The recommendations have changed. Now what?

by Amanda Painter, South Chapter Coordinator 

In response to the LEAP (Learning Early About Peanut) study, the American Academy of Pediatrics and other medical professional organizations are endorsing the recommendation of early introduction of peanuts to infants considered “high-risk”.  AAP News (High-risk infants were defined based on family history, egg allergy and eczema).

First, I want to most importantly note that it is recommended that infants at high-risk be evaluated and tested, by a medical professional, before introduction. There will be infants that test positive at a young age. Please also be aware that there were a number of children in the LEAP study that weren’t able to complete it because they had a confirmed peanut allergy. Confirmed through proper testing/challenge. Do not feed your at-risk infant peanuts without consulting your physician (preferably a board certified allergist). 
You can read FACET’s Medical Advisor, Dr. Singer’s thoughts on the LEAP study here.

Now what?  What do we do with this information?  How do we respond?

To the parents of children with food allergies:

• Your child’s food allergy (peanut or other food) is not your fault. All we can do as parents is make the best choices we can for our family with the given information and knowledge we have at the time.  Blame and guilt are not healthy emotions. I urge you to not be bitter. Medical research is always ongoing and recommendations are ever changing.
  
• It is possible that if the recommendations were different when your child was an infant that it wouldn’t have changed anything for your child. I know many of your children had reactions at very young ages.  It is possible that if your child was selected for the study that they would have been part of the group unable to complete it. 
  
• Continue to raise awareness, teach your child self-management, and advocate for their needs.
  

To those that don’t have child with a food allergies (or have a food allergies yourself):

• Please understand that this changes nothing for those of us managing a peanut allergy in our home.  This isn’t a cure. This is not the time to point fingers and make comments of “if only you had fed peanut sooner”. That helps nothing at this point. Believe me, parents of children with food allergies are already hard on themselves. They have always wondered if they did something to cause this.  This change in recommendation has likely already caused these parents to be upset, angry, confused, or resentful. They never wanted this for their child. 
  
• This is only a study on early introduction of peanuts. Don’t misunderstand this study to mean that early introduction of all foods will prevent all food allergies. Notice the babies in the study are partially considered high-risk because of their already diagnosed egg allergy.  Many infants show signs of food allergies and are diagnosed well before the possibility of food introduction.  
  
• Be aware of the 15 million Americans that currently have a food allergy. There are children and adults in your community (family, church, neighborhood, school, etc.) that need your understanding, compassion and support. 
  

In my personal story, my daughter’s significant eczema (later discovered to be her reaction to the foods I was eating that she was exposed to through nursing) started before she was 3 months old. I could not have introduced any foods to her before that point. She tested positive for milk, egg, peanut, and tree nut at 9 months (others were added later and some outgrown). Hindsight shows that she was clearly reacting at 3 months. Was she allergic to all of these allergens at that point? What if her allergies were only milk and egg at 3 months? If we had introduced peanut at 6 months would she not have that allergy at 9 months? We’ll never know. At this point I won’t waste my time wondering “what if”…. that’s not productive.

The AAP recommendation change does nothing for my daughter or for the many families that I work with.  It may slow the growing number of children being diagnosed however. Fewer children diagnosed with a peanut allergy can lead to fewer children living with the heavy weight of self-management on their shoulders, fewer parents terrified that they may receive the dreaded phone call about a reaction while their child is at school (Kindergarten or college), and possibly fewer precious lives lost to anaphylaxis. Again, it’s not a cure, but it is progress. I’m all for progress.