Haven’t we cracked that nut already?

Haven’t we cracked that nut already?

Again, this week I had the same conversation as last. Another understandably upset parent, another long discussion about where we go from here; what scientific breakthrough may or may not be just around the corner to try to reverse this newly diagnosed food allergy. I’m tired of diagnosing children with peanut allergy.


I can’t help but to ask myself, “why has the rate of new peanut allergy in my office remained seemingly unchanged, when doctors have discovered a way of preventing at least 80% of cases?” It’s hard not to turn to parents and tell them that their 18-month-old would likely be at home right now instead of being skin tested in my office if they would have introduced peanut-containing food at 5-10 months of age and routinely fed it to their child. But it’s not parents’ fault. For some reason society has been slow to digest this new science.


This isn’t just theory dreamt up by an immunologist or even a proven intervention with 5 or 10% effectiveness. This is like buckling your seatbelt or taking aspirin for a heart attack, this is clear as day. In a study of high risk children, early introduction of peanut prevented over 80% of cases of peanut allergy. National guidelines now reflect this recommendation.


If we extrapolate this data to the entire country, this means we could potentially decrease the frequency of peanut allergy from as much as 3% of children to around 0.5% by doing nothing but introducing peanut early – a food that is coincidentally loved by children, nutritious, protein rich and widely considered to be a staple in the diet of just about anyone over the age of 5.


Notably, those at very high risk, like children with eczema or other food allergy, should talk to their medical provider before introducing peanut. Some of these children may need to be tested first or their provider may suggest taking a first bite in the doctor’s office. But, these children also have potentially the most to gain in terms of risk reduction from early introduction. Also, remember actual peanuts pose bigtime choking risks and it’s bad news if they get aspirated by little kiddos, so don’t give actual bits of peanut or other nuts to little kids.


So please, parents, mix peanut butter with puree, mix it with breast milk, or yogurt, or – if you’re a busy mom or dad then pick up a few pouches of MyPeanut™. Talk to your provider and, if she or he doesn’t know this information, share it. Let’s spread the word that new science has changed our understanding and it is time we all crack this nut together.


Thank you from all the future children I will not be getting to see in my office for peanut allergy J


– David R. Scott, MD, Allergist and founder of MyPeanut(TM)

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