When your little one starts eating solid foods, do you feel a little scared to give them things like peanuts and eggs? "Oh, will they get an allergy, will they get sick, will they have trouble breathing?" You may be thinking, right? This fear is something that many mothers and fathers have. In fact, peanut allergy is something that can be dangerous. That's why, for so long, we all thought that we should delay giving peanuts to little ones. However, now this opinion in medical science has completely changed. Let's talk about it today.
The old view and the new way we think now
For decades, allergists and pediatricians have believed two things. One is that peanuts should be introduced to babies after they are infants, believing that the risk of developing an allergy is lower. The second is that if a child develops an allergy, peanuts should be avoided completely for the rest of their life.
But now these ideas are changing. Today we know that peanuts are not actually a nut, but a legume . The latest advice is that introducing peanuts to babies as soon as they start solid foods, which is around 4-6 months, can help prevent allergies.
Think about it, not as your baby's first solid food. You can mix some oatmeal with a little peanut butter.
But this is very important: If your baby already has a skin condition like eczema or another food allergy, that child falls into the high-risk category. You should definitely introduce peanuts to such a child only under the supervision of your pediatrician.
It has also been found that even children and adults who are already allergic to peanuts can be gradually desensitized to the allergen through desensitization. Simply put, gradual exposure to peanuts under the supervision of a doctor can prevent the severe reactions (anaphylaxis) that can occur from accidental ingestion of peanuts.
What are the results of giving peanuts early?
This major change was due to the results of a massive clinical trial called LEAP (Learning Early About Pea Nut Allergy ) , which was published in 2015.
This study showed that introducing peanuts to high-risk children (those who already had eczema or other food allergies) at an early age reduced their risk of developing peanut allergies by 81% . The study involved more than 600 children aged 4-11 months. One group was given peanuts until they were 5 years old, while the other group was not given peanuts at all.
The results were surprising. 17% of the children in the group that didn't eat peanuts had developed a peanut allergy by age 5. However, only 3% of the children in the group that ate peanuts had the condition. This highlights the importance of early introduction.
The difference between avoidance and desensitization
The LEAP trial focused on preventing allergies. But what about people who already have allergies? That's what Oral Immunotherapy (OIT) is for.
OIT is simply retraining the immune system of someone who already has a peanut allergy. This involves starting with a very small dose of peanut protein, under medical supervision, and gradually increasing the dose over months or years. This allows the body to stop reacting so badly to peanuts and to learn to tolerate them .
This method is now being used in some hospitals in Sri Lanka. In addition to OIT, research is also underway on other methods, such as a peanut patch that delivers peanut protein through the skin and sublingual drops.
Why is peanut allergy so common?
A question many parents have is, "We didn't have these things in our time, so why are there so many now?" Doctors suspect several reasons for this.
- Hygiene Hypothesis: Because we are so clean these days, our immune systems have less opportunity to fight germs when they are young. So it may be that it is simply starting a "battle" with something as harmless as peanuts.
- Vitamin D deficiency: Children are now spending less time outside and playing in the sun. They are spending more time indoors with computers and phones. This is thought to be a cause of vitamin D deficiency.
- Food production methods: When food is produced in large quantities, cross-contamination with other foods and the use of pesticides can also be a factor.
This is not the only reason, it could be a combination of all of these.
Real-life experience: How OIT treatment was successful
They know how stressful it is to be the parent of a child with a severe peanut allergy. You have to carefully consider every meal. You have to read the label on everything you buy at the store. You have to keep an epinephrine auto-injector (an emergency medicine injection) with you at all times.
Jemma is a 12-year-old girl who had a severe allergy to peanuts and several other nuts. She received OIT treatment. Her mother described the experience as follows:
"First, at the doctor's clinic, Gemma was given a milligram of peanut powder. We were observed for a few hours. When there was no reaction, she came home. After that, I gave Gemma the same amount of powder every night at home. I even bought a diamond weighing scale to measure it accurately. We continued giving her that dose for months until the doctor told us to."
"Every time the dose was increased, it was done in the hospital. Then she waited for hours before coming home. Sometimes Gemma would get stomach aches and a scratchy throat. They gave her medicine for that. Gradually, her body got used to it."
"We've been doing this treatment for over 2 years now. Gemma is no longer on drugs, and eats two regular peanuts every night. Without any side effects."
The goal of this treatment is to reach a maintenance dose . That is, the amount that needs to be taken daily to maintain safety. This is to prevent a severe reaction if you accidentally eat something containing peanuts.
Important facts and statistics to know
It is very important to keep these points in mind.
| Fact | Details |
|---|---|
| Risks for other types of nuts | If you have a peanut allergy, your risk of developing an allergy to tree nuts, such as almonds and cashews, is 25% - 40% higher. |
| Severe reactions (Anaphylaxis) | More than 40% of children with food allergies have experienced a severe allergic reaction at least once in their lives, with peanuts being the most common. |
| Association with other allergies | Children with food allergies are two to four times more likely to develop other allergies, such as asthma and pollen. |
| Future treatments | An OIT drug called AR101 , which is given as a pill, is currently being considered for approval. This could be a treatment for children aged 4-17. |
Take-Home Message
- Always talk to your doctor or pediatrician before introducing foods that may cause allergies, such as peanuts, to your baby.
- The latest opinion is that introducing peanuts at an early age (4-6 months) can prevent allergies.
- If your baby has eczema or other allergies (high-risk), peanuts should only be introduced under medical supervision.
- If you already have allergies, Oral Immunotherapy (OIT) is a treatment option. Never try this at home on your own. It should only be done under strict medical supervision in a hospital or clinic.
- If you notice signs of a severe allergic reaction (e.g. difficulty breathing, swelling, vomiting), immediately take them to the nearest Emergency Department (ETU) .
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