Protecting your child from peanut allergies

In recent years, I've seen more and more kids with peanut allergies. A recent study in the journal Pediatrics backs up my anecdotal evidence. In that study, researchers found that the number of children with peanut allergies doubled between 1997 and 2002—they increased from 0.4% to 0.8% of the U.S. population. That means almost 1 out of every 100 children has a peanut allergy. Scientists don't yet know why there is such an increase.

Peanut allergies tend to be more severe than other food allergies. Other food allergies can cause rashes or hives or asthma. Peanut allergy can be deadly. Plus, children usually do not outgrow peanut allergies.

My colleague, Dr. Henry Bernstein, gives these good tips to help your children either avoid or live with a peanut allergy:

• Know if your infant is at risk for developing a peanut allergy. Risk is greater if both parents or one parent and at least one sibling have food allergies. If your child is at risk, the American Academy of Pediatrics recommends that you avoid peanuts during pregnancy and breastfeeding. Peanut products should not be given to any child before his or her 3^rd birthday.
• If you think your child may have peanut allergies, see an allergy specialist. The allergist can test your child for other food allergies and be sure you have everything you need to prevent reactions.
• If your child has a peanut allergy, the best treatment is to avoid peanut exposure altogether. Even small amounts of peanuts can be harmful, and avoiding peanuts can be hard. Here are some specific tactics:

• Let everyone know your child is allergic. This should include the school, day care, family, friends, babysitters, and the families of everyone your child plays with.
• Read labels on all packaged foods carefully.
• Avoid all foods that contain peanuts. Avoid even those foods that are made using equipment that also processes peanuts.
• Ask about ingredients in foods prepared by others.
• Watch your naturally curious toddler to make sure he does not put potentially dangerous foods in his mouth.

• Be aware that children with peanut allergies are often allergic to other foods too. Children with peanut allergies may be allergic to eggs, fish, tree nuts, sesame seeds, cow's milk, soy, and wheat.
• Stay alert and have an emergency plan. If necessary, have emergency medicine, such as epinephrine, available in case your child is exposed to peanuts. Know how to give epinephrine via an EpiPen, and teach other caregivers how to do this as well. Epi pens should be renewed every two years. Older children should learn how to give themselves the medicine. When your child is old enough not to choke on it, get him or her a medical necklace or bracelet, which tells emergency medical workers that the child has a peanut allergy.
• Remember that children do outgrow many food allergies, but before reintroducing a food that caused a reaction before, check with your doctor first.

Does your child have peanut or other food allergies? How do you make sure he or she avoids those foods?

Dr. Victoria McEvoy graduated from Harvard Medical School in 1975 and is currently an Assistant Professor of Pediatrics at HMS. She is the Medical Director and Chief of Pediatrics at Mass General West Medical Group. She has practiced pediatrics for almost thirty years. She has been married to Earl for thirty six years and raised four children. She currently enjoys writing, traveling, reading, almost all sports, and spending time with her two grandsons.

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