When her son, Ian, was almost a year old, Kati Ohlmeyer, a mother and registered dietician, said she fed Ian a peanut butter sandwich, prompting his severe allergic reaction to the food. Soon, the topic became second nature to her, she said.
“I was always worried someone else would, in a well-meaning way, hand him a peanut butter sandwich,” Ohlmeyer said.
Now at age 9, although Ian has grown out of many of his allergies, he remains highly allergic to peanuts and eggs and carries an epinephrine shot, or an EpiPen, with him always, she said.
An EpiPen is used to administer epinephrine to an individual having a severe allergic reaction, or anaphylactic shock, to a food or other item.
“Peanut allergy is a huge topic, and it’s a huge public health problem right now,” said Dr. Allen Lieberman, an allergist who specializes in food allergies with The Allergy and Asthma Center of Austin. “We don’t know why this is happening, but peanut allergy has tripled in the past 15 years.”
Allergic reactions to peanuts tend to be more severe than other food allergy reactions and are less likely to be outgrown, he said.
“These are kids at risk of [severe allergic reaction] that if they eat the wrong foods, they can go into shock,” Lieberman said. “There are fatalities related to it.”
For years, some parents have kept their children away from peanuts, fearing an allergic reaction, Lieberman said.
However a New England Journal of Medicine article published in March confirmed the guidelines given to doctors treating patients with peanut allergies. It cited a 2015 study in England that followed infants who had eczema and/or egg allergies, an indication the child was at high risk to develop a peanut allergy. At 6 months of age, the researchers fed these children a peanut snack—Bamba—found in most Israeli households. As a result, these children had an 80 percent less risk of developing a peanut allergy later on, Lieberman said. Israel has far fewer peanut allergy incidences than the U.S. or Europe, and its children eat peanut products at a young age, he said.
The study showed that restricting children from peanut when they are young actually appears to make them more likely to have an allergy to peanut when they get older, he said.
Change in treatment
Lieberman said he has altered his practice to now introduce peanut to very young children who are at risk for a peanut allergy, after doing a skin test.
“If the skin test reaction is very small, the recommendation is to feed him peanut and introduce it, hopefully preventing peanut allergy from taking hold when the child is older,” he said.
Once a child can safely eat a food, he said, “you want to keep them eating it because there’s a window [after which] they will become positive to it and start reacting to [the food].”
“Now the recommendations are for allergists to see these kids at 6 months of age,” Lieberman said. “We used to wait until they were older—a year old—to see them, but that might be too late. We are seeing these kids at 6 months of age and replicating what [researchers] did in the study and test them [for peanut allergy].”
Lieberman keeps a carton of Bamba peanut products in his office that he said he purchases online or at H-E-B.
He said a lot of research is being devoted to peanut allergy in recent years.
“We do not have a treatment for [peanut allergy],” Lieberman said. “We finally have something encouraging—this early introduction of peanut in these kids. So we’re very aggressive about testing these kids.”