Many parents don’t know the steps they can take to reduce the risk of their child developing a peanut allergy, five years after new prevention guidelines emerged, according to a new report.
In 2017, the National Institutes of Health recommended parents expose their infants to peanuts as young as four months old to prevent peanut allergies.
But only 13% of parents and caregivers reported being aware of those guidelines, according to the new survey from Northwestern University and the Ann & Robert H. Lurie Children’s Hospital of Chicago.
The report, published earlier this month in the peer-reviewed journal Pediatrics, also found the parents who said they were aware of the guidelines were more likely to be white, between the ages of 30 and 44, educated and wealthy. Study authors say the findings highlight the need for more education and awareness, especially in communities with fewer health resources.
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Peanut allergy awareness
Parents and caregivers were more likely to be aware of the guidelines if they had a pediatrician who recommended early peanut introduction, the study found.
“There is a lot to juggle during a four- or six-month appointment. We need to find ways to support pediatricians in their workflows to incorporate the prevention guidelines,” said senior author Dr. Ruchi Gupta, director for Northwestern’s Center for Food Allergy and Asthma Research and pediatrician at Lurie Children’s Hospital.
In 2019, the American Academy of Pediatrics estimated more than 4 million children did not have health coverage, which could impede access to the health care system where most patients learn about food allergies.
To help close this gap, peanut allergy education should be available in community centers, daycares, and supplemental nutrition programs at clinics, said Dr. Waheeda Samady, associate professor of pediatrics at Northwestern University Feinberg School of Medicine and director of clinical research at Northwestern’s Center for Food Allergy and Asthma Research.
“We have to get to all the pediatricians, not just those who work in academic or affluent areas,” she said. “But we need to think outside that box as well.”
Despite not knowing the guidelines, 48% of surveyed parents still believed feeding peanuts early prevented a peanut allergy. Seventeen percent of parents first offered peanut-containing foods before seven months while 42% did so between seven and 12 months.
How to introduce peanuts to infants
It’s important to check with a doctor before introducing peanuts to an infant as the National Institutes of Health recommend those who have severe eczema, an egg allergy, or both, should undergo a food allergy evaluation, according to Texas Children’s Hospital.
With a doctor’s approval, Texas Children’s recommends mixing up to two teaspoons of peanut butter with up to three teaspoons of water to thin out the peanut butter. Parents should offer the infant a serving no bigger than the tip of a teaspoon and monitor symptoms for up to 20 minutes. If there aren’t any signs of an allergic reaction, parents can continue giving the infant what’s left of the puree in small doses.
Thirty-three percent of those who delayed introducing peanuts to their little one reported fearing an allergic reaction, but experts say this is uncommon and generally mild among infants.
“You should be more concerned about your older child, not your five-month-old. Statistically, reactions are much milder younger in life,” Samady said.
What are the signs of a peanut allergy?
Research estimates about 2.2% of children in the United States have a peanut allergy. The American College of Allergy, Asthma and Immunology says symptoms of a peanut allergy may include:
- Vomiting,
- Stomach cramps,
- Indigestion,
- Diarrhea,
- Wheezing,
- Shortness of breath, difficulty breathing,
- Repetitive cough,
- Tightness in throat, hoarse voice,
- Weak pulse,
- Pale or blue coloring of the skin,
- Hives and swelling, or
- Dizziness or confusion.
A skin patch for peanut allergies
The report comes a few months after Phase 3 trial data in May showed a new skin patch could increase peanut tolerance in young children with peanut allergies, reducing the risk of a severe allergic reaction if they had accidentally eaten peanuts.
The patch, developed by French biopharmaceutical company DBV Technologies, introduces 250 micrograms of peanut protein, or about 1/1000th of a peanut, to re-educate the immune system to increase its tolerance to allergens.
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Of more than 300 children aged 1 to 4, researchers found 67% of those who received the patch were able to increase their tolerance versus about 33% of kids in the placebo group.
The only other immunotherapy for peanut allergies on the American market, Palforzia, is a daily powder taken by mouth and only approved for children ages 4 to 17. The hope is that introducing immunotherapy at a younger age may lead to longer-term tolerance, experts say, but more research is needed.
It’s unclear when the patch will be available to patients in the United States.
Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.
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