Pulling the Plug on Peanut Allergy

DALLAS, April 14, 2017 (GLOBE NEWSWIRE) -- As national guidelines have changed recently regarding the introduction of peanuts into infant diets, select Allergy Partners’ locations have begun offering a new program called Food Allergy Risk Reduction (FARR®).

Peanut allergy is an increasingly common and potentially life-threatening condition.  Two recent studies indicate that, contrary to previous recommendations, the early introduction of peanut to the diet of at risk children lowers the risk of developing peanut allergy.

These studies have profound clinical implications in that they offer a strategy to prevent the onset of peanut allergy in high-risk children. Recently, the National Institutes of Allergy and Infectious Disease (NIAID) convened an expert panel to review and revise guidelines for the introduction of peanut into the diets of infants. These new guidelines were published in January, 2017 and can be found at: http://www.jacionline.org/article/S0091-6749(16)31222-2/fulltext.

In summary, the new guidelines emphasize the following:

  • Consider peanut introduction into the diet between 4 and 6 months of age.

  • Risk factors including the presence and severity of eczema as well as the presence of any other food allergy should be taken into account in order to help determine the safest way to introduce peanut.

These guidelines mark a significant change in the approach to food allergy, with an emphasis on prevention. Yet, there are several outstanding questions that remain, including how to approach children with other food allergies or children with food allergic first degree relatives.

Given these considerations, Allergy Partners is pleased to offer the Food Allergy Risk Reduction (FARR®) Program. Developed by Richard Wasserman, MD, PhD of Allergy Partners of North Texas, FARR® is aimed at select infants less than one year of age who might be at increased risk for allergy to foods such as milk, egg, or peanut. The children are skin tested to that food, and, if skin testing is negative or mildly positive, then challenged with the food (milk, egg or peanut). If there is no reaction, the parents are instructed to administer the specified quantity of food at least three times a week.

Who should be referred for FARR®?
The LEAP study only enrolled infants who had severe eczema or egg allergy. Such children are those most likely to benefit from FARR®. We know, however, that many children with food allergy do not meet those criteria. In an effort to assist you in counseling parents about the LEAP study and FARR®, we recommend referral of children with the following:

Recommendations of the NIAID Expert Panel

  • Severe eczema, egg allergy, or both

While these patients are the most likely to develop peanut allergy, prior studies have identified other risk factors for peanut allergy which may increase the risk of at-home introduction of peanut for infants. Infants with the following risk factors for peanut allergy may also benefit from referral for the FARR® Program:

  • Moderate to Severe Eczema
  • Other food allergies
  • 2 or more first degree family members with significant allergic disease
  • Sibling or parent with peanut allergy
  • Sibling or parent with a food allergy other than peanut

FARR® is not necessary for an infant already eating the food of concern without any adverse reactions. FARR® would rarely be appropriate for a child with no personal or family history of atopy. Children with a strongly positive in vitro (ImmunoCAP) food allergy test are not good candidates for FARR®.

The management of infants at high risk for food allergy requires consultation with an allergist to determine whether it is safe to introduce allergenic foods, such as peanut. Parents and medical providers are encouraged to seek guidance from the experts at Allergy Partners regarding strategies to minimize the risk of peanut and other allergies, for their children.

For more information, contact your local Allergy Partners’ allergist.  You can find a location near you by visiting www.allergypartners.com/locations.


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