Have nut allergies got more severe?

[Beansandneedles]

Have nuts always been widely discouraged at settings which may feature children? Or is this something that has increased in recent years? And if the latter...is it because the number of people suffering has increased? Or because reactions have gotten worse? Or is everyone just living in fear?

We're not allowed to send them into school or nursery, they shouldn't feature in packed lunches at various playgroups. Much of this I understand when eating indoors because of tiny particles etc. My sister has an allergy so some of it I have experience with. And I remember once it being announced they wouldn't be served on a plane as someone had an allergy and the air was so regularly circulated it would have been a bad combo. However very recently they were banned from an outdoor birthday party even though it wasn't a pot luck (where you all share food). Which seemed incredibly extreme to me! Wasn't going to argue or ignore the request, but it got me to wondering...

Have allergies gotten worse?! Or am I perceiving this wrong and it's always been like this?

Allergies have gotten more common, and nut and peanut allergies are more likely to be severe than other allergies (although any allergen can cause anaphylaxis).

Nuts and peanuts are also easily avoided in a way that, say, milk or egg aren't. So a ban is less of a restriction on others than bans on other ingredients.

Nut and peanut bans aren't about airborne particles, they're about contact. So the outdoor party scenario was aiming to avoid sticky fingers leaving peanut butter or Nutella on the play equipment that the allergic child would then touch (and either react through their skin or put their contaminated fingers in their mouth and have a more serious reaction through ingestion).

Nut and peanut bans aren't actually supported by experts any more - they create a false sense of security and there's no evidence they reduce the rate of serious reactions. But a lot of parents and schools strongly feel that bans are the best way to protect allergic children.

I have a very severe nut allergy and managed to survive school in the 80s/90s before bans were a thing but they were much much less likely to appear in a kid's packed lunch in those days. I only had issues a handful of times from cross contamination and all but one were mild. I had a nasty reaction (requiring adrenaline and high dose antihistamine) at a party at school as a teenager. I hadn't eaten at the party at all but there were bowls of peanuts out which meant any surface I touched was probably nutty. It was a frightening wake up call for me about just how careful I had to be.

I'm not saying I agree with the bans though as I grew up learning how to navigate buffets, checking the ingredients in school lunches, asking parents at parties etc. It equipped me to go into teenage/grown up life knowing that I needed to ask.

Allergies are on the rise across the board - no one really knows why, I don't think. Now the advice is to expose babies who have a higher risk of allergies (eg allergies are in the family) to allergens very early, but a decade ago pregnant women were told to avoid peanuts and of course the weaning age is six months so no babies would have got early enough exposure.

I understand the logic of saying nut bans aren't effective, but if you had a young child to whom nuts are a life threatening risk I promise you would feel so much better going places where nuts are not present. Even a low risk thing like a picnic in the park.

It's much more about the legal landscape. Any setting that doesn't have a nut ban might get sued if a child had a bad reaction while on the premises. Given that a severe allergic reaction could be potentially triggered if a non-allergic child had peanut butter at breakfast time and still has traces on their fingers or clothes, it doesn't make a place safe. But the important thing (for the setting) is to protect their own arse legally.

I'm not saying I agree with the bans though as I grew up learning how to navigate buffets, checking the ingredients in school lunches, asking parents at parties etc. It equipped me to go into teenage/grown up life knowing that I needed to ask.

This is so important, and I would say a point missed by many parents of DC with allergies based on the posts I see in allergy groups (although of course that's a self selecting group). The most important thing we can do is teach our DC how to risk assess.

Having said that, I understand why my DD's school don't want any part in that and go with a nut and peanut ban to reduce the risk of her and others coming into contact with something.

Rates of allergies are rising and information on how a child can be exposed has improved. I know quite a few children that are touch sensitive so if your child has eaten something with peanuts in and then held the handles of the ladder up a slide without cleaning hands first and a child with a severe peanut then goes up that slide they can react to the residue of peanuts that has transferred from your child's hands to the slide and on to the hands of the child with allergies. I know a lot of parents with children with severe food allergies that can't go to the park because of the cross contamination of foods consumed in the park being transferred on to the equipment

There is a bit of a discussion about whether nut free policies and it can breed complacency and specific policies based on the needs of the children with allergies at the school might be better as it's more of an active approach rather than a blanket policy introduced years ago and the details of the risk assessment forgotten. I am more confident with someone providing my daughter with food when they have prepared it. To do so they have more actively involved into what her allergies are compared to just placing food on a plate.

Dairy allergies lead to more fatal anaphylaxis reactions than nuts but it would be more of a challenge and detrimental to other children to make a school dairy free but I do know children who require very strict processes in the classroom to manage their exposure - the free milk given at the end of the day for the children to take home rather than during the day to protect the child with allergies during the school day for example. I know children who can't go into coffee shops because the milk throthing disperses milk proteins to the air and they can then have severe reactions.

I think the other thing that has changed is the starting position of reactions should be avoided at all costs. I had hayfever in school and my mum had issues getting them to give me prescribed antihistamines. The options were I was having a reaction and needed antihistamines so would have to go home or if I wasn't so unwell to go home I could stay at school but didn't require medication even if symptomatic. Even if sent home 30 minutes after antihistamines I would have been well enough to go back to school. Eventually they agreed otherwise I would have missed most of the spring term!