Tag Archives: Peanut Allergy

Imperial College London study: Feeding babies egg and peanut may prevent food allergy, study suggests

25 Sep

More children seem to have peanut allergies. Ross Brenneman wrote in the Education Week article, How Peanuts Became Public Health Enemy #1:

Researchers aren’t sure why, but over the past several years, the number of children reported to have allergies has doubled, to 5 percent of children in the United States. Yet at the same time, in schools and elsewhere, allergies have drawn what some see as an oversized amount of attention. A new paper out of Princeton University explores why that may have happened.

Allergy attacks are awful. I’ve been there plenty of times. Eyes swollen shut, coughing, hacking, sneezing—and that’s just garden-variety pollen. But severe allergic reactions, also known as anaphylaxia, can cause death, even for the constantly vigilant. That’s why the U.S. House of Representatives voted unanimously last week in favor of a bill that would incentivize states, through a pre-existing grant program, to make sure their schools have a supply of epinephrine (usually an EpiPen) on hand, as well as staff members trained in using it…

One percent. That’s it. One estimate pegs it closer to 1.4 percent for children, but only .6 percent for adults. Either way, it’s small. Not all of those affected are seriously allergic, either. One percent isn’t nothing, but it’s not the kind of number that would suggest a strong cultural reaction, either.
Why, then, have peanut allergies become such a well-known public health menace? Maybe it’s partly from the mystery surrounding all allergies; scientists don’t know why allergies exist and why some people grow out of them. It’s also not clear how much an allergy attack may be exacerbated by asthma; the two often go hand in hand….
http://blogs.edweek.org/edweek/rulesforengagement/2013/08/how_peanuts_became_public_health_enemy_number_one.html?intc=es

Kids With Food Allergies has some excellent resources.
http://www.kidswithfoodallergies.org/resourcespre.php?id=62&title=Peanut_allergy_avoidance_list&gclid=CJTC7sfLuLICFWdxQgodxHcAJQ

Kate Wighton wrote in Feeding babies egg and peanut may prevent food allergy:

Feeding babies egg and peanut may reduce their risk of developing an allergy to the foods, finds a new study.

In the research, which is the largest analysis of evidence on the effect of feeding allergenic foods to babies, scientists from Imperial College London analysed data from 146 studies. In total the studies involved more than 200,000 children.

The study, which was commissioned by the UK Food Standards Agency, also found feeding children peanut, between the ages of four and eleven months, may reduce risk of developing peanut allergy. In addition, the team analysed milk, fish (including shellfish), tree nuts (such as almonds) and wheat, but didn’t find enough evidence to show introducing these foods at a young age reduces allergy risk.

The research is published today in the Journal of the American Medical Association.

Although previous studies have found feeding children peanut and egg may reduce allergy risk, other studies have found no effect.

Dr Robert Boyle, lead author of the research from the Department of Medicine at Imperial, said: “This new analysis pools all existing data, and suggests introducing egg and peanut at an early age may prevent the development of egg and peanut allergy, the two most common childhood food allergies.

“Until now we have not been advising parents to give these foods to young babies, and have even advised parents to delay giving allergenic foods such as egg, peanut, fish and wheat to their infant.”

Allergies to foods, such as nuts, egg, milk or wheat, affect around one in 20 children in the UK. They are caused by the immune system malfunctioning and over-reacting to these harmless foods. This triggers symptoms such as rashes, swelling, vomiting and wheezing.

“The number of children diagnosed with food allergies is thought to be on the rise”, added Dr Vanessa Garcia-Larsen, a co-author on the study from the National Heart and Lung Institute at Imperial. “There are indications that food allergies in children have become much more common over the last 30 years.

The number of patients coming into our clinics has increased year-on-year, and allergy clinics across the country have seen the same pattern.”

She added that the reasons behind this rise are still unclear – doctors may be better at recognising food allergy, or there may be environmental factors involved.

In the new study, called a meta-analysis, the team initially analysed 16,289 research papers on allergies and other immune system problems. Out of these, 146 were used for data analysis of when to feed babies allergenic foods such as egg, peanut, wheat and fish.

The results showed that children who started eating egg between the ages of four and six months had a 40 per cent reduced risk of egg allergy compared to children who tried egg later in life.

Children who ate peanut between the ages of four and eleven months had a 70 per cent reduced peanut allergy risk compared to children who ate the food at a later stage. However, the authors cautioned that these percentages are estimates based on a small number of studies……                                                                   http://www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/newssummary/news_20-9-2016-14-46-0

Citation:

Feeding babies egg and peanut may prevent food allergy, study suggests

Date:        September 20, 2016

Source:    Imperial College London

Summary:

Feeding babies egg and peanut may reduce their risk of developing an allergy to the foods, finds a new study.

Journal Reference:

  1. Despo Ierodiakonou et al. Timing of Allergenic Food Introduction to the Infant Diet and Risk of Allergic or Autoimmune DiseaseA Systematic Review and Meta-analysis. JAMA, 2016 DOI: 10.1001/jama.2016.12623

Here is the citation from the Journal of the American Medical Association:

September 20, 2016, Vol 316, No. 11 >

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Original Investigation|September 20, 2016

Timing of Allergenic Food Introduction to the Infant Diet and Risk of Allergic or Autoimmune Disease A Systematic Review and Meta-analysis

Despo Ierodiakonou, MD, PhD1,2; Vanessa Garcia-Larsen, PhD2; Andrew Logan, PhD1; Annabel Groome, BSc1; Sergio Cunha, MD2; Jennifer Chivinge, BSc1; Zoe Robinson, BSc1; Natalie Geoghegan, BSc1; Katharine Jarrold, BSc1; Tim Reeves, BSc2; Nara Tagiyeva-Milne, PhD3; Ulugbek Nurmatov, MD, PhD4; Marialena Trivella, DPhil5; Jo Leonardi-Bee, PhD6; Robert J. Boyle, MD, PhD1

[+] Author Affiliations

JAMA. 2016;316(11):1181-1192. doi:10.1001/jama.2016.12623.

