Peanut And Tree Nut Allergies
Peanut and tree nut allergies are often studied together because about 40% of children are allergic to both. About 20% to 25% of children naturally outgrow their peanut allergies, whereas only 9% of children outgrow tree nut allergies.
In both cases, having lower IgE levels of smaller wheals on skin prick testing predicted a higher chance of outgrowing the allergy.
Even though peanut and tree nut allergies overlap, outgrowing a peanut allergy does not mean a child will outgrow their tree nut allergies. Each food has to be considered separately.
Whos More Likely To Grow Out Of Their Food Allergy
Food allergy affects up to 10% of infants and 8% of children in Australia and New Zealand. Common food allergies in young children are egg, cows milk and peanut. Allergies to tree nuts, fish and seafood tend to be more common in adolescents.
Rates of food allergies have increased in children and adults in developed countries including Australia. Theres also an increase in the number of children up to four years old whove been admitted to hospital with food anaphylaxis .
Yet, Australian research shows almost all children with an egg allergy outgrow their allergy by the time they are four years old, as do about 20% of children with a peanut allergy.
However, for others, food allergies are likely to persist. This is most likely if they have eczema, hay fever and/or asthma alongside a tree nut allergy from a young age, or they have a severe allergic reaction to a low dose of their particular food allergen.
Things I Wish Id Known About Raising A Child With A Peanut Allergy
My daughters diagnosis made me realize just how misunderstood life-threatening allergies are.
The day my daughter, Carolyn, first tried peanut butter was arguably the scariest day of my life. At the time, almost a decade ago now, the health guidelines advised waiting until two years old to introduce peanuts to kids. So one day, when she was two and a half, we gave her a peanut butter cup. I waited until the middle of the day when the doctors office would be openjust in casebut we didnt really think it would be a problem.
Afterward, I tried to put her down for her nap, as usual. But she started coughing and crying so hard she threw up, and when I pulled up her sleeve, I saw that her arm was red and puffy. So we headed to the doctor.
While they were drawing blood from her, she threw up on me again. Sure enough, her blood test showed that she had a severe peanut allergy. Her symptoms were a sign of an anaphylactic reaction, which can be life-threatening. The clincher: Her doctor said shed likely never outgrow her allergy. I later learned that only about 20 to 25 percent of children with peanut allergies outgrow them, and about 80 percent who outgrow them will do so by age eight. She had never shown any warning signs, and we dont have peanut or nut allergies in the family, so it was a complete shock and surprise.
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Anyone Have A Child That Has Outgrown A Peanut Allergy
My son was diagnosed with a class 4 peanut allergy shortly before his first birthday. When he had his reaction to peanut butter we were told by our allergist that often times kids with a peanut allergy will outgrow it over time. When we went back to his allergist this week for his annual exam, we saw a different doctor as the allergist we saw a year ago is no longer with the practice. In talking with the doctor this week I got the impression that it is far less likely than I once thought that my son will ever outgrow his allergy. She did not come right out and say that it was unlikely but she said that a peanut allergy is very different from milk or egg allergies which are often outgrown. I came away from the appointment very discouraged – after living with my son’s peanut allergy for the past year, I was always very optimistic that it would be something he would outgrow and I don’t think I ever really considered this to be something that he’d live with forever. Now, after seeing the doctor this week, I am realizing that I may not have been realistic and probably need to accept that this could be a permanent problem that he will be dealing with indefinitely. Does anyone have a child who outgrew a peanut allergy? And if so, was it several years before the allergy went away?
Check Double Check And Triple Check Labels
My daughter never eats anything without checking the label. When she was young, we taped a piece of construction paper up in our kitchen with words for her to look out for: peanut, tree nut, almond, cashew, hazelnut, walnut, and pecan. It helped prepare her to navigate the world as she got older.
I check things Ive bought hundreds of times in the past: applesauce, frozen corn. Things do change, and products weve bought before can suddenly become unsafe for her. You can never be 100 percent certain without reading the label. Every. Single. Time. Its become second nature at this point.
Im also in a Facebook group for local families with food allergies. Theyre always posting pictures of great products labeled to be allergen-free, and they share information theyve received by asking companies about their packing facilities and ingredients.There are so many more brands now that are allergen-free, and I love to buy those. I read those labels, toobecause they make me happy!
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How To Know A Food Allergy Has Been Outgrown
Being diagnosed with a food allergy or having your child diagnosed with a food allergy might feel like a jail sentence.
It can be exhausting to have to scour ingredients lists, find modified recipes and worry about accidentally ingesting the wrong food.
