Poor parents, we’re so misunderstood. We’re just trying to do the right thing and protect our kids from a devastating legume and then someone throws a bunch of annoying facts around and we have to face the truth. We are responsible for the peanut anaphylaxis plaguing our offspring.
I know, it’s, like, so hard to swallow. (See what I did there?). Here we are delaying the introduction of the dreaded edible in order to protect our youngsters, when incontrovertible research now shows that it is, in fact, this late introduction that causes the dangerous allergic reactions we are trying so hard to avoid. What was that? It’s true. The research shows that it is precisely our delaying the introduction of peanuts into our kid’s diets that’s responsible for the unprecedented surge in peanut allergies.
You see there is a window theory that has dominated our nation’s feeding philosophies for years. It says that if you introduce foods too early, or too late, you will increase allergic diseases later in life. These allergic diseases include food allergies, eczema (atopic dermatitis), hay fever (allergic rhinitis), wheezing and asthma. Many of us remember the dire warnings to avoid eating peanuts during pregnancy and to never feed a baby anything peanut-tinged until they are at least 3 years of age. Wrong!
In December 2008, the American Academy of Pediatrics (AAP) released a policy statement saying that although solids should not be introduced before 4 to 6 months of age, there is no current convincing evidence that delaying their introduction has a significantly protective effect. This includes foods considered to be highly allergy-inducing, such as fish, eggs and foods containing peanut protein. Many studies now confirm this finding. One of the more comprehensive five-year studies showed that delaying introduction of peanut protein to 2 or 3 years of age did not decrease the rate of allergies at all. In fact, there are convincing studies showing that earlier introduction of these foods actually decreases allergies. The best study to demonstrate this is one by Du Toit, et al, in the Journal of Clinical Immunology, November 2008. This study followed 5,615 kids in Israel and 5,171 kids in the United Kingdom, all of Jewish descent, to assure a similar genetic makeup. The Israeli kids ate peanuts earlier and in larger quantities than the English children and had a tenfold lower rate of peanut allergies than the UK kids.
Another paper, recently published in the January 2010 issue of Pediatrics by Bright, et al, was a Finnish prospective cohort study. It concluded that late introduction of solid foods was associated with increased risk of allergic sensitization to food and inhalant allergens. Specifically, the study showed a significant increased allergic risk by delaying fish past 8.2 months and eggs past 10.5 months. The fact remains that food allergies are increasing at an alarming rate (20 years ago we had never heard of “peanut-free zones”). According to the Center for Disease Control (CDC), in 2007, approximately 3 million children under age 18 (that’s almost four out of every 100) were reported to have a food allergy. Numerous studies show that the prevalence of peanut allergies has tripled in the past decade.
Why might that be? Well, in a recent article published by the Journal of Allergy & Clinical Immunology, researchers acknowledged an alarmingly high rate of false positives with our current system of skin, in-vitro and blood testing for allergies. Out of 110 children who allegedly suffered from severe peanut allergies, only about one in 50 actually had a true clinical peanut allergy. While these tests can certainly identify what a patient may have sensitivity to, they do not indicate that the patient is going to ultimately show clinical allergy symptoms if exposed to a particular food. The most recent food allergy guidelines put out by the National Institute of Allergy and Infectious Diseases also concurs that our current testing methods are not adequate predictors of clinical diagnosis. They also stress that there is no data to support mothers eliminating foods during pregnancy or breast-feeding in order to protect children from allergies. Most importantly, the Institute encourages physicians and parents to recognize the difference between food sensitivity and clinical food allergy.
As I see it, maybe it’s time to re-examine our feeding philosophies. The facts seem indisputable. Early introduction of high- risk foods is the best way to avoid allergies later in life. But we’re all so darn afraid of making a mistake that we overcompensate and choose to delay, or even decline, the introduction of certain foods, like peanuts, and we miss the critical window of opportunity for safe introduction. Our fears are actually causing more harm than good. And because this is such a hotly debated issue in our culture, the media has shied away from reporting these findings. So join with me in telling the truth about peanuts and offer an alternative view of the beleaguered legume. Especially when that view is based on solid research, clear clinical data, and scientifically sound evidence. Be bold! Dare to stand up for the unfavorable protein! Go on, I say, break out the PB&J for junior — and the sooner the better.
HERE ARE A FEW CONVINCING TIDBITS FROM VARIOUS SIDES:
Pediatrics July 2008; Snijders, et al: Delayed introduction of cow’s milk and other foods was associated with a higher risk of eczema (a type of skin allergy).
Pediatric Allergy Immunology, February 2008; Prescott, et al: tolerance to food allergies appears to be driven by regular, early exposure to these proteins during a critical early “window” of development.
Acta Pediar, May 2009; Wennergrad: elimination of food allergens during pregnancy and infancy failed to prevent food allergy. Instead, several studies indicate early introduction of foods such as fish and peanuts may be beneficial. Conclusions: early introduction rather than avoidance may be a better strategy for the prevention of food allergy. (this was a meta analysis.)
Pediatrics, February 2006; Zutavern: Cohort study — no evidence to support delayed introduction of solids beyond six months of age to prevent atopic disease.
Archive of Childhood Diseases, 2004; Zutavern: late egg introduction increased eczema and wheezing.
Debra Rich Gettleman is a mother and blogger based in the Phoenix area. For more of her work, see unmotherlyinsights.com.