Text Size: A A A

Article

Figures

Tables

Supplemental Content

References

CME

ABSTRACT

ABSTRACT | INTRODUCTION | METHODS AND LITERATURE SEARCH | RESULTS | DISCUSSION | CONCLUSIONS | ARTICLE INFORMATION | REFERENCES

Importance  Timing of introduction of allergenic foods to the infant diet may influence the risk of allergic or autoimmune disease, but the evidence for this has not been comprehensively synthesized.

Objective  To systematically review and meta-analyze evidence that timing of allergenic food introduction during infancy influences risk of allergic or autoimmune disease.

Data Sources  MEDLINE, EMBASE, Web of Science, CENTRAL, and LILACS databases were searched between January 1946 and March 2016.

Study Selection  Intervention trials and observational studies that evaluated timing of allergenic food introduction during the first year of life and reported allergic or autoimmune disease or allergic sensitization were included.

Data Extraction and Synthesis  Data were extracted in duplicate and synthesized for meta-analysis using generic inverse variance or Mantel-Haenszel methods with a random-effects model. GRADE was used to assess the certainty of evidence.

Main Outcomes and Measures  Wheeze, eczema, allergic rhinitis, food allergy, allergic sensitization, type 1 diabetes mellitus, celiac disease, inflammatory bowel disease, autoimmune thyroid disease, and juvenile rheumatoid arthritis.

Results  Of 16 289 original titles screened, data were extracted from 204 titles reporting 146 studies. There was moderate-certainty evidence from 5 trials (1915 participants) that early egg introduction at 4 to 6 months was associated with reduced egg allergy (risk ratio [RR], 0.56; 95% CI, 0.36-0.87; I2 = 36%; P = .009). Absolute risk reduction for a population with 5.4% incidence of egg allergy was 24 cases (95% CI, 7-35 cases) per 1000 population. There was moderate-certainty evidence from 2 trials (1550 participants) that early peanut introduction at 4 to 11 months was associated with reduced peanut allergy (RR, 0.29; 95% CI, 0.11-0.74; I2 = 66%; P = .009). Absolute risk reduction for a population with 2.5% incidence of peanut allergy was 18 cases (95% CI, 6-22 cases) per 1000 population. Certainty of evidence was downgraded because of imprecision of effect estimates and indirectness of the populations and interventions studied. Timing of egg or peanut introduction was not associated with risk of allergy to other foods. There was low- to very low-certainty evidence that early fish introduction was associated with reduced allergic sensitization and rhinitis. There was high-certainty evidence that timing of gluten introduction was not associated with celiac disease risk, and timing of allergenic food introduction was not associated with other outcomes.

Conclusions and Relevance  In this systematic review, early egg or peanut introduction to the infant diet was associated with lower risk of developing egg or peanut allergy. These findings must be considered in the context of limitations in the primary studies.                                                                                                     http://jama.jamanetwork.com/article.aspx?articleid=2553447

A physical examination is important for children to make sure that there are no health problems. The University of Arizona Department of Pediatrics has an excellent article which describes Pediatric History and Physical Examination http://www.peds.arizona.edu/medstudents/Physicalexamination.asp The article goes on to describe how the physical examination is conducted and what observations and tests are part of the examination. The Cincinnati Children’s Hospital describes the Process of the Physical Examination http://www.cincinnatichildrens.org/health/p/exam/
If children have allergies, parents must work with their schools to prepare a allergy health plan. See, Journal of American Medical Association study: Consumption of nuts by pregnant woman may reduce nut allergies in their children https://drwilda.com/tag/peanut-allergy/

Resources:

Micheal Borella’s Chicago-Kent Law Review article, Food Allergies In Public Schools: Toward A Model Code
http://www.cklawreview.com/wp-content/uploads/vol85no2/Borella.pdf

USDA’s Accomodating Children With Special Dietary Needs
http://www.k12.wa.us/ChildNutrition/pubdocs/SpecialDietaryNeeds.PDF

Child and Teen Checkup Fact Sheet
http://www.health.state.mn.us/divs/fh/mch/ctc/factsheets.html

Video: What to Expect From A Child’s Physical Exam

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda©                                                                                                                                     https://drwilda.com/

 

 

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Mercy Children’s Hospital study: Children with asthma often have undiagnosed peanut allergy

17 May

More children seem to have peanut allergies. Ross Brenneman wrote in the Education Week article, How Peanuts Became Public Health Enemy #1:

Researchers aren’t sure why, but over the past several years, the number of children reported to have allergies has doubled, to 5 percent of children in the United States. Yet at the same time, in schools and elsewhere, allergies have drawn what some see as an oversized amount of attention. A new paper out of Princeton University explores why that may have happened.