The good news: Some food allergies fade away, with many children managing to outgrow those allergies before they leave kindergarten. And if youre a food-allergy sufferer worried about passing it down to your children, we now know there are ways to prevent food allergies from developing.
How can we tell?
If an allergist like me once diagnosed you with a food allergy and you suspect youve outgrown it, we would perform two tests: a skin-prick test and a blood test.
If the results tell us that you could have outgrown that allergy, well start a food challenge.
Say you were diagnosed with an egg allergy. During a food challenge, youll come to the clinic and eat a tiny piece of egg while we carefully monitor your bodys reaction. After some time, youll try a larger piece of egg. If you dont have an allergic reaction, the process will be repeated until you eat whats considered a full serving.
A food challenge can take several hours. If you reach the milestone of eating an entire serving with no reactions, we can safely say that youve outgrown that allergy.
Which allergies are likely to be outgrown?
Egg, milk, soy and wheat allergies are the ones we usually see being outgrown.
How to prevent food allergies
What Treatments Are Available For A Peanut Allergy
Outgrowing a peanut allergy may still require some caution and maintenance. Johns Hopkins Medicine advises children to eat concentrated forms of peanut products, such as peanut butter, at least once a month to retain tolerance levels. You may also need to carry an epinephrine auto-injector in case of emergencies.
For the many children who still experience reactions to peanuts, there are options beyond simply avoiding harmful foods. Oral immunotherapy treatment is a process of desensitization, with patients consuming small amounts of peanut protein over many months. The intake levels are periodically increased to allow the immune system to build tolerance. Over time, you should be able to eat peanuts and not suffer an allergic reaction.
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Children Who Have Known Allergies
The best way to prevent your child with food allergies from experiencing an allergic reaction is to help them avoid the foods that they are allergic to. If someone else prepares their food for example, in another persons home, at a restaurant or at a school canteen you should make sure that they know about your childs food allergy and how they can help your child avoid eating foods that they are allergic to.
Planning can help make sure that suitable food will be available when they need it. You can order a special meal on an airplane, call a restaurant before you visit to let them know your childs needs or even bring food from home if you are unsure. Food allergies are common in Australia, and it is not unusual for venues to receive such requests.
Your child should have an ASCIA action plan. You should also work with their school on how they can help your child avoid foods that they are allergic to, and what the staff should do in case of an allergic reaction, including knowing where your childs adrenaline autoinjectors are kept.
Can Kids Outgrow A Peanut Allergy
There is a lot of focus on peanut allergies for children . The risk is greater for accidental exposure that can happen outside the watchful eye of mom or dad. Ive blogged on the topic before with wonderful response from our followers. I felt compelled to share with you some exciting breakthrough research.
Did you EVER think that your child could be DESESITIZED to peanuts? You know..outgrow the allergy?
Several researchers believe so and are challenging the idea that peanuts should be avoided the first year of life.
In a study published last week in the New England Journal of Medicine, researchers in Britain studied over 600 children with peanut allergies.
- The children were 4-11 months old and considered high risk of developing peanut allergy because of eczema or egg allergy.
- Those highly allergic to peanuts by skin testing were excluded and NOT considered a safe population to participate in the study.
- Half the group avoided peanuts, the other group ate a small amount of peanut protein every week.
- The children were followed for 5 years.
- The kids eating peanuts had 81% LESS peanut allergies than the kids that AVOIDED the peanut protein.
- Pediatric allergists are now encouraging evaluation of children with a designated peanut allergy to be evaluated for the introduction of peanut protein.
Talk to your childs pediatrician about what options you may have for your children. NEVER attempt desensitizing measures on your own as they can be life threatening.
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Ige Tests: In Vivo And In Vitro
Laboratory tests that identify specific IgE, such as the skin prick test and the ImmunoCAP-FEIA, should be conducted to confirm food allergy. A skin prick test with commercially prepared food extracts is a convenient and inexpensive method of detecting IgE bound to dermal mast cells. A drop of glycerinated extract is placed on the forearm, and the skin is pricked through the drop. Positive and negative controls are also tested. Results are available in 15 minutes a positive result is one in which the wheal from the extract is at least 3 mm larger than that from the negative control.37,38 There is no age limit for food allergy skin testing, but very young and very old people are less likely to produce adequate control wheals.39 These tests are easily conducted and the results easily interpreted by most physicians. Ideally, all patients who require evaluation for food allergy should be seen by an allergist, particularly if they require food challenges. The skin prick test is safe to perform, but systemic reactions have been reported, especially when skin testing is performed at the time of active wheezing or when foods are tested intradermally.40,41,42,43,44,45 No fatal reactions have been reported. In general, skin tests have excellent sensitivity and negative predictive value but poor specificity and positive predictive value.46,47,48,49
There’s Nothing In Pregnancy That We’ve Seen That Can Induce Food Allergy It’s Important That Mothers Realise This
But while some babies may have a higher risk of developing allergies later, due to these inherited traits, they don’t develop them while still in the womb.”There’s nothing in pregnancy that we’ve seen that can induce food allergy,” says Nadeau. It is important that mothers realise this, she says. Many have asked her “What did I do wrong?” when their child develops an allergy, thinking it may be linked to their diet during pregnancy. But there is no evidence for this, Nadeau says.
