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To prevent peanut allergies, feed infants with peanuts.
Thus, the American Academy of Pediatrics (AAP) states in a new clinical report showing that early exposure to common allergens can prevent the development of allergies during childhood.
The group, which represents pediatricians often on the front lines in the fight against allergies in children, began by urging parents to feed infants with foods made from peanuts and other common allergens.
The new study published in the journal Pediatrics reinforces this recommendation with more research and also updates the allergy guidelines published in 2008.
"There is no reason to delay giving your baby foods that are considered allergens such as peanut products, eggs or fish," said Dr. Scott Sicherer, allergist at Mount Sinai Hospital in New York and co-author of the report. . "These foods can be added to the diet early, as are foods that are not common allergens, like rice, fruits or vegetables."
"The immune system develops very early in life, so if we can change it at that time, we can change the fate of the patient," said Dr. Purvi Parikh, allergist in New York and spokesman at Healthline. of the Allergy & Asthma Network. .
The advice nevertheless leaves some parents of allergic children pause, especially since for years, doctors have explicitly advised against any early exposure to potential allergens.
Chris Schulter Bizarro, one of Colorado 's parents of a girl suffering from peanut allergy, said that his pediatrician "had advised to wait until after that. she could speak to have her judged, so that she could say something if she had a problem. "
Later, "my sister-in-law was watching her and did not know she would not have eaten peanut butter. A mouthful and she spit, burst into hives and started crying, "she said. "She was 18 months old. I'm not sure that an earlier exposure would have made a difference. "
"My daughter had an anaphylactic reaction before her first birthday, so I could not express the symptoms," said Shelly Goudreau of Bristol, Rhode Island. "It was the scariest moment of my life. As for the introduction of any food, I would start with a very small taste and would stop there, introducing extremely slowly with an education on the symptoms of any reaction. "
Dr. David Stukus, badociate professor of pediatrics at Nationwide Children's Hospital in Columbus, Ohio, and spokesperson for the American College of Allergy, Asthma and Immunology, told Healthline that peanut introduction in childhood was not without risk.
However, he added, 98% of people never develop peanut allergy and, even in susceptible people, the risk of early exposure is minimal compared to that of developing a permanent allergy peanuts.
"The parents come to see me because they have fed something with their child and that they have developed a rash, not because they are dying," he said. declared. "So, it's time to understand that."
Even if an infant has some sort of allergic reaction, his immune system continues to develop antibodies that may protect him in the future, Stukus said. "It's all about tolerance," he added. "If you are regularly exposed to an allergen early in life, you will become more tolerant."
Experts recommend giving children ground peanuts or special preparations that include peanuts and not whole nuts, which can pose a choking hazard.
Such foods can be introduced around the age of six months, once other solid foods are tolerated, said the PAA.
The report also confirmed the previous finding, that there is no evidence that delaying the introduction of allergens beyond 4 to 6 months prevents atopic diseases, which cause reactions in remote areas from the site of exposure to allergens, such as allergic rhinitis, asthma and eczema.
High-risk infants, such as those who suffer from severe eczema requiring prescription treatment and those who suffer from egg allergy, may also be exposed to foods containing peanuts while undergoing a badfeeding test. screening for possible peanut allergies, the report said.
"We encourage parents to talk with their pediatrician or allergist about allergy symptoms and ask them to test their child," said Dr. A. Wesley Burks, dean of the UNC School of Medicine and co-author of the report. "The doctor can help you track any changes in allergies, some of which may go away as the child grows up."
Peanut allergies are well known because of their sometimes fatal consequences. But peanuts are just one of eight food allergen groups to declare on US food labels, including cow's milk, eggs, fish, shellfish, nuts, wheat and soy.
These foods account for about 90% of all food allergies.
"We know that some children are predisposed to allergies because of their family history," said Dr. Frank Greer, co-author of the report. "It is clear that sometimes nutrition can play a key role in preventing or reducing allergies that may be of concern – or even death – for some children."
"Early exposure is not only a piece of the puzzle, but we think it's a big piece," added Stukus. "We do not need to protect a baby's immune system, we have to challenge it."
The clinical report also addressed a broader range of issues related to allergy prevention in infants. The PAA concluded that restricting the mother's diet during pregnancy or badfeeding did not seem to prevent allergies. Neither the use of hydrolysed preparations, even in children at high risk of allergies.
This latest discovery has updated previous advice on allergies published by the AAP in 2008, according to which there was limited evidence that hydrolyzed preparations could prevent infantile dermatitis.
The group of pediatricians also said that exclusive badfeeding during the first 3 to 4 months of life would protect against eczema during the first 2 years of the child and that any badfeeding at 3-4 months protected against wheezing and could reduce asthma in the long term. risk.
The evidence does not argue in favor of excluding potential food allergens such as peanuts in the infant's diet.
According to the PAA, infants should be exposed to these foods as soon as they start eating solid foods.
Early dietary exposure can prevent the subsequent development of food allergies. The risk of early exposure is largely offset by the risk of developing allergies throughout life.
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