Allergy attacks are awful. I’ve been there plenty of times. Eyes swollen shut, coughing, hacking, sneezing—and that’s just garden-variety pollen. But severe allergic reactions, also known as anaphylaxia, can cause death, even for the constantly vigilant. That’s why the U.S. House of Representatives voted unanimously last week in favor of a bill that would incentivize states, through a pre-existing grant program, to make sure their schools have a supply of epinephrine (usually an EpiPen) on hand, as well as staff members trained in using it…

One percent. That’s it. One estimate pegs it closer to 1.4 percent for children, but only .6 percent for adults. Either way, it’s small. Not all of those affected are seriously allergic, either. One percent isn’t nothing, but it’s not the kind of number that would suggest a strong cultural reaction, either.
Why, then, have peanut allergies become such a well-known public health menace? Maybe it’s partly from the mystery surrounding all allergies; scientists don’t know why allergies exist and why some people grow out of them. It’s also not clear how much an allergy attack may be exacerbated by asthma; the two often go hand in hand….
http://blogs.edweek.org/edweek/rulesforengagement/2013/08/how_peanuts_became_public_health_enemy_number_one.html?intc=es

Kids With Food Allergies has some excellent resources.
http://www.kidswithfoodallergies.org/resourcespre.php?id=62&title=Peanut_allergy_avoidance_list&gclid=CJTC7sfLuLICFWdxQgodxHcAJQ

Science Daily reported in Many children with asthma have reaction to peanuts, but do not know it:

A new study has shown that many children who have asthma have a sensitivity to peanuts, but did not know it. Conducted by researchers in the U.S., the study specifically looked at pediatric asthma patients at a pediatric pulmonary clinic.

The study will be presented at the ATS 2015 International Conference.

“Many of the respiratory symptoms of peanut allergy can mirror those of an asthma attack, and vice versa. Examples of those symptoms include shortness of breath, wheezing and coughing,” said study lead author Robert Cohn, MD, MBA. “This study aimed to evaluate the proportion of asthmatic children who also demonstrated a sensitivity to peanuts.”

For the study, the researchers looked at 1,517 children from the pediatric pulmonary clinic at Mercy Children’s Hospital in Toledo, Ohio. They determined if the children’s charts had a documented peanut allergy and if they had undergone a blood test for antibodies demonstrating a potential reaction to peanuts, known as IgE. Children were considered positive if they had a documented history of peanut allergy or a specific IgE blood test that showed a level higher than normal.

What they found was that of the 1,517 charts that were reviewed, 163, or about 11%, had a documented history of peanut allergy. Nearly 44% (665) had specific IgE testing at some point to test for peanut allergy. Out of that group, 148, or approximately 22%, had a positive test to peanut sensitivity. However, more than half of these children and their families did not suspect there was any sensitivity to peanuts. The prevalence of positive tests varied across age groups but the prevalence of known peanut allergy was strikingly similar across age groups…

Citation:

Many children with asthma have reaction to peanuts, but do not know it

Date: May 17, 2015

Source: American Thoracic Society (ATS)

Summary:

In recent years and months, peanut allergies in children have been in the news frequently, as scientists reveal new insights into why more and more children are developing them and what can be done to avoid them. However, until now, few have studied the connection between peanut allergy and childhood asthma.
http://www.sciencedaily.com/releases/2015/05/150517143400.htm

Here is the press release:

Public Release: 17-May-2015 Many children with asthma have reaction to peanuts, but do not know it

American Thoracic Society

ATS 2015, DENVER – In recent years and months, peanut allergies in children have been in the news frequently, as scientists reveal new insights into why more and more children are developing them and what can be done to avoid them. However, until now, few have studied the connection between peanut allergy and childhood asthma.
A new study has shown that many children who have asthma have a sensitivity to peanuts, but did not know it. Conducted by researchers in the U.S., the study specifically looked at pediatric asthma patients at a pediatric pulmonary clinic.

The study will be presented at the ATS 2015 International Conference.

“Many of the respiratory symptoms of peanut allergy can mirror those of an asthma attack, and vice versa. Examples of those symptoms include shortness of breath, wheezing and coughing,” said study lead author Robert Cohn, MD, MBA. “This study aimed to evaluate the proportion of asthmatic children who also demonstrated a sensitivity to peanuts.”

For the study, the researchers looked at 1,517 children from the pediatric pulmonary clinic at Mercy Children’s Hospital in Toledo, Ohio. They determined if the children’s charts had a documented peanut allergy and if they had undergone a blood test for antibodies demonstrating a potential reaction to peanuts, known as IgE. Children were considered positive if they had a documented history of peanut allergy or a specific IgE blood test that showed a level higher than normal.

What they found was that of the 1,517 charts that were reviewed, 163, or about 11%, had a documented history of peanut allergy. Nearly 44% (665) had specific IgE testing at some point to test for peanut allergy. Out of that group, 148, or approximately 22%, had a positive test to peanut sensitivity. However, more than half of these children and their families did not suspect there was any sensitivity to peanuts. The prevalence of positive tests varied across age groups but the prevalence of known peanut allergy was strikingly similar across age groups.
“This study demonstrates children with asthma might benefit from a test for peanut sensitivity, especially when control of wheezing and coughing is difficult to achieve. If a physician is having this problem, or if a parent notices it in his or her asthmatic child, they should consider testing, even if they believe their child is not sensitive to peanuts,” said Dr. Cohn. “There should be continued investigation to learn more about the connection between asthmatic children and peanut sensitivity.”
###
* Please note that numbers in this release may differ slightly from those in the abstract. Many of these investigations are ongoing; the release represents the most up-to-date data available at press time.
Abstract 61468
Prevalence of Peanut Sensitivity Among Children with Asthma
Type: Scientific Abstract
Category:01.21 – Pediatric Epidemiology: Risk Factors, Outcomes and Management (PEDS)
Authors: R.C. Cohn, A. Al-Yazji; Mercy Children’s Hospital/University of Toledo – Toledo, OH/US

Abstract Body
Introduction: The prevalence of childhood asthma in the US is increasing. Coexistence of peanut allergy with asthma could be a risk factor for increased morbidity and mortality. Also some asthma medications should be avoided in children with peanut allergy. Few studies are available assessing the relationship between peanut allergy and asthma. In this study we set out to determine the prevalence of peanut sensitivity among children with asthma who were active patients in a large pediatric pulmonary clinic.
Methods: All charts of children who carried the diagnosis of asthma and who were actively seen in the pediatric pulmonary clinic at Mercy Children’s Hospital in Toledo, Ohio were retrospectively reviewed for documented peanut allergy and the presence or absence of peanut IgE testing. Children were considered positive if they had a documented history of peanut allergy or a specific IgE blood test >0.35 ku/l. Children who had a positive test and who did not report a peanut allergy before testing were labeled as”unsuspected”. Data were analyzed collectively and by age groups.

