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Peanut allergy in infants and toddlers

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Allergy is very common and can cause dangerous reactions in allergic children. Usually, this allergy develops at a young age, during the first year. How does peanut allergy develop and how can you recognize it in your child? And what should you do if your child has a severe allergic reaction?

Peanut allergy

Peanut allergy is an unpleasant and sometimes deadly allergy. Between 2% and 5% of children suffer from it. It can be overcome, but that only happens in forty percent of cases. More and more children are suffering from this condition. The reason is not yet known, but it is clear that this trend also applies to other food allergies.

What many people don’t know is that peanuts are not nuts. They are legumes, like beans, peas and lentils. Therefore, some children with peanut allergies are also allergic to soy (beans) or other legumes. Even so, allergy is quite common in combination with a nut allergy. But when your child is allergic to nuts, they are not automatically allergic to peanuts.

 

How does peanut allergy develop?

It is often mistakenly assumed that a child is not allergic the first time he eats or ingests pieces. This is not the case. 70% of children react to their first bite of peanuts, to a greater or lesser extent. A child may have already developed antibodies to peanuts.

When does peanut allergy develop?

Children are not born with peanut allergies, but develop them during the first years of their lives. That’s why giving peanuts at a young age can prevent the allergy itself. However, it is also possible for a person to develop an allergy when they are older. In that case, the so-called “secondary cross-allergy” usually occurs. This occurs mainly in older children and adults who already have a pollen allergy. As a cross-reaction, they later develop a particular food allergy. In the case of peanuts, it usually occurs as a cross-reaction to an allergy to tree pollen.

Is peanut allergy hereditary?

Undoubtedly, inheritance plays an important role. Peanut allergy in itself is not hereditary, but the predisposition to suffer from it is. This is a predisposition to allergic symptoms in general, which is called atopy. Children with atopic predisposition are more likely to suffer from hay fever, asthma and, therefore, also food allergy. The way it manifests itself can vary from child to child.

Children who react to peanuts often also suffer from eczema. However, eczema is not the expression of an allergy, but a skin disease. Children with eczema are not properly protected from the outside world and produce antibodies against food entering through the skin. Thus, a child with eczema may develop an allergy from skin contact with, for example, