Peanut treatments early on can protect most children from suffering severe allergic reactions

VANCOUVER, British Columbia — For parents of young children dealing with food allergies, checking their food is safe can be a full-time job. In the hopes of preventing serious allergic reactions, a study is looking at how children can beat their peanut allergy head-on. Researchers from the University of British Columbia and BC Children’s Hospital say regular oral exposure to food allergens early on in life makes kids much more capable of tolerating accidental exposure as they grow up.

“There’s a common misperception about peanut allergies–that it’s not a serious health issue. Although the risk of a fatal reaction to peanuts is low in patients with peanut allergy, it has a major impact on quality of life and many families feel hopeless in dealing with what can seem like an unmanageable problem,” says study senior author Dr. Edmond Chan in a university release.

The Canadian team says this is the first study to show that exposing young children to small doses of allergens (particularly peanuts) in the real world can lower their risks for suffering an allergic reaction. This type of treatment, also called oral immunotherapy, sees children gradually increase the amount of peanuts they eat to build tolerance.

The process has two main goals. One is to reach a level of desensitization, so the child can have a full serving of peanuts without suffering a severe reaction. The other goal is to help protect kids against accidental exposure by lessening the need for epinephrine injections to combat the reaction. Researchers caution that children need to keep eating peanut products regularly to maintain their level of immunity.

Learning to live with peanuts

The study examined 117 preschool-age children between nine months and five years-old. All of the youngsters had peanut allergies and received a daily dose of 300mg of peanut protein during the experiment. That’s about the same as one peanut or a quarter-teaspoon of peanut butter each day.

After one year of regular exposure, study authors reveal almost 80 percent of the children could eat 15 peanuts (4,000mg of peanut protein) before having a reaction during an allergy test. Over 98 percent of the group could eat three or four peanuts without having an allergic reaction. This is enough protection in 99 percent of accidental peanut exposure cases.

Just over one in five preschoolers (21.4%) still experienced a reaction during an allergist-supervised peanut challenge. Luckily, 14.5 percent were classified as mild and six percent had a moderate reaction. Only two children needed an epinephrine injection after exposure to peanuts. Researchers did not report any severe allergic reactions during the study.

“Thanks to oral immunotherapy, these kids can accidentally eat something with peanut butter in it–like a cookie or cake–and not suffer a reaction, which is wonderful news for the families,” study lead author Dr. Lianne Soller says.

A game-changer for kids with allergies

This new report follows a study last year by the Canadian team which also demonstrated the safety of peanut oral immunotherapy on preschool-aged children in a hospital setting.

“Before starting therapy, our lives were filled with anxiety because every outing revolved around her food allergies,” explains Ravinder Dhaliwal, whose six-year-old daughter, Saiya, was part of the study. “Now, we can go to a restaurant or a birthday party without being in constant fear.”

Saiya started receiving small peanut doses in the spring of 2018. A year later, the young participant could eat up to 20 peanuts without triggering a reaction. Her mother adds she is now eating peanut butter sandwiches three times a week and is finally enjoying the taste of peanut products for the first time.

Chan and Soller recommend that children with a food allergy start oral immunotherapy as early as possible for the best results. If left unchecked, peanut allergies can become more severe and possibly life-threatening over time.

The study appears in the Journal of Allergy and Clinical Immunology: In Practice.

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