Peanut Allergy: Are We Driving Ourselves Nuts?

Peanut butter has been part of American kids’ diets for decades. Millions of us were raised on PB&J sandwiches. Our parents fed them to us because they thought peanut butter was an excellent source of protein — and they were right. Grocery-store shelves today remain stocked with smooth, crunchy, and organic varieties of the spread, all wrapped in colorful labels touting their nutritional merits.

And yet, in the past decade, the number of pediatric peanut allergy diagnoses has doubled. A whopping 1.5 million Americans affected with the allergy as children grow into peanut-allergic adults. What's more, peanut allergies are deadly serious — they’re responsible for 80 percent of the nation’s fatal or near fatal anaphylactic reactions each year. In response to these alarming statistics, many schools, summer camps, and youth centers have gone "peanut-free," banning any sandwiches or snacks made with even a small amount of the legume.

What Causes Peanut Allergies?

While a great deal of current research seeks the answer to this question, the issue remains unresolved. In a recent article in the journal Pediatrics, Drs. Lynda C. Schneider and Jordan Scott of Children’s Hospital Boston suggested that several factors contribute to — or are strongly correlated with — developing a peanut allergy. These include:

One intriguing and emerging concept is that the allergy may not occur because of exposure to peanut protein through eating it, as you’d expect, but because of exposure to the protein through the skin! Researchers, though, still need to determine whether any of these correlations directly cause the allergy, or whether they simply indicate an increased risk of peanut allergy in children who have other allergies.

Why Are Peanut Allergies on the Rise?

There’s little consensus about why diagnoses of peanut allergy are climbing. Part of the increase may just reflect better parental reporting of allergic reactions. But part of it may be attributed to a surprising change in family feeding habits that runs counter to American Academy of Pediatrics (AAP) recommendations.

Some parents are sure that early exposure to peanuts will help prevent the development of the allergy in children, but most professionals, including the AAP, insist that the reverse is true: Delayed exposure to peanuts helps minimize the risk of acquiring the allergy. The AAP recommends that no child be given peanut butter at all until at least age 2 — or age 3 if there’s a family history of peanut allergy.

However, as pediatric allergist Todd D. Green of Children’s Hospital of Pittsburgh has reported in the journal, Pediatrics, parents today increasingly appear to be introducing peanut butter to their children earlier rather than later. When he compared data from two allergy clinics across two decades, he found that in the 1990s parents held off giving their children peanut butter until they were between 22 and 24 months. Now, though, parents seem to be introducing peanut butter to children when they are 14 to 18 months old. This earlier exposure could very well be a factor in the increased incidence of peanut allergies.

While it's possible to be surprised by a grandchild developing a peanut allergy, 82 percent of kids who become affected have someone else in their immediate family with allergies of one kind or another. Similarly, 82 percent of peanut-allergic kids have had atopic dermatitis and 68 percent previously experienced allergies to other foods. Parents who are themslves food-allergic often expect that their child might develop allergies as well, and proceed with caution when introducing peanuts.

If Your Grandchild Has the Allergy

Keep a list of your grandchild’s food allergies handy. When choosing recipes, stocking up for a sleepover, or planning the menu for holiday meals, be sure to check in with parents to see if the child has developed any new allergies.
If your grandchild should display mild symptoms like nausea or a rash after eating a peanut-butter sandwich, treat her with Benadryl and then call her parent or pediatrician. More serious symptoms — itching or swelling of the lips, tongue, or mouth, or difficulty breathing — demand immediate action. Call 911 or your local emergency number. If your grandchild has known peanut allergies, always keep an EpiPen close at hand when they visit.

Keep the panicked headlines in perspective. American children are suffering from peanut allergies in increasing numbers, but the vast majority are not allergic at all. If your grandchild has no signs of the allergy, keep the sandwiches, granola bars, and Reese’s Pieces coming. If your grandchild does have the allergy, help train her to watch out for potential risks. Although public pressure will likely force even more schools, family restaurants, and airlines to provide nut-free zones, it’s much more important to teach an allergic child to be aware of her limitations, and to take age-appropriate responsibility for her condition.

For more information: The Mayo Clinic offers excellent information for families with allergies. Or, go to Foodallergy.org.