It is during the first weeks and months of their lives that babies are exposed to allergens in their environment and start developing antibodies. This exposure is through the skin, not the gut, says Nadeau.
“The moment a ‘foreign object’ touches our skin, even on a microscopic level, those allergic pathways start to be embedded in the system, and we start to activate B cells and T cells, that set down memory responses for life,” she explains. B cells and T cells are two cell types that play a very important part in our immune response. They allow us to react to a perceived threat, and remember that reaction so it’s faster and stronger the next time the threat appears.
This means that a child can be exposed to peanuts through dust or residue on their parents’ hands, which can trigger an immune response long before they have ever eaten peanut protein.
A child is examined at an asthma clinic in Washington, DC
It begins with the skin
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How Are Food Allergies Diagnosed
If you think your child may have a food allergy, their doctor may recommend some tests. These could include:
- Skin-prick testing this tests for allergies by placing tiny amounts of the food being tested on your childs arm, and gently pricking it into the skin. The test is positive if a small itchy lump appears on the arm within 20 minutes.
- Blood tests check if your childs immune system has a response to a particular type of food as a sign of allergy. This is useful if your child is taking eczema or allergy medicines, since a skin-prick test would not be reliable.
How Do You Know If A Peanut Allergy Has Been Outgrown
If you suspect a peanut allergy has been outgrown, make an appointment with your allergist. Typically, your allergist will conduct a skin prick test to see if there is a response to peanut proteins on the skin. A different approach is to use a blood test to analyze for high levels of antibodies related to peanut allergies.
Your allergist may also use an oral food challenge test. This involves consuming gradually increasing levels of peanut products to check for any reactions. If your child can consume a number of peanuts without a reaction, the allergy has been outgrown. These tests offer clarityon the condition and allow individuals to manage their diets based on up-to-date medical advice.
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Q: Can My Childs Peanut Allergy Go Away Are Certain Children More Likely Than Others To Outgrow A Peanut Allergy
A: Its disappointing to hear that most kids with a peanut allergy will not outgrow it. The numbers most often quoted are that only 20% of kids will outgrow their peanut allergy.
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There are only a few predictors of who may outgrow it, and they are not reliable. Having low positive numbers on blood tests, or the size of the skin test reaction is one thing. The severity of the reaction at presentation may also be related. However, if someone has low numbers or was not diagnosed by a specialist taking a precise history of any reactions, then the diagnosis of peanut allergy may not be correct.
It is important to know if kids are truly allergic, because if they arent allergic and avoid the food unnecessarily, then they may become allergic due to the avoidance. And our allergy tests have a lot of false positives a positive test does not necessarily mean they are allergic. Because of this and the fact that kids may not outgrow the allergy, it is important to make a good diagnosis in the beginning.
Pediatric allergist Brian Schroer, MD
Milk Allergy / Cows Milk Allergy / Dairy Allergy
Cow’s milk allergy is the most common food allergy in babies and young children, but also an allergy very likely to resolve.
Outgrowing cows milk allergy depends on whether it is IgE mediated or non-IgE mediated, what age it started, and if a child can tolerate baked milk.
Children are more likely to outgrow cows milk allergy if:
- Their allergy is non-IgE mediated
- Their allergy started after 1 month old
- They can tolerate baked milk , and regularly eat baked milk
- They have lower IgE levels
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Signs And Symptoms: Could Your Child Be Allergic To Peanuts
Depending on how sensitive your childs immune system is, any type of exposure to peanuts or peanut residue can trigger an allergic reaction, including:
- Eating peanuts or peanut butter
- Eating any food made with peanuts, which can happen accidentally
- Touching peanuts or peanut residue before putting their hands in their mouth or rubbing their eyes
- Breathing in peanut residue
If your child is having an allergic reaction to peanuts, you may notice:
- Itching or tingling in or around the mouth and throat
Anaphylaxis is a severe, life-threatening allergic reaction that can affect the whole body. Call 911 immediately if your child shows signs of anaphylaxis, such as:
- Difficulty breathing
- Swelling or closing of the throat
- Sudden drop in blood pressure
- Turning pale
- Dizziness or lightheadedness