Hold the Peanut Butter, Please

Med Headlines - Peanut allergies in children seem to be getting more common and they seem to be developing at an earlier age than in recent years. Todd D. Green, MD, of the Children’s Hospital of Pittsburgh, reports these findings in the December issue of Pediatrics.

The American Academy of Pediatrics recommends abstaining from peanuts until a child is three years old if a parent or sibling has been diagnosed with a peanut allergy. Mothers with peanut allergies in the family are also urged to avoid peanut intake during pregnancy and breastfeeding. The retrospective study suggests these precautions aren’t being widely followed.

Studies of pediatric allergy records indicate the age of first introduction to peanuts in the 1990s was 22 months. Records of children’s peanut allergies for the period 2000 to 2006 indicate first exposure at age 14 months is more common now.

The age of adverse reaction to peanuts has dropped from 24 months to only 18 months of age over the last ten years.

Increased public awareness of the possibility of allergies is cited as one reason for the earlier diagnoses. The availability of serum and skin tests are also considered a possible factor.

Atopic dermatitis, a form of eczema related to food allergies, was the first symptom in almost all the children brought in for medical treatment. Gastrointestinal and respiratory symptoms were other reasons for seeking medical care. In most cases, symptoms developed within ten minutes after eating peanuts.

A family history of atopy associated with peanuts is call for caution, especially when asthma and allergic rhinitis are also experienced.

Many children eventually outgrow their peanut allergies. Children also develop stronger immune systems as they grow. By waiting until a susceptible child is at least three years old before introducing him or her to peanuts, it is likely any allergic reactions can be avoided or minimized.