Results: 1517 charts of children diagnosed with asthma were reviewed; 163 (10.7%) had a documented h/o peanut allergy. 665 patients of the 1517 (43.8%) had specific IgE testing at some point. Of the 665, 148 (22.3%) had a positive test to peanut. 53% of these children and their families did not suspect peanut sensitivity. The prevalence of positive tests varied across age distributions but the prevalence of known peanut allergy was strikingly similar across age groups.

Conclusion: In this select group of asthma patients the prevalence of peanut sensitivity was high. Many children/families did not suspect a peanut sensitivity. We speculate that children with asthma might benefit from peanut sensitivity screening especially when control is difficult to achieve.
Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

Media Contact
Nathaniel Dunford
ndunford@thoracic.org

@atscommunity
http://www.thoracic.org

A physical examination is important for children to make sure that there are no health problems. The University of Arizona Department of Pediatrics has an excellent article which describes Pediatric History and Physical Examination http://www.peds.arizona.edu/medstudents/Physicalexamination.asp The article goes on to describe how the physical examination is conducted and what observations and tests are part of the examination. The Cincinnati Children’s Hospital describes the Process of the Physical Examination http://www.cincinnatichildrens.org/health/p/exam/
If children have allergies, parents must work with their schools to prepare a allergy health plan. See, Journal of American Medical Association study: Consumption of nuts by pregnant woman may reduce nut allergies in their children https://drwilda.com/tag/peanut-allergy/

Resources:

Micheal Borella’s Chicago-Kent Law Review article, Food Allergies In Public Schools: Toward A Model Code

Click to access Borella.pdf

USDA’s Accomodating Children With Special Dietary Needs

Click to access SpecialDietaryNeeds.PDF

Child and Teen Checkup Fact Sheet
http://www.health.state.mn.us/divs/fh/mch/ctc/factsheets.html

Video: What to Expect From A Child’s Physical Exam
http://on.aol.com/video/what-to-expect-from-a-childs-physical-exam-325661948

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©                                                                                                                                                                                https://drwilda.com/
https://drwilda.com/

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Journal of American Medical Association study: Consumption of nuts by pregnant woman may reduce nut allergies in their children

24 Dec

Moi wrote about allergies in Food allergies can be deadly for some children:
If one is not allergic to substances, then you probably don’t pay much attention to food allergies. The parents and children in one Florida classroom are paying a lot of attention to the subject of food allergies because of the severe allergic reaction one child has to peanuts. In the article, Peanut Allergy Stirs Controversy At Florida Schools Reuters reports:

Some public school parents in Edgewater, Florida, want a first-grade girl with life-threatening peanut allergies removed from the classroom and home-schooled, rather than deal with special rules to protect her health, a school official said.
“That was one of the suggestions that kept coming forward from parents, to have her home-schooled. But we’re required by federal law to provide accommodations. That’s just not even an option for us,” said Nancy Wait, spokeswoman for the Volusia County School District.
Wait said the 6-year-old’s peanut allergy is so severe it is considered a disability under the Americans with Disabilities Act.
To protect the girl, students in her class at Edgewater Elementary School are required to wash their hands before entering the classroom in the morning and after lunch, and rinse out their mouths, Wait said, and a peanut-sniffing dog checked out the school during last week’s spring break….
Chris Burr, a father of two older students at the school whose wife has protested at the campus, said a lot of small accommodations have added up to frustration for many parents.
“If I had a daughter who had a problem, I would not ask everyone else to change…. http://www.reuters.com/article/2011/03/22/us-peanut-allergy-idUSTRE72L7AQ20110322

More children seem to have peanut allergies. Researchers are trying to discover the reason for the allergies, but also asking the question of whether the number of nut allergies in children can be reduced.

Michael Pearson of CNN reported in the story, Study: Eating nuts during pregnancy may reduce baby’s allergy risk:

The children of women who regularly ate peanuts or tree nuts during pregnancy appear to be at lower risk for nut allergies than other kids, according to a new study published Monday.
The study, published in the Journal of the American Medical Association, is the first to demonstrate that a mother who eats nuts during pregnancy may help build up a baby’s tolerance to them after birth, its lead author, Dr. Michael Young, told CNN.
The effect seemed to be strongest in women who ate the most peanuts or tree nuts — five or more servings per week, according to the study, which controlled for factors such as family history of nut allergies and other dietary practices.
Peanut and tree nut allergies tend to overlap, according to the researchers.
What food allergies are costing families — and the economy
Earlier studies indicated that nut consumption during pregnancy either didn’t have any effect or actually raised the risk of allergies in children.
However, the authors of the latest study say those studies were based on less reliable data and conflict with more recent research suggesting that early exposure to nuts can reduce the risk of developing allergies to them.
There is currently no formally recognized medical guidance for nut consumption during pregnancy or infancy. http://www.cnn.com/2013/12/23/health/nut-allergy-study/

Citation:

