Deciding what to feed your child can be confusing for new parents… Especially when it comes to food allergies. In the last 10 years, peanut allergies have doubled in western countries.
Scientists have found that exposing infants to peanuts early on can dramatically reduce their chances of becoming allergic later. Miriam Sitz reports on this major shift in thinking.
When Carlyn Kolker’s son Caleb was almost two, he accidentally ate a peanut butter and jelly sandwich. Accidentally because his parents were being cautious, not giving him peanuts so young. It was December of 2010.
KOLKER: A couple minutes later we noticed that Caleb’s lip was swelling up, and pretty soon after that he was covered in hives head to toe. Wound up spending Christmas Eve at the emergency room.
She was terrified, but also confused.
KOLKER: This is sort of absurd of me but I thought, we don’t have food allergies. This can’t be.
Now, the six-year-old carries an Epipen with him at all times. Before sleepovers and parties, Kolker sends a detailed note about what he can and can’t eat. It’s on their minds all the time. And for the last year, he’s been part of a clinical trial at Mount Sinai, where he eats small, increasing amounts of peanut flour — the very thing that makes him sick.
CALEB: (Does it taste like anything to you?) No just tastes like applesauce. (Yeah? Because you mix it in with your apple sauce?) Yeah.
They visit the hospital every two weeks, schleeping from Windsor Terrace to the Upper East Side to get tested and pick up a new supply of flour capsules. Mixed into his food, he eats it…
CALEB: Every day, at nighttime except for the day I go to Mount Sinai.
Scott Sicherer (sish-er-er) is professor of pediatrics at Mount Sinai and former head of the American Academy of Pediatrics’ allergy and immunology committee. He explains that by giving Caleb small amounts of peanut flour, the hope is…
SICHERER: To get the body essentially used to the food that it’s allergic to and to try to change the immune response.
But the recommendations on when to introduce peanuts have been changing wildly. In 2000, the American Academy of Pediatrics recommended NO peanuts for kids younger than 3. But in 2008, they modified that stance, saying exposure was probably ok.
Then in February, it all changed again.
SICHERER: The study that just came out is the LEAP study.
LEAP stands for “learning early about peanuts.”
SICHERER: It was a well done study, it was a large study, and there seemed to be a benefit to this early eating of peanuts.
It showed that healthy kids who don’t have a diagnosed allergy really SHOULD eat peanut products when they’re very young.
And the study came about because of a snack.
BAMBA THEME
There’s nothing like Bamba, the jingle says. In Israel, the puffed corn and peanut snack is as ubiquitous as Cheerios. But researchers noted that peanut allergies are ten times as high among Jewish kids in the UK as in Israel.
The LEAP study watched more than 640 babies less than a year old, who had other allergies, put into two groups. Half ate peanut products like Bamba several times a week, and half waited until age 5.
The Bamba babies ended up with a lot fewer peanut allergies.
RAMESH: And they saw that there was an 80% reduction in the risk of developing peanut allergies by this very simple intervention.
That’s Manish Ramesh, assistant professor of medicine and director of the food allergy group at Montefiore Medical Center.
So now, the advice is to give healthy kids peanut products when they’re young — really young, like under a year — to prevent allergies.
RAMESH: We decided this is actually almost like a public health thing. It’s almost as if we were vaccinating kids against measles. In the same way we are essentially preventing development of an allergy by a very simple intervention.
So they’ve set up a program, to test then expose kids to peanuts in a medically supervised setting. Similar to the LEAP study, the Montefiore program targets kids who have eczema, or are allergic to milk or egg. Those things indicate a high risk of later peanut allergy.
On the day I called, they were just ready to take their first appointments.
RAMESH: We just confirmed that we have the call system in place, as of today.
And time of the essence. This has only been proven to work in very young children, during a narrow developmental window. And though many in the study didn’t develop an allergy after regular exposure, some still did. It’s not a foolproof plan. Even so, Ramesh seems urgent. He says the pros outweigh the cons.
RAMESH: This early intervention which is relatively low risk might be better than waiting to see what happens after five or six years when child has already developed peanut allergy.
At six years old, Caleb is too late for this kind of preventive treatment. But in his study, he’s shown progress.
CALEB: (What do you hope to happen from the clinical trial?) For my peanut allergy to go away. A little. (A little?) Or as much as it can.
Parents who are interested in a peanut screening can make an appointment with Montefiore in Scarsdale or in the Bronx.
Miriam Sitz, Columbia Radio News.