Reducing peanut allergy risks in children—The Nurse Practitioner presents update

February 15, 2018, Wolters Kluwer Health
peanuts
Credit: Daniele Pellati/public domain

New prevention and treatment approaches can reduce serious health risks due to peanut allergy in children, according to an article in the March issue of The Nurse Practitioner.

Early introduction of peanuts into the diet can prevent the development of allergy in high-risk infants, according to the article by Jaime Hopper, MSN, FNP-C, and Courtney Hopp, MSN, FNP-C, of Indiana University Health Methodist Center, Indianapolis; and Jessica Durbin, DNP-FNP-BC, of Indiana State University, Terre Haute. The authors also discuss the emerging role of oral immunotherapy and other desensitization approaches to reduce serious reactions in peanut-allergic .

What's New in Peanut Allergy? Update for Nurse Practitioners

With the rising prevalence of peanut and other food allergies, nurse practitioners and other providers must be prepared to care for children with peanut allergy. "Peanut allergies are a significant public health issue and are the primary reason for food-related anaphylactic reactions that result in death," the authors write. Rates of peanut allergy in the United States have been estimated between 1.6 and 2.7 percent.

Children who have siblings or parents with known peanut allergy are at increased risk of developing peanut allergy, as well as other food allergies, asthma, or atopic dermatitis. Until recently, the American Academy of Pediatrics (AAP) recommended avoiding peanuts in high-risk children until age three.

However, a 2015 study (the LEAP trial) found that early introduction of peanuts into the diet led to a "compelling reduction" in the risk of peanut allergy in high-risk children. The updated AAP recommendations define a three-tiered exposure level, including introducing peanuts at about four to six months of age in high-risk children with severe eczema and/or , with a recommendation for allergy testing. Other recommendations apply to children with mild to moderate eczema, and to those with no eczema or any food allergy.

For children who have developed peanut allergy, a technique called oral immunotherapy (OIT) is a promising approach to allergen desensitization. In one trial, OIT increased the threshold amount of peanut children could ingest before experiencing a by at least 25 times.

"With desensitization for known , clinicians may be able to reduce the incidence and other severe reactions in the future for children by making the reactions less severe," Hopper and coauthors write. "Although OIT has not been shown to be 100 percent effective, it offers the potential for an increased quality of life for severe sufferers."

Further studies will be needed to establish the short- and long-term safety and effectiveness of OIT. Sublingual and epicutaneous approaches to peanut immunotherapy are being studied as well.

The authors discuss the implications for evaluation and management of children receiving immunotherapy for peanut , including assessment of asthma and other forms of allergic disease. Patients need ongoing education in recognition and emergency treatment of life-threatening allergic reactions, including the use of an epinephrine auto-injector.

The theory that early introduction of highly allergic foods could desensitize patients and lead to fewer adverse reactions could lead to major changes in the management of food allergies. "While currently utilized by clinicians in specialty settings and still experimental in nature, the potential exists for administration of OIT into other clinical sites," the article notes. "This would further advance the availability of lifesaving therapies to the most vulnerable individuals in our population."

Explore further: New study suggests 21 percent increase in childhood peanut allergy since 2010

More information: Jaime Hopper et al. Peanut allergy reduction in high-risk pediatric patients, The Nurse Practitioner (2018). DOI: 10.1097/01.NPR.0000530210.24654.36

Related Stories

New study suggests 21 percent increase in childhood peanut allergy since 2010

October 27, 2017
Parents often worry about peanut allergies because the reaction to peanuts can be very severe. New late-breaking research being presented at the American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific ...

Experimental peanut allergy patch shows promise

November 15, 2017
An experimental patch that delivers a high dose of peanut protein has shown promise in reducing allergic reactions in children and adults, researchers said on Tuesday.

Peanut in household dust linked to peanut allergy in children with eczema during infancy

November 18, 2014
A new study led by researchers at King's College London in collaboration with the US Consortium of Food Allergy Research and the University of Dundee has found a strong link between environmental exposure to peanut protein ...

Study suggests women eating peanuts during breastfeeding could prevent child from developing allergy

October 2, 2017
(Medical Xpress)—A team of researchers with members from several institutions in Canada has conducted a study on women eating peanuts while breastfeeding and has found evidence that suggests doing so can reduce the chances ...

Anaphylaxis risk up for siblings of peanut allergic children

June 14, 2016
(HealthDay)—The risk of anaphylaxis is increased upon peanut introduction in siblings of children with peanut allergy, according to a study published online June 13 in Allergy.

New guidelines show how to introduce peanut-containing foods to reduce allergy risk

January 5, 2017
The wait is over for parents who've been wanting to know how and when to introduce peanut-containing foods to their infants to prevent peanut allergy. New, updated guidelines from the National Institute of Allergy and Infectious ...

Recommended for you

Composition of complex sugars in breast milk may prevent future food allergies

June 12, 2018
The unique composition of a mother's breastmilk may help to reduce food sensitization in her infant, report researchers at the University of California San Diego School of Medicine with colleagues in Canada.

Drug may quell deadly immune response when trauma spills the contents of our cells' powerhouses

June 11, 2018
When trauma spills the contents of our cell powerhouses, it can evoke a potentially deadly immune response much like a severe bacterial infection.

Immune system does not recover despite cured hepatitis C infection

June 11, 2018
Changes to the immune system remain many years after a hepatitis C infection heals, a new study by researchers at Karolinska Institutet, Sweden, and Hannover Medical School, Germany, shows. The findings, presented in Nature ...

Food allergies connected to children with autism spectrum disorder

June 8, 2018
A new study from the University of Iowa finds that children with autism spectrum disorder (ASD) are more than twice as likely to suffer from a food allergy than children who do not have ASD.

A 'super' receptor that helps kill HIV infected cells

June 8, 2018
While treatments for HIV mean that the disease is no longer largely fatal, the world still lacks a true therapy that can eradicate the virus across a globally—and genetically different—population.

Antibody blocks inflammation, protects mice from hardened arteries and liver disease

June 6, 2018
Researchers at University of California San Diego School of Medicine discovered that they can block inflammation in mice with a naturally occurring antibody that binds oxidized phospholipids (OxPL), molecules on cell surfaces ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

PeterPassword
not rated yet Mar 06, 2018
'Early introduction of peanuts into the diet can prevent the development of peanut allergy in high-risk infants' NO NO NO
There's a good chance it is the very early sensitization of infants to peanut oil via nipple cream [it's one of the ingredients] is what has caused this condition, which, previous to nipple cream having this ingredient, didn'ty exist. The tiny infant's immune system is barely adequate to cope with the natural challenges,and nuts have never been something tiny babaies encountered previously.

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.