Every news media outlet has touted the exciting results of the British LEAP (Learning Early About Peanut Allergy) study: there may be a way to prevent the development of peanut allergies by feeding your child peanuts at an early age. This study, published in the New England Journal of Medicine, concludes that there is a narrow window between four and 11 months of age where consuming peanuts is beneficial in the prevention of peanut allergies. Wow!
This groundbreaking research has the potential to change the peanut allergic landscape for future generations. This is about as exciting as science gets because there may be way to affect the path of the immune system, especially if it was heading down that dark alley towards developing a peanut allergy.
As a mom to a peanut allergic child, this research thrills me. Perhaps this will mean my son's genetic risk of having a nut allergy can be avoided in his future generations. If I read the headlines correctly, all he will need to do is feed his children peanuts at four months old, right? In fact, should all new parents go out and feed their young babies peanuts right away? Hold on. Not so fast. Let us understand what the research is saying, and more importantly, what it is not. Just like many things in life, there is no black and white here. Things are always more complicated than the headlines indicate.
Every child that participated in this study was considered at "at-risk" child and received a skin prick test concurrent with a supervised oral challenge prior to the consumption of peanuts. Those children that had a significant reaction (greater than 4mm) to the skin prick test were excluded from the study. So the first take home message is: Do not try to give peanuts to at-risk children at home. Do we have the resources to evaluate skin testing results for the population of at-risk patients of developing a peanut allergy?
Other vital unanswered questions include: what is the optimum amount of peanuts one must consume to keep the allergy at bay, and what will happen if you discontinue eating peanuts? My kids ate certain foods as young children that they won't touch now as they have developed their own personal taste preferences. Does this study apply to kids that aren't "at-risk," or to those with other food allergies such as tree nut and dairy? I hope further studies will help us with these questions.
Peanut allergies are potentially life threatening. If the guidelines of when parents should introduce nuts to children are going to change, pediatricians must teach parents (especially those who do not have experience with allergies) to recognize the signs and symptoms of a food allergic reaction. There could be serious ramifications of not identifying food aversion, hives or swelling, as a reaction to food. In addition, pediatricians must screen those at-risk patients for food allergies and then refer them for further testing.
We must realize that this study has the enormous potential to reduce the prevalence of food allergies, but not eliminate them. It may take years before we see significant changes in the numbers of the food allergic population. In the meantime, we need to keep the children and adults who have these allergies safe. We need to educate the public, and advocate for those people who suffer from this disease. Food allergies are unique as they require the help of those around us to keep us safe.
I applaud the work of the doctors of this study, and those groups who sponsored this groundbreaking research. Remember, there have been many facts that society has been scientifically certain, only to learn over the course of time that our understanding turned out to be not entirely correct. For now, it seems that early exposure to nuts may be a big part of the riddle that has resulted in an increased prevalence of food allergies. I remain cautiously optimistic.
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