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New Peanut Allergy Guidelines Target Babies

Blog New Peanut Allergy Guidelines Target Babies

Five things you should know about the guidelines on kids and peanut allergies released this week.

Yes. More news about peanut allergy in kids popped up this week. This time, a new set of peanut allergy guidelines was issued by an expert panel sponsored by the National Institute of Allergy and Infectious Diseases.

With more than 2 million children in the United States estimated to suffer from peanut allergy, researchers, doctors and scientists are constantly trying to find the best way to prevent and treat the condition, which can be fatal.

Thursday's guidelines recommend that some children should have peanuts introduced as early as four months of age, while other kids should wait until 6 months. Still, other children, can wait until their parents choose to introduce peanuts.

It all can get a bit confusing. In a nutshell, here are five things you need to know about Thursday's new guidelines:

Why So Early?

The idea behind these guidelines isn't new; they simply formalize what doctors have known, said Frederick Leickly, M.D. a pediatric allergist with Indiana University Health.

Plenty of recent scientific research has shown that introducing peanut-containing foods into a child's diet during infancy can prevent the development of peanut allergy, he said. Why? Researchers believe there is a period of time early on that a person's immune system doesn't recognize peanuts as dangerous.

Clinical trial reports released in 2015 found that regular peanut consumption that starts in infancy and continues until a child is 5 led to an 81 percent reduction in development of peanut allergy for high-risk infants.

"The amendment to the food guidelines issued this week just make it a little more formal, put a punctuation mark on it that this is what you should be doing," said Dr. Leickly. "But it's not earth-shattering, brand new if you paid attention."

Risk Level is Key

There is no one-size-fits-all rule for introducing peanuts to children. The guidelines emphasize that risk level is key to advising health care providers and parents on what to do. There are actually now three separate recommendations for infants at various levels of risk for developing peanut allergy.

Infants at High Risk

Babies who already have severe eczema, egg allergy or both are deemed at high risk of developing a peanut allergy. The expert panel recommends that these infants have peanut-containing foods introduced into their diets as early as 4 to 6 months old. This, researchers believe, will reduce the risk of developing a peanut allergy.

Parents should always check with their child's pediatrician before feeding the infant peanut-containing foods. A doctor may choose to perform an allergy blood test or send the infant to a specialist for a skin prick test or an oral food challenge. The results will help determine how peanuts should be safely introduced into the infant’s diet.

Solid Food First

The other two categories of guidelines include infants with mild or moderate eczema and infants without eczema or any food allergy. The mild or moderate group of children should have peanut-containing foods introduced into their diets around 6 months of age. Those with little risk can have peanut-containing foods introduced into their diets freely at the parents' discretion.

In all cases, even with high-risk infants, babies should start other solid foods before they are introduced to peanut-containing foods, the guidelines say.

Guideline Goals

With the new recommendations, the National Institute of Allergy and Infectious Diseases ultimately hopes to drastically reduce peanut allergy in kids, as well as the medical costs that come with the condition.

“Living with peanut allergy requires constant vigilance. Preventing the development of peanut allergy will improve and save lives and lower health care costs,” Anthony S. Fauci, M.D.,  the director at NIAID, said in a statement. “We expect that widespread implementation of these guidelines by health care providers will prevent the development of peanut allergy in many susceptible children and ultimately reduce the prevalence of peanut allergy in the United States.”

-- By Dana Benbow, Senior Journalist at IU Health. Reach Benbow via email dbenbow@iuhealth.org or on Twitter @danabenbow.

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