New Study Suggests Exposing Infants to Peanut Products Could Prevent Allergy

Once a lunchtime staple for many American children, PB & J is disappearing from lunchboxes since the rise of peanut allergies in recent years, an allergy that, for many children, can be life-threatening.

Blog contributed by Kathleen
Zimmerman, MD, Pediatrician 

In the US, about 2 percent of children are allergic to peanuts, a figure that has quadrupled since 1997.  As a result the American Academy of Pediatrics used to recommend that peanuts be withheld from children until they were 3 years old. However back in 2008, the American Academy of Pediatrics changed its policy, when a committee within the AAP concluded that there was no evidence that delaying the introduction of allergenic food protects against the development of allergies.

Policy or not, many parents are still avoiding allergenic foods for their young children, but surprising evidence from a recent study is proving the AAP policy shift to be the correct approach.

The study, involving infants 4 to 11 months old who had shown a high risk of developing a peanut allergy, indicated that feeding these children peanut products early in life may prevent a peanut allergy.  In the study, half of the children’s parents were told to avoid peanuts, while the others fed their children peanut products regularly.  After 5 years, only 1.9 percent of children who were fed peanuts were allergic to them, compared to 13.7 in the group that avoided peanuts.

According to Dr. Gideon Lack, a professor of pediatric allergy at King’s College, London and leader of the study, not feeding infants peanut products “could have been in part responsible for the rise in peanut allergies we have seen.”

While there is no evidence whether allergies will develop if regular feeding of peanuts is stopped, the results from this study are promising.  As attitudes shift in light of recent evidence, peanuts may start popping up in lunchboxes once again.

Here are some tips to stay safe:

• Do not feed whole peanuts to infants.  Because of the choking risk, opt for peanut butter or other foods.
• Get an allergy test if your baby has one of these risk factors for allergy:
• A sibling with food allergy
• Had previous allergy to foods
• Has severe eczema
• Always try one new food at a time for at least 3 days at a time and watch for rashes, vomiting, diarrhea, or any sign of reaction to that food. 
• Before feeding peanut products to your child, see your doctor for an allergy test to determine whether your child already has a peanut allergy.
• Be aware of other children’s allergies.  Always inquire before bringing snacks or lunches that contain peanut products around other children.

Is My Child Overweight?

Blog contributed by Kathleen Zimmerman, MD,  Pediatrician

It’s no secret that childhood obesity is an epidemic in the US.  About 1 in every 3 American children is overweight.  Ask your medical provider what your child’s body mass index (BMI) is and where it fits on the normal growth curve.  If your child’s BMI is >95%ile, then your child is overweight.  In this case, your child would be more likely to develop adult type diseases such as high cholesterol, high blood pressure and type II diabetes in their early teen or even pre-teen years.

What can you do to keep your child’s weight healthy?  Here are four simple tips:

1. Make sure your child has healthy food choices at home.  Do not keep junk food or soda in your house.  It is too tempting for everyone and introduces bad habits that are more difficult to break later on. 
2. Avoid all sugary drinks, EVEN JUICE.  Don’t be fooled.  Juices have as much or even more sugar than soda, even if the label says “all natural” or “no added sugar”.  Your child’s drinks should be mostly water and 3 cups of milk (for calcium and vitamin D).
3. Do not eat fast food more than one time per month.  I know this is difficult with busy schedules, but even making a quick sandwich at home is a much healthier option and just as fast.
4. Make sure your child exercises for at least an hour every day.  This can be an organized activity or playing outside, as long as their heart rate is up.  This is not only good for their body, but also good for their mind!

Children and the Flu

Now that school has been back in session, more of our children are coming home with the sniffles, a cough, or even some vomiting and diarrhea. Most of these illnesses are easily managed at home for a day or two and your child is back to school. Pretty soon, however, influenza virus –“the flu” – will be circulating around. This causes a more severe illness and has much more potential for complications.  Therefore it is important to be informed about influenza and be prepared to keep your child as healthy as possible during the flu season.

Influenza virus is a smart virus that makes changes every year (and sometimes within the same season) to trick our immune system so that it can infect anyone, even people who have had the flu before. Influenza is not choosy about who it infects. Adults, children, and babies are all susceptible – even if they are healthy and have never been sick before. So please do not say to yourself (or to your doctor): “My child is never sick and has never had the flu, so I know she won’t get it.”  This is NOT TRUE!

Symptoms
When your child has the flu, he will typically develop a sudden fever (at least 100 degrees F and often higher than 102 degrees) along with chills, muscle aches, headache, and lack of energy. Most children also develop a runny nose, nasal stuffiness, sore throat, and a cough. Some also have stomach pain and vomiting. Don’t be confused:  if your child only has vomiting and/or diarrhea with no respiratory symptoms and no fever – this is not influenza. Some people refer to this type of illness as “stomach flu,” but actually it is a different virus and has nothing to do with influenza.

Complications
Flu (influenza) will likely cause your child to miss about a week of school and the fever lasts three to seven days. However, often there are complications or additional (“secondary”) infections that can develop on top of the flu. This is especially true for children under five years old. The most common secondary infections are ear infections and pneumonia. Young children can develop bronchiolitis (wheezing and shortness of breath). These complications of flu require additional visits to your doctor and can also result in hospitalization.

What can you do to help your child?
If your child develops flu symptoms, call your doctor early. Depending on your child’s age, how long they have been sick, and whether they have other chronic illnesses (like asthma), your child’s doctor may decide to prescribe antiviral medicine. These medicines work best in the first 48 hours of symptoms. But they do have side effects and are only going to shorten the illness, so they often are not the right choice for your child.

If your child has fever for more than five days, has ear pain, or has a cough that is not improving after one week, call your doctor again. These are signs of possible complications. If your child is under three months of age or has chronic illnesses, you should have them seen at the office sooner.

There is no treatment for influenza that works 100%. The best thing to do is to give your child rest and plenty of fluids so that their body can fight off the flu virus. Sometimes your doctor will recommend over the counter fever reducers and pain relievers, such as acetaminophen (Tylenol), but never use aspirin (acetylsalicylic acid) – this can a rare but serious illness called Reye syndrome. If your child has fever but is able to rest comfortably, it may be best to not treat the fever – the fever helps the body fight off the virus.

Flu vaccine
The most important and useful thing you can do for your child is to get yourself and your child a flu vaccine every year. This may reduce your child’s chances of getting the flu by 60 – 90%. If everyone in a household is vaccinated, it reduces their chance of getting the flu even more. Contact your doctor’s office now– most offices have vaccine available in September and the sooner your child is vaccinated the better.

If your child is under nine years old they may require a second dose of flu vaccine one month later.  However, if they are over two years old and healthy, they may be able to get the nasal mist (nose spray) vaccine – kids love this because there is NO NEEDLE!  Check with your doctor to see which vaccine is the right choice for your child.

The benefits of the flu vaccine are far greater than the risks of side effects. There are many myths about the flu vaccine out there. Please discuss any concerns you have with your doctor and check out our blog post from last week on the flu vaccine!

Another good resource: http://www.cdc.gov/flu/protect/children.htm

Kathleen M. Zimmerman, MD

Heritage Pediatrics
Pinnacle Heath Medical Group