Original Investigation | December 23, 2013 JOURNAL CLUB
Prospective Study of Peripregnancy Consumption of Peanuts or Tree Nuts by Mothers and the Risk of Peanut or Tree Nut Allergy in Their Offspring FREE ONLINE FIRST
A. Lindsay Frazier, MD, ScM1,2; Carlos A. Camargo Jr, MD, DrPH2,3,4; Susan Malspeis, MS2; Walter C. Willett, MD, DrPH4,5,6; Michael C. Young, MD7
[+] Author Affiliations
JAMA Pediatr. Published online December 23, 2013. doi:10.1001/jamapediatrics.2013.4139
Article
Tables
References
Comments
ABSTRACT
ABSTRACT | METHODS | RESULTS | DISCUSSION | CONCLUSIONS | ARTICLE INFORMATION | REFERENCES
Importance The etiology of the increasing childhood prevalence of peanut or tree nut (P/TN) allergy is unknown.
Objective To examine the association between peripregnancy consumption of P/TN by mothers and the risk of P/TN allergy in their offspring.
Design, Setting, and Participants Prospective cohort study. The 10 907 participants in the Growing Up Today Study 2, born between January 1, 1990, and December 31, 1994, are the offspring of women who previously reported their diet during, or shortly before or after, their pregnancy with this child as part of the ongoing Nurses’ Health Study II. In 2006, the offspring reported physician-diagnosed food allergy. Mothers were asked to confirm the diagnosis and to provide available medical records and allergy test results. Two board-certified pediatricians, including a board-certified allergist/immunologist, independently reviewed each potential case and assigned a confirmation code (eg, likely food allergy) to each case. Unadjusted and multivariable logistic regression analyses were used to evaluate associations between peripregnancy consumption of P/TN by mothers and incident P/TN allergy in their offspring.
Exposure Peripregnancy consumption of P/TN.
Main Outcomes and Measures Physician-diagnosed P/TN allergy in offspring.
Results Among 8205 children, we identified 308 cases of food allergy (any food), including 140 cases of P/TN allergy. The incidence of P/TN allergy in the offspring was significantly lower among children of the 8059 nonallergic mothers who consumed more P/TN in their peripregnancy diet (≥5 times vs <1 time per month: odds ratio = 0.31; 95% CI, 0.13-0.75; Ptrend = .004). By contrast, a nonsignificant positive association was observed between maternal peripregnancy P/TN consumption and risk of P/TN allergy in the offspring of 146 P/TN-allergic mothers (Ptrend = .12). The interaction between maternal peripregnancy P/TN consumption and maternal P/TN allergy status was statistically significant (Pinteraction = .004).
Conclusions and Relevance Among mothers without P/TN allergy, higher peripregnancy consumption of P/TN was associated with lower risk of P/TN allergy in their offspring. Our study supports the hypothesis that early allergen exposure increases tolerance and lowers risk of childhood food allergy.
Peanut allergy affects 1% to 2% of the population in most Western countries,1- 3 and in the United States, the prevalence of childhood peanut allergy has more than tripled, from 0.4% in 1997 to 1.4% in 2010.4 Typically, the onset of peanut allergy is in early childhood; 70% of reactions occur during the first known exposure.5 These IgE-mediated hypersensitivity reactions require prior allergen exposure and sensitization, implying that prior exposure to peanut had already occurred in utero or through unknown exposures in the diet or environment, such as through skin or respiratory routes.6 Because of frequent overlap between peanut allergy and tree nut allergy and their similar natural history, with 80% to 90% persistence of the food allergy into adulthood,7 these 2 allergies are often considered together as peanut or tree nut (P/TN) allergy.
For many years, pediatric guidelines have recommended the avoidance of P/TN for at least the first 3 years of life, with some experts also recommending that P/TN be avoided during pregnancy.8 These recommendations were rescinded recently when literature reviews showed little support for them.9,10 For decades, many investigators have posited that modifications of the maternal diet during pregnancy might prevent food allergies.11- 14 However, some studies on maternal avoidance of peanut during pregnancy actually demonstrated an increase in peanut sensitization in the child,15- 17 while other studies found no association.5,14,18,19 In related research, early exposure to allergenic foods in infant diets may decrease sensitization and increase oral tolerance to those foods.20- 24
Given the lack of clarity in the current literature, an important quandary exists: should the pregnant mother include or exclude P/TN in her diet? The goal of our investigation was to clarify the association between peripregnancy consumption of P/TN by mothers and the subsequent development of P/TN allergy in their offspring…. http://archpedi.jamanetwork.com/article.aspx?articleid=1793699

Resources:

Micheal Borella’s Chicago-Kent Law Review article, Food Allergies In Public Schools: Toward A Model Code

Click to access Borella.pdf

USDA’s Accommodating Children With Special Dietary Needs http://www.k12.wa.us/ChildNutrition/pubdocs/SpecialDietaryNeeds.PDF

Child and Teen Checkup Fact Sheet http://www.health.state.mn.us/divs/fh/mch/ctc/factsheets.html
Video: What to Expect From A Child’s Physical Exam
http://on.aol.com/video/what-to-expect-from-a-childs-physical-exam-325661948

Related:
New federal guidelines for schools regarding student allergies
https://drwilda.com/2013/11/04/new-federal-guidelines-for-schools-regarding-student-allergies/

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

Tags: , , , , , , , , , , , , , , , , , , ,

New federal guidelines for schools regarding student allergies

4 Nov

Moi wrote about allergies in Food allergies can be deadly for some children:
If one is not allergic to substances, then you probably don’t pay much attention to food allergies. The parents and children in one Florida classroom are paying a lot of attention to the subject of food allergies because of the severe allergic reaction one child has to peanuts. In the article, Peanut Allergy Stirs Controversy At Florida Schools Reuters reports:

