The American medical community's stance on peanut-containing foods has done a 180-degree turn.
A few years ago I noticed that I’m no longer asked if my kids have food allergies. Instead, I’m asked what allergies my kids have, as if it’s a foregone conclusion that “child=allergic” and that the presence of an allergy is more likely than not.
It’s a sad state of affairs when adults must assume that kids cannot eat certain foods, and it reflects the colossal failure of the medical community to figure out how to prevent allergies. In 2000, the American Academy of Pediatrics issued guidelines recommending that parents avoid feeding all peanut products to children until age three, in order to avoid life-threatening reactions. At the time, the peanut allergy rate was low, around 0.4 percent.
Since then, it has quadrupled, climbing to 1.4 percent in 2008 and now over 2 percent in 2010, making it the leading cause of food-related anaphylaxis and death in the United States. Peanut allergy is even appearing in Asia and Africa, where it was previously unheard of. Clearly doctors and parents are doing something wrong, if this is the end result.
Now the medical community has drastically changed its approach, due in large part to a 2015 study published in the New England Journal of Medicine. It found that early exposure (during infancy) to peanut products reduced allergies by 81 percent. The study found that:
“Peanut avoidance was associated with a greater frequency of clinical peanut allergy than was peanut consumption, which raises questions about the usefulness of deliberate avoidance of peanuts as a strategy to prevent allergy.”
The U.S. medical community has paid attention to countries such as Israel, where peanut products are a popular component of the diet and where they are introduced early in life, the prevalence of peanut allergy is low.
In light of these findings, the National Institute of Allergy and Infectious Diseases, which funded the study, has now written an addendum to the guidelines for the prevention of peanut allergy. There are 3 parts to the guidelines:
1) Children with severe eczema (a skin condition often indicative of food allergy) or egg allergy should be introduced to age-appropriate peanut foods between 4 and 6 months of age, with doctor supervision. The child should already be eating solids.
2) Children with mild-to-moderate eczema should be introduced to peanut-containing foods by 6 months.
3) Infants without eczema or any food allergy should have age-appropriate peanut-containing foods freely introduced in the diet together with other solid foods and in accordance with family preferences and cultural practices.
While these guidelines cannot help the many children who are already allergic to peanuts and must live with the allergy for the rest of their lives, they will likely reduce the number of future allergies, improving quality of life for subsequent generations.