The prevalence of peanut allergies in the U.S., according to researchers at Mount Sinai Hospital in New York, has tripled over the past 15 years.
The general thinking among physicians has been to delay introducing peanuts into children's diets until the age of 3 in order to prevent the development of an allergy. But that thinking has changed.
Earlier this year, a study in England found that introducing peanuts to babies considered to be at high risk for a reaction actually reduced their chances of developing a peanut allergy. Last month, the American Academy of Pediatrics endorsed the study's findings.
Genevieve Dix, 1, of Lewiston is not a big fan of meat.
When she was six months old, her parents gave her some scrambled egg as a source of protein. Genevieve loved it, her mom, Abby, says.
"And then like 5 minutes in, she started breaking out with hives, and she was really itchy and swollen," she says.
Dix says she brought Genevieve to an allergist for testing, which confirmed that she was allergic to eggs. Then, the allergist asked Dix something that, just a year ago, likely never would have even been suggested.
"'Have you given her peanut butter?' And I said, 'No, not really,'" she says. "And she said, 'Would you feel comfortable giving her some?'"
That, says Dr. Scott Sicherer, marks a dramatic shift in the approach to peanut allergies. Sicherer is a researcher and a pediatric allergist at the Jaffe Food Allergy Institute at Mount Sinai in New York. He's also a member of the American Academy of Pediatrics committee on allergy and immunology.
"In the old days, we would have looked at child like that, and aside from any recommendations, common sense would have been, 'Well, gee — I just fed this child eggs and they got hives, I'm certainly not going to feed them peanuts tomorrow,'" he says. "That just sounds crazy, right?"
Not according to a study published in February called the Learning Early About Peanut study, or LEAP. Conducted in London, the randomized trial evaluated about 700 babies. All had an egg allergy, eczema or both, which meant they were at high risk for peanut allergies.
Starting at age 4 months to 11 months, some of the babies ate two teaspoons of peanut butter or equivalent peanut product several times a week. Others ate none.
"They followed them over a long period of time, and they found there was a strikingly dramatic reduction in the prevalence of developing a peanut allergy in the infants who were regularly consuming peanut products," says Dr. Carah Santos, an allergist at Allergy and Asthma Associates in Portland. "So it's really changed our way of thinking, that we probably shouldn't be delaying these foods for as long as we once thought."
It's a change in thinking that's being embraced by physicians in the U.S.
In August, the American Academy of Pediatrics endorsed a consensus statement by 10 medical organizations that says early peanut introduction is safe and effective in infants at high risk of peanut allergy. But the statement also suggests it's a good idea to have an allergist evaluate these babies and possibly observe them when they first ingest peanuts.
Genevieve Dix was one of those high risk babies. And after an evaluation, Santos recommended that she start eating peanut butter.
It's been six months, and while mom Abby Dix says Genvieve can be a picky eater, peanut butter sandwiched between two graham crackers has become a breakfast staple.
"It's kind of been a lifesaver that she can eat peanut butter and she's been able to eat peanut butter since 6 months old, because I don't know what we would have done," she says.
The burning question that remains, say researchers, is when to introduce peanuts to babies considered to be at low risk of peanut allergy. Another study is currently underway in England to answer that question.
Both Santos and Sicherer say they're eagerly anticipating the results, but believe it's likely that waiting to introduce peanuts to babies is counter-productive.