Some public school parents in Edgewater, Florida, want a first-grade girl with life-threatening peanut allergies removed from the classroom and home-schooled, rather than deal with special rules to protect her health, a school official said.
“That was one of the suggestions that kept coming forward from parents, to have her home-schooled. But we’re required by federal law to provide accommodations. That’s just not even an option for us,” said Nancy Wait, spokeswoman for the Volusia County School District.
Wait said the 6-year-old’s peanut allergy is so severe it is considered a disability under the Americans with Disabilities Act.
To protect the girl, students in her class at Edgewater Elementary School are required to wash their hands before entering the classroom in the morning and after lunch, and rinse out their mouths, Wait said, and a peanut-sniffing dog checked out the school during last week’s spring break….
Chris Burr, a father of two older students at the school whose wife has protested at the campus, said a lot of small accommodations have added up to frustration for many parents.
“If I had a daughter who had a problem, I would not ask everyone else to change…. http://www.reuters.com/article/2011/03/22/us-peanut-allergy-idUSTRE72L7AQ20110322

More children seem to have peanut allergies.
See, More school battles about peanut allergies https://drwilda.com/tag/allergy/

Mike Stobbe of AP reported in the article, Feds post food allergy guidelines for schools:

ATLANTA (AP) — The federal government is issuing its first guidelines to schools on how to protect children with food allergies.
The voluntary guidelines call on schools to take such steps as restricting nuts, shellfish or other foods that can cause allergic reactions, and make sure emergency allergy medicine — like EpiPens — are available.
About 15 states — and numerous individual schools or school districts — already have policies of their own. “The need is here” for a more comprehensive, standardized way for schools to deal with this issue, said Dr. Wayne Giles, who oversaw development of the advice for the Centers for Disease Control and Prevention.
Food allergies are a growing concern. A recent CDC survey estimated that about 1 in 20 U.S. children have food allergies — a 50 percent increase from the late 1990s. Experts aren’t sure why cases are rising.
Many food allergies are mild and something children grow out of. But severe cases may cause anaphylactic shock or even death from eating, say, a peanut.
The guidelines released Wednesday were required by a 2011 federal law.
http://www.huffingtonpost.com/2013/10/30/school-allergy-guidelines_n_4177867.html?utm_hp_ref=email_share

Here is information from the Centers for Disease Control about the guidelines:

Food Allergies in Schools
Food allergies are a growing food safety and public health concern that affect an estimated 4%–6% of children in the United States.1, 2 Allergic reactions can be life threatening and have far-reaching effects on children and their families, as well as on the schools or early care and education (ECE) programs they attend. Staff who work in schools and ECE programs should develop plans for preventing an allergic reaction and responding to a food allergy emergency.
Voluntary Guidelines for Managing Food Allergies In Schools and Early Care and Education Programs [PDF – 10MB]
Food Allergy Guidelines FAQs [PDF – 163KB]
What is a Food Allergy?
A food allergy occurs when the body has a specific and reproducible immune response to certain foods.3 The body’s immune response can be severe and life threatening, such as anaphylaxis. Although the immune system normally protects people from germs, in people with food allergies, the immune system mistakenly responds to food as if it were harmful.
Eight foods or food groups account for 90% of serious allergic reactions in the United States: milk, eggs, fish, crustacean shellfish, wheat, soy, peanuts, and tree nuts.3
Symptoms of Food Allergy in Children
Symptoms Communicated by Children with Food Allergies4
• It feels like something is poking my tongue.
• My tongue (or mouth) is tingling (or burning).
• My tongue (or mouth) itches.
• My tongue feels like there is hair on it.
• My mouth feels funny.
• There’s a frog in my throat; there’s something stuck in my throat.
• My tongue feels full (or heavy).
• My lips feel tight.
• It feels like there are bugs in there (to describe itchy ears).
• It (my throat) feels thick.
• It feels like a bump is on the back of my tongue (throat).
The symptoms and severity of allergic reactions to food can be different between individuals, and can also be different for one person over time. Anaphylaxis is a sudden and severe allergic reaction that may cause death.5 Not all allergic reactions will develop into anaphylaxis.
Food Allergies in Schools
• Children with food allergies are two to four times more likely to have asthma or other allergic conditions than those without food allergies.1
• The prevalence of food allergies among children increased 18% during 1997–2007, and allergic reactions to foods have become the most common cause of anaphylaxis in community health settings.1,6
• In 2006, about 88% of schools had one or more students with a food allergy.7

Treatment and Prevention of Food Allergies in Children
There is no cure for food allergies. Strict avoidance of the food allergen is the only way to prevent a reaction. However, since it is not always easy or possible to avoid certain foods, staff in schools and ECE programs should develop plans to deal with allergic reactions, including anaphylaxis. Early and quick recognition and treatment of allergic reactions that may lead to anaphylaxis can prevent serious health problems or death.
Voluntary Guidelines for Managing Food Allergies In Schools and Early Care and Education Programs
In consultation with the U.S. Department of Education and a number of other federal agencies, CDC developed the Voluntary Guidelines for Managing Food Allergies in Schools and Early Care and Education Centers [PDF – 10MB] in fulfillment of the 2011 FDA Food Safety Modernization Act to improve food safety in the United States. Download Food Allergy Guidelines FAQs [PDF – 163KB].
The Voluntary Guidelines for Managing Food Allergies provide practical information and planning steps for parents, district administrators, school administrators and staff, and ECE program administrators and staff to develop or strengthen plans for food allergy management and prevention. The Voluntary Guidelines for Managing Food Allergies include recommendations for each of the five priority areas that should be addressed in each school’s or ECE program’s Food Allergy Management Prevention Plan:
1. Ensure the daily management of food allergies in individual children.
2. Prepare for food allergy emergencies.
3. Provide professional development on food allergies for staff members.
4. Educate children and family members about food allergies.
5. Create and maintain a healthy and safe educational environment.
References
1. Branum AM, Lukacs SL. Food allergy among U.S. children: trends in prevalence and hospitalizations. NCHS Data Brief. 2008;10:1-8.
2. Liu AH, Jaramillo R, Sicherer SH, et al. National prevalence and risk factors for food allergy and relationship to asthma: results from the National Health and Nutrition Examination Survey 2005-2006. J Allergy Clin Immunol. 2010;126(4):798-806.e13.
3. Boyce JA, Assa’ad A, Burks AW, et al; NIAID-Sponsored Expert Panel. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010;126(suppl 6):S1-S58.
4. The Food Allergy & Anaphylaxis Network. Food Allergy News. 2003;13(2).
5. Sampson HA, Munoz-Furlong A, Campbell RL, et al. Second symposium on the definition and management of anaphylaxis: summary report—Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network Symposium. Ann Emerg Med. 2006;47(4):373-380.
6. Decker WW, Campbell RL, Manivannan V, et al. The etiology and incidence of anaphylaxis in Rochester, Minnesota: a report from the Rochester Epidemiology Project. J Allergy Clin Immunol. 2008;122(6):1161-1165.
7. O’Toole TP, Anderson S, Miller C, Guthrie J. Nutrition services and foods and beverages available at school: results from the School Health Policies and Programs Study 2006. J Sch Health. 2007;77:500-521.
Voluntary Guidelines for Managing Food Allergies In Schools and Early Care and Education Programs [PDF – 10MB]
Food Allergy Guidelines FAQs [PDF – 163KB]
http://www.cdc.gov/healthyyouth/foodallergies/

It requires a great deal of tact and give and take on the part of parents and the school to produce a workable situation for students, the child with the allergy, and parents.
A physical examination is important for children to make sure that there are no health problems. The University of Arizona Department of Pediatrics has an excellent article which describes Pediatric History and Physical Examination http://www.peds.arizona.edu/medstudents/Physicalexamination.asp The article goes on to describe how the physical examination is conducted and what observations and tests are part of the examination. The Cincinnati Children’s Hospital describes the Process of the Physical Examination http://www.cincinnatichildrens.org/health/p/exam/
If children have allergies, parents must work with their schools to prepare a allergy health plan.

Resources:

Micheal Borella’s Chicago-Kent Law Review article, Food Allergies In Public Schools: Toward A Model Code http://www.cklawreview.com/wp-content/uploads/vol85no2/Borella.pdf

USDA’s Accommodating Children With Special Dietary Needs http://www.k12.wa.us/ChildNutrition/pubdocs/SpecialDietaryNeeds.PDF

Child and Teen Checkup Fact Sheet http://www.health.state.mn.us/divs/fh/mch/ctc/factsheets.html

Video: What to Expect From A Child’s Physical Exam http://on.aol.com/video/what-to-expect-from-a-childs-physical-exam-325661948

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART© http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews © http://drwildareviews.wordpress.com/

Dr. Wilda © https://drwilda.com/

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More school battles about peanut allergies

11 Aug

Moi wrote about allergies in Food allergies can be deadly for some children:
If one is not allergic to substances, then you probably don’t pay much attention to food allergies. The parents and children in one Florida classroom are paying a lot of attention to the subject of food allergies because of the severe allergic reaction one child has to peanuts. In the article, Peanut Allergy Stirs Controversy At Florida Schools Reuters reports:

Some public school parents in Edgewater, Florida, want a first-grade girl with life-threatening peanut allergies removed from the classroom and home-schooled, rather than deal with special rules to protect her health, a school official said.
“That was one of the suggestions that kept coming forward from parents, to have her home-schooled. But we’re required by federal law to provide accommodations. That’s just not even an option for us,” said Nancy Wait, spokeswoman for the Volusia County School District.
Wait said the 6-year-old’s peanut allergy is so severe it is considered a disability under the Americans with Disabilities Act.
To protect the girl, students in her class at Edgewater Elementary School are required to wash their hands before entering the classroom in the morning and after lunch, and rinse out their mouths, Wait said, and a peanut-sniffing dog checked out the school during last week’s spring break….
Chris Burr, a father of two older students at the school whose wife has protested at the campus, said a lot of small accommodations have added up to frustration for many parents.
“If I had a daughter who had a problem, I would not ask everyone else to change…. http://www.reuters.com/article/2011/03/22/us-peanut-allergy-idUSTRE72L7AQ20110322

More children seem to have peanut allergies.

Ross Brenneman wrote in the Education Week article, How Peanuts Became Public Health Enemy #1:

Researchers aren’t sure why, but over the past several years, the number of children reported to have allergies has doubled, to 5 percent of children in the United States. Yet at the same time, in schools and elsewhere, allergies have drawn what some see as an oversized amount of attention. A new paper out of Princeton University explores why that may have happened.
Allergy attacks are awful. I’ve been there plenty of times. Eyes swollen shut, coughing, hacking, sneezing—and that’s just garden-variety pollen. But severe allergic reactions, also known as anaphylaxia, can cause death, even for the constantly vigilant. That’s why the U.S. House of Representatives voted unanimously last week in favor of a bill that would incentivize states, through a pre-existing grant program, to make sure their schools have a supply of epinephrine (usually an EpiPen) on hand, as well as staff members trained in using it.
The de facto allergen mascot, the peanut, has been at the forefront of anti-allergy crusades. Several schools have banned peanuts, sports arenas have set up “peanut-free” zones, and pretzels long ago committed a coup d’état against their salty brethren aboard airlines. The public response and media coverage at times suggests an epidemic.
One percent. That’s it. One estimate pegs it closer to 1.4 percent for children, but only .6 percent for adults. Either way, it’s small. Not all of those affected are seriously allergic, either. One percent isn’t nothing, but it’s not the kind of number that would suggest a strong cultural reaction, either.
Why, then, have peanut allergies become such a well-known public health menace? Maybe it’s partly from the mystery surrounding all allergies; scientists don’t know why allergies exist and why some people grow out of them. It’s also not clear how much an allergy attack may be exacerbated by asthma; the two often go hand in hand.
That allergies carry even some of the same the notoriety of a true epidemic, like typhoid, AIDS, or smallpox, intrigued Princeton University researcher Miranda R. Waggoner.
In a paper set to be published in the August 2013 edition of the journal Social Science & Medicine, Waggoner explores the momentum behind society’s Planters paranoia.
Medical journals first discussed peanut-based anaphylaxia in the late 1980s, while more and more parents separately but simultaneously started banding together to promote allergen awareness, assisted by speculation within the press about a new, interesting, and potentially hazardous health problem.
http://blogs.edweek.org/edweek/rulesforengagement/2013/08/how_peanuts_became_public_health_enemy_number_one.html?intc=es

