In 2017, the National Institute of Allergy and Infectious Disease (NIAID) published new guidelines recommending that most children should be exposed to a small amount of peanut protein before six months old and continue to ingest it regularly if no allergic reaction is present. It also indicated that children at the highest risk level should be fed peanut protein in a specialist’s office so that any reaction can be evaluated and treated by a medical professional.
Newton Li, M.D., a Board-Certified Allergist and Immunologist with NCH Medical Group provides these “tests” to his patients as a preventative measure for infants and to continuously monitor and promote peanut tolerance in allergic children as they age.
“Infants with severe eczema and/or egg allergy early in infancy are considered the highest risk patients,” says Dr. Li. “I recommend feeding those infants peanut protein between four and six months. Infants with mild-to-moderate eczema should be fed peanut protein at six months, and low-risk infants can be introduced to peanuts along with other solid foods.”
The idea behind these new guidelines and practices is to help the immune system learn to tolerate peanuts and prevent an allergic reaction. Research is currently underway to further desensitize patients’ immune systems with various treatments, including a “peanut patch.”
This research is especially exciting to Dr. Li, who explains that an estimated 15-20 percent of children can outgrow their peanut allergy by adulthood. Routine testing will help to determine if a child is in that category.
Lisa Stienstra is hoping her four-year-old son, Jack, is one of those children. Jack’s symptoms began right around the time he turned one. Lisa was introducing solid foods and happened to give him peanut butter—one of her favorite foods. Jack seemed to be enjoying spoonful after spoonful but soon showed signs of an allergic reaction.
Much like any other allergic reaction to food, a reaction to peanuts can include a rash, swelling, shortness of breath, abdominal pain, vomiting, diarrhea, light headedness and, in more severe cases, low blood pressure. Luckily, Jack’s reaction was mild. Lisa quickly called 911 and Jack received treatment both in the ambulance and at the emergency room. A blood test determined that Jack was indeed allergic to peanuts.
He has since been put on an allergy plan that includes yearly blood tests and the “peanut challenge,” where Dr. Li tests Jack’s actual peanut tolerance against the results of his blood and skin tests. He has not passed yet, but his allergy level continues to downgrade, which makes Lisa hopeful and grateful for the entire staff at Dr. Li’s office.
“They have been super helpful and very assertive,” she states. “In a field where there is so much uncertainty, they are very confident, which helps me feel more at ease.”
Parents who suspect their child may be allergic should see an allergist for evaluation and testing before introducing peanut protein. Dr. Li also stresses the importance of education in avoiding potentially life-threatening allergic reactions.
“Read ingredient labels and avoid restaurants or eating establishments where cross-contamination can occur,” he highlights. “Never assume that certain menu items or packaged foods will consistently remain peanut-free.”
Most importantly, Dr. Li stresses that parents and guardians should have an action plan in place in case of a reaction and that plan should always include having an epinephrine auto-injector available.
Make an appointment with an NCH allergist to help diagnose and treat a peanut allergy by calling Call 847-618-3470. Our allergy specialists are available at 1051 W. Rand Road, Suite L02 in Arlington Heights, and 1450 Busch Parkway, Suites 103-105, Buffalo Grove.