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Jun
21
2010

This post is authored by Rima Sanka, D.O., a Tampa-based pediatric allergy, asthma and immunologist.  Dr. Sanka has published research about red tide, aeroallergies and primary immune deficiency, has served as a distinguished lecturer at several Florida conferences and has been featured on local news broadcasts.

Food allergies appear to be on the rise – with peanut and tree nut allergies leading the way.  One study showed that from 1997 to 2002, the incidence of peanut allergy doubled in children.  Peanuts and tree nuts can trigger severe, life threatening reactions and are among the leading causes of fatal and near-fatal reactions to foods.  Many of you may remember hearing about a teenage girl who died after kissing her boyfriend – who had eaten a peanut butter sandwich.  Schools, camps, restaurants and daycares have had to completely change their practices and implement special policies to protect children with food allergies.  “Peanut free” schools are becoming more and more common.  Is it all hype?  What should we believe?  Here are some common questions – and the facts.

Can food allergies be outgrown? Allergies to peanuts, tree nuts, fish and shellfish are generally lifelong allergies; however, recent studies indicate that up to 20% of kids will outgrow peanut allergies (with the rate slightly lower at 10% for tree nut allergies).  The good news is that 85% of children will outgrow milk and egg allergies by 5 years of age.

Can alternative nut butters (e.g., cashew nut butter) be substituted for peanut butter? Many nut butters are produced on the same equipment used to process peanut butter – making them risky alternatives.  Also, many experts recommend that peanut-allergic patients avoid tree nuts as well.  (Tree nuts include, but are not limited to, walnuts, almonds, hazelnuts, cashews, pistachios, Brazil nuts and coconuts.  These are not to be confused or grouped together with peanuts (which are legumes) or seeds, such as sunflower or sesame.)  Tree nuts can be found as ingredients in many unexpected places.  For tips on reading labels, visit the FAAN website.

Can I prevent or decrease the risk of my child developing food allergies? The data here is conflicting. Although it may be the case that delaying the introduction of highly allergenic foods (such as waiting until a child is 3-years-old to give peanut butter) can stem the effects, this may not always work.  According to the results of a prospective, birth cohort study reported in the December 7, 2009 issue of Pediatrics, late introduction of solid foods into the infant diet was actually associated with an increased risk for allergic sensitization to food and inhalant allergens at age 5 years.  The protective effects of breastfeeding for 6-12 months have also had conflicting data.

What’s in store for the future? There has been some exciting new research looking into oral peanut immunotherapy.  This involves introducing minute amounts of peanut daily into a peanut allergic patient in order to desensitize and cure them of their allergy.  Dr. Wesley Burks at Duke University has had some promising results, but this type of therapy is still strictly an academic tool – so don’t try this at home!

How should I manage food allergies? This can be a challenge.  At this time there is NO cure for food allergies.  Avoidance is the ONLY treatment.  In case of accidental ingestion, your doctor may prescribe injectable epinephrine, antihistamines or steroids.

FAAN has developed a variety of resources to help parents, physicians and schools to work together to keep kids with food allergies safe.  Education, communication and cooperation are the keys to preventing allergic reactions in schools, daycares and camps – so make sure to keep an open dialogue.  We’re all in this together!

And remember you’re not alone.  It helps to meet other families who are in the same situation to share experiences.  Support groups are available.

© 2010 Rima Sanka, D.O.
http://www.allergydoc.us

The advice and contents of this blog post are for general informational purposes only and are not intended to constitute any expert or professional opinion.  Nothing contained herein is intended to create a physician-patient relationship.  You are advised to consult with a medical professional.

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