Kids With Food Allergies has some excellent resources.http://www.kidswithfoodallergies.org/resourcespre.php?id=62&title=Peanut_allergy_avoidance_list&gclid=CJTC7sfLuLICFWdxQgodxHcAJQ

Kids With Food Allergies recommends the following 10 TIPS TO A HEALTHY STUDENT-SCHOOL PARTNERSHIP:

1. Pick your battles.
Many issues will arise. Non-negotiable ones will need to be dealt with immediately. Negotiable ones let you work to keep your child safe, while also allowing the school to accomplish what they are trying to accomplish.
2. Provide solutions.
If your child’s principal wants all students to bring in milk jugs for an arts and crafts project, ask if your child’s class can bring in water jugs (or orange juice, lemonade or iced tea jugs instead). Planning in advance can work for class parties, too. If your child’s teacher wants to throw an ice cream party, ask if water ice or a safe sorbet could work instead. Many times, activities that appear to be blatant disregard for your child’s situation are caused by a lack of education about food allergies. Explain the severity of the situation to your child’s teacher and/or school officials, or offer to find an expert to present the topic of food allergy at a teacher meeting. Offer alternative suggestions so teachers consider asking you for advice prior to the event!
3. Smile and stay calm (if only for appearances).
It’s true. You really do catch more bees with honey. If you have a give-and-take relationship with the school and show appreciation when events go right, they will be more apt to help you next time.
4. Get support.
You can’t do this alone. Involve your spouse, family, friends and people you trust. Sometimes a nurse from the allergist’s office will agree to accompany you to meetings or speak to a group. If this is possible, make sure you are on the same page first—with regard to diagnosis and treatment as well as your expectations of the school.
5. Get it in writing.
Make sure you trust and feel confident in your child’s allergist, and try to keep your relationship a positive one. Get the best possible documentation you can from your allergist.
6. Keep your child’s self-esteem in mind.
Always consider what is in the best interest of your child. Sometimes it is healthier for you to forfeit a conflict now, so that you don’t alienate someone who could help you down the road. There are many creative ways to allow your child to participate safely without changing the activity for the rest of the class.
7. Become an expert in substitutions.
Have your child’s teacher tap your very creative brain any time food is used in a lesson. Then, be observant and creative. Next time a teacher wants to use washed-out cream of mushroom soup cans to hold the scissors, suggest washed-out Play-Doh containers…and provide them, if possible.
8. Grow a thick skin.
Your child’s teacher may try their hardest to convince parents not to send their child in with a peanut butter cup or Cheetos for a school snack. But, sadly, there will always be one or two people who are difficult to convince. It’s not an excuse; it’s reality. Try not to take it personally.
9. Show you care.
Let other parents know that you would make the same accommodations for their child—and follow through. Sometimes the school is responding to outside pressure from parents who insist on keeping the school “normal.” Showing that you are a team player can alleviate the pressure.
10. Say “Thank you” when things go right.
Food allergy awareness greeting cards can be used to express appreciation and thanks to school staff.
Show your heartfelt appreciation any time another parent, child, teacher or school staff member goes out of their way to help make life easier for you or your child. If the classroom keeps special snacks all year long to help keep your child safe, sponsor a “thank you” party, safe snack or game time at the end of the year. Send flowers or a card to the principal or school nurse. Donate a food allergy book to the school library. Or start out a meeting by thanking the attendees for being there to listen and help.http://www.kidswithfoodallergies.org/resourcespre.php?id=155&title=10_tips_for_dealing_with_food_allergies_at_school

It requires a great deal of tact and give and take on the part of parents and the school to produce a workable situation for students, the child with the allergy, and parents.

A physical examination is important for children to make sure that there are no health problems. The University of Arizona Department of Pediatrics has an excellent article which describes Pediatric History and Physical Examination http://www.peds.arizona.edu/medstudents/Physicalexamination.asp The article goes on to describe how the physical examination is conducted and what observations and tests are part of the examination. The Cincinnati Children’s Hospital describes the Process of the Physical Examination http://www.cincinnatichildrens.org/health/p/exam/
If children have allergies, parents must work with their schools to prepare a allergy health plan.

Resources:

Micheal Borella’s Chicago-Kent Law Review article, Food Allergies In Public Schools: Toward A Model Code

Click to access Borella.pdf

USDA’s Accomodating Children With Special Dietary Needs

Click to access SpecialDietaryNeeds.PDF

Child and Teen Checkup Fact Sheet
http://www.health.state.mn.us/divs/fh/mch/ctc/factsheets.html
Video: What to Expect From A Child’s Physical Exam
http://on.aol.com/video/what-to-expect-from-a-childs-physical-exam-325661948
Where information leads to Hope. © Dr. Wilda.com
Dr. Wilda says this about that ©
Blogs by Dr. Wilda:
COMMENTS FROM AN OLD FART© http://drwildaoldfart.wordpress.com/
Dr. Wilda Reviews © http://drwildareviews.wordpress.com/
Dr. Wilda © https://drwilda.com/

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