saving medicine in the event of a severe allergic or anaphylactic reaction and should be used without delay.

Provide your child’s school nurse or teacher with an autoinjector and clear written instructions for proper use (a “Food Allergy Action Plan”) signed by your doctor. Consider having your child wear a MedicAlert bracelet listing any food allergies. 

Living with peanut and other food allergies requires patience and attention. However, with proper education and planning, children with food allergies can enjoy a safe and satisfying diet.

Marianne Worley
[email protected]
703-558-1287