Peanuts - to introduce or not? Please tell me your experiences...

[naturopath]

I can't decide whether to introduce peanuts to my 5 month-old ds (in due course). Current advice is to avoid peanuts until 3 years. Yet peanut allergy is increasing. Can't decide whether this is because peanuts are being introduced, witheld, or not related to either.

It would really help me if you could tell me the following:

(a) is your child allergic to peanuts?
(b) if yes, at what age did you find out?
(c) at what age did you give your child peanuts, or are you witholding until they are over 3, or older?
(d) do you think that your child's peanut consumption or avoidance bears any relation to their allergic or non-allergic status?
(e) did your child start out not being allergic to peanuts and then developed the allergy (following either peanut consumption or avoidance)?

Any other details you can think of would also be very helpful.

Thanks!

a - don't know as they haven't had any
DH is allergic so we are nut free

I fail to see how avoidance can result in allergy
I don't buy this stuff about cultures where they eat lots of nuts having no allergies - surely it was just natural selection so the ones with allergies to nuts all died off

dc's not allergic to peanuts - have no nut allergies in the family - I didn't stop eating peanuts during pregnancy as I don't believe that the rise in peanut allergies is attributable to eating peanuts whilst pregnant.
We were a little cautious when DS1 was born but once he was weaned and having toast etc he ate a little of Dh's peanut butter toast and after there was no reaction we didn't think twice, he loves it as does DS2.
However - This has to be your call - peanut allergies seems to be quite severe. I hope the responses you get help you make up your mind.

3 DC, none allergic, I think all had something peatnutty before 1yo, certainly by 18months.
Not sure where you read what you call "current advice" -- I don't think that is current advice in UK.
I read that peanut allergies have risen in spite of the mass advice over a recent 5 (?) yr period to avoid them in pregnancy and in 1st year of life, which suggests that avoidance doesn't work to prevent allergies (on a mass population level).

hmm..

TheBlonde - don't think you're right about other cultures, as there is definitely currently lower incidence of peanut allergy in some developed cultures where the children don't just die - they just aren't allergic. Those that are take the same precautions as children here (epi-pen etc.) - it's just that there as less of them.

..

I think that until very recently the advice was avoidance up to 3 years, including during pregnancy, but this seems to have been called into question earlier this year when it was suggested that avoidance may actually increase the risk. There's a clinical trial going on at the moment to determine the effects of avoidance or exposure here

I'm having the same dilemma (dd 2.2 - history of peanut allergy in family and have avoided so far including in pregnancy) so not much help I'm afraid but really glad you've posted this.

Thanks Kittock -yes, I know about the study. We're actually taking part in it, but that has only reinforced my hesitation.. I'm not sure if I like the group we have been randomised into! I don't want to pull out of the study, so was seeking some answers from alternative sources to try to see if there's some pointer towards one theory or other..

There were a lot of press reports earlier in the year suggesting that peanut allergy was increasing in England, where the advice was to avoid them in pregnancy and for the first 3 years, but remaining constant in other countries where there was no such advice. It does seem logical that exposing the system to tiny amounts of a potential allergan in the womb might make the body learn how to cope with it better. Or is that too simplistic?

My DD has had all manner of nuts since she was 9mo. We have no allergies/asthma in the family and nuts are very nutritious so I went for it and we've had no probs whatsoever. My BIL's family are all allergic to something and my sis's DS had mild eczma when he was tiny but she ended up trying peanut butter at around 12mo with him and there have been no problems. She had a peanut fetish in pregnancy with him yet he turned out fine. Her DD has been on nut products since she was 9mo and she's been fine too.

We both spent a lot of our childhoods in SE Asia where peanuts are a staple and no one was allergic to them, so I am pretty much convinced that consumption does not increase the risk of allergy. Where I live now has never had a history of nut allergies, but has recently witnessed a rise in sensitivity which appears to have coincided with new dietary guidelines to avoid peanuts in pregnancy.

One thing I've never understood, though, is that peanuts are actually a legume, so how does it follow that you can be allergic to peanuts but not to baked beans (for instance)? And why are people who are allergic to peanuts often allergic to tree nuts when there is no relation? Is there a medical explanation for this? I've always been curious.

I have no idea re the tree nuts point Brangelina, but I assume that it's not because tree nuts are simiar to peanuts, but rather that the individual has a tendency to allergies to various triggers.

I wonder whether a person with family history of allergies and some other allergies themselves might be more susceptible, even if Africa or Asia for example, simply because they have it in their genetic makeup? (i.e. maybe populations are generally less allergic in other parts of the world and can therefore eat most things freely without worry of a reaction)..?

I'm not sure if genetic make up has an effect on sensitivity. Of all the people allergic in the UK, are they all white anglo saxons or are there equal proportions of afro carribeans, asians, southern mediterraneans etc.?

I'm in Italy, so western Europe with a mix of ethnic influences (germanic/french in north, greek/norman/north african in south), and until the no peanuts in pg guidelines peanut allergies were pretty much unheard of. Now they're on the increase, albeit with less incidence than the UK.

hmm, not sure. I know genetics has some influence on allergies, but not sure if it would be true of a whole population.. think I may be speculating far too much for a non-scientist!

Genetics can certainly have an effect on things like asthma and eczema so if allergies fit into the same group of illnesses then it is possible that intolerance can be passed down the generations.
I have eczema & asthma as did my grandparents and their parents. (somehow my Mum didn't but Aunts have got both)
I am very interested about the results of the study you mentioned.

Ds 2.7 has peanut butter with no problem. We introduced other nut butters at a much earlier stage (10mo?) but stayed clear of peanut butter until about 2. Ds has has some excema on and off, and I'm lactose intollerant and allergic to chocolate, and get excema - dh has mild asthma - although no nut allergies in either family.

You could always do the 'peanut butter sandwich when sitting in the car park at the hospital' routine - then if there was an allergic reaction you wouldn't have far to go...

Of all the ethnic groups, African-Americans have the highest rates of allergy and asthma in general (read more), which seems to blow out of the water some idea that African genes are protective.

I can't find a good single authoritative link, but most the little studies seem to find that for food allergies specifically, race seems to make little or no difference in western based populations; in other words, being of African or Indian or whatever other racial make-up doesn't protect you from nut allergies when you live in the West. This suggests it's not just genetics protecting people in poor countries.

It's something about how we live in the West that is causing our modern problem.

Wouldn't the safest thing be just to rub some peanut butter on the skin, and see if the skin welted up or reacted? I heard that even mildly allergic children react noticeably just from a little exposure on skin or lips.
Not that I think I was so cautious myself, but I think that's how I'd do things if I were nervous.

ds is allergic to peanuts and cashews. He had other nuts with no problems until he tried some peanut butter at 2 (not intentionally)-that is when we found out about the allergy as an ambulance was necessary.

No peanuts in pregnancy-no family history of allergies-so donot understand why he is so allergic.

DD cannot be tested without exposure to peanuts and so we keep her nut free as she is more likley to have it given ds.

if you are going to try peanuts-do it in circumsatnces that enable you to get immediate help should this prove necessary.

This is purely anecdotal but I live in Italy and peanuts have never been mentioned to me as a problem for allergies by health professionals (other things such as strawberries have), and consequently I'm assuming peanut allergy must be relatively rare here. Genetics may be a factor but until recently peanut butter wasn't even available here and it's still not all that common, kids eat Nutella here. They might eat the odd peanut at a party but they're not really part of the Italian diet.

Brangelina, I was never told to avoid nuts in pg, despite telling them I have a mild walnut allergy. I wonder how much the advice has filtered down or is followed?

In other words it might be the advice to restrict causing the rise in allergies here, then again it might be that peanuts are being consumed more (not much help then Naturopath )

i ate cashwes and brazil nuts in pg if i really fancied them. i have mild asthma, dh has quite bad eczema, and we both have hay fever type allergies.

we have avoided nuts until now, ds is 16.5 months, and has taken to peanut butter amazingly! he licks it off the toast... and shown no signs of allergy either, although he is lactose intolerant - just gets really congested.

Thanks everyone so far..
To answer your questions, i have already had ds allergy-tested, which has shown that he is not allergic to peanuts (athough there was a very slight sensitivity in the blood test, but they told me that is not unusual). The question I think I am trying to find an answer to is this: will he develop an allergy to peanuts at a later date and if so, was this because he either ate or avoided peanuts?

I can'y just give him some peanut butter outside A&E because, as part of this study, I can't let him have any peanuts until he is 5 years old (unless I pull out of the study). I would have to have a pretty strong hunch that eating peanut products would protect him from developing an allergy to pull out. I guess I am trying to garner enough information from you guys to maske that decision.

My allergy paed reckons that the increase in peanut allergy in the west (UK and US) is linked to the way we process them - partic dry roasting.

Apparently, in most other countries, they are cooked differently.

interesting.. is that true of say, peanut butter made in the US?

I didn't avoid them during pregnancy and DD seems fine with them (introduced after 12 months).

I have always thought that it would be interesting to know the stats for somewhere like Malaysia where peanuts are a very common ingredient in cooking.

naturopath, the best thing you can do is to ring Anaphylaxis UK and ask them - they will explain everything to you, they will have all their facts straight, and they are marvellously clear, patient and helpful!

I avoided peanuts during pregnancy and during breastfeeding. My ds was diagnosed with a peanut allergy at 8 months (having never eaten a peanut, or any other nut for that matter). So for us the question of 'when to introduce' never arose.

I wish I could help with the rest of your questions (I often lie awake and wonder, if I had done things differently...) but I really don't think anyone knows.

I do believe that at least part of peanut allergy is down to genetics, and also remember that whatever you do, your child is unlikely to be allergic. Most kids aren't.

As for the rates in developing countries, I'm not sure they'd be much help unless some serious investigation was carried out. I lived in rural Nigeria for several years. Peanuts are a dietry staple there and although I never heard of a case of peanut allergy (or any allergy for that matter) it was also true that many small children just died, of causes unknown. Certainly any child with a severe peanut allergy would not have survived for long, and as virtually nobody could afford medical care, I doubt whether the cause of such a death would have been recognised, let alone recorded.