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February 27, 2015

Early Exposure to Peanuts May Reduce Peanut Allergies, but Choking Risks Remain!

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In response to peanut allergies and children being in the news this week (Feb 2015), the American Academy of Otolaryngology—Head and Neck Surgery is cautioning parents and caregivers about choking risks especially posed to young children and infants by peanuts, tree nuts, and nut fragments.

The 2015 NEJM study on peanut ingestion and allergies in children suggested that exposing infants to peanuts before age 1 (even as young as 4 months) actually helped prevent peanut allergy from developing, lowering that risk by as much as 81 percent. Instead of provoking an allergy, early exposure seemed to help build tolerance.

Although this research is great news on possible interventions to help prevent such food allergies from developing, please caution parents and caregivers that whole peanuts or peanut pieces should never be fed to children under age four years, due to the risk of choking and aspiration. When introducing to an infants' diet, use of smooth, not chunky, peanut butter is advisable. Spread a thin layer on toast, crackers, or fruit.

Although babies should never be given peanuts, only because they pose a choking hazard, peanut protein in safe forms are a different story!

References:
Randomized Trial of Peanut Consumption in Infants at Risk for Peanut Allergy. NEJM 2015; 372:803-813February 26, 2015DOI: 10.1056/NEJMoa1414850

Early consumption of peanuts in infancy is associated with a low prevalence of peanut allergy. J Aller Clin Immuno 2008 Volume 122, Issue 5, Pages 984–991. DOI: http://dx.doi.org/10.1016/j.jaci.2008.08.039

Sources:
Feeding Infants Peanut Products Could Prevent Allergies, Study Suggests. NYT 2/23/15

EARLY EXPOSURE TO PEANUTS HELPS PREVENT ALLERGIES IN KIDS. AP 2/23/15

Treatment reduces kids' peanut allergy risk up to 86%. USA Today 2/23/15

Exposing infants to peanuts causes big reduction in peanut allergy, study shows. Washington Post 2/23/15
Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids. Google+ Christopher Chang, MD Bio

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