Recent studies on food allergies have gotten high-profile attention as researchers test an old method to develop new treatments for severe food allergies, especially for kids and teens.
Trial results for immunotherapy – building up resistance through tightly controlled exposure – give hope to families who stay vigilant to avoid life-threatening allergic reactions. One clinical trial, whose results were published in the New England Journal of Medicine in November, exposed children to tiny amounts of peanut protein under medical supervision, increasing in minute increments as tolerance develops. The goal: Reduce the risk that accidental exposure to trace amounts of peanut will trigger a life-threatening reaction – and ease the anxiety of living with severe peanut allergy. About 1% to 2% of children have peanut allergies – often severe and lifelong, according to the American Academy of Pediatrics.
“For parents of children with food allergies, this is exciting research. Even though fatal reactions to food allergens are not very common, the fear of having one really has a big impact on quality of life,” says dietitian nutritionist Kristi Winkels, RDN, LD. “While it’s not a cure, I think being able to reduce the severity of reactions through oral immunotherapy is a big step forward.”
The research won’t change how Winkels educates patients on allergen avoidance. “The goal is to avoid any kind of reaction, so strict avoidance is still the best treatment,” Winkels says. “Using substitutions like sunflower butter instead of peanut butter offers similar nutrients without the threat of an allergic reaction.”
Eventually, new treatment methods might give more confidence with foods at risk of contact with the allergen – snacks processed in the same factory as peanuts, for example. For now, people with food allergies should avoid foods with advisory statements about possible contact (like “May contain peanuts”), Winkels says.
Meanwhile, the American Academy of Pediatrics (AAP) has updated its recommendations for introducing infants to peanuts, a common allergen. Parents who worry that their children might develop food allergies often delay introducing those foods – but research shows it’s better to introduce peanuts early.
AAP’s new (in 2017) guidelines recommend introducing peanut protein early to infants at higher risk of developing the allergy – but not already allergic. (A skin prick or blood test, along with health history, can help your provider diagnose existing allergies.)
Infants at highest risk, those with severe eczema and/or egg allergy, should be introduced to peanut at 4-6 months once they’re eating other solid food, AAP recommends. Because peanuts and peanut butter are choking hazards, it’s best to mix peanut butter into pureed fruits or vegetables. Babies at this level of risk should be tested for allergies before eating peanut.
Infants with mild to moderate eczema should be introduced to peanut around 6 months of age, in accordance with family preferences and cultural practices, AAP recommends. Infants without eczema or food allergy are not at increased risk for peanut allergy; peanut can be introduced freely along with other solid foods.
Talk with your pediatrician or family medicine provider about your child’s diet and any concerns about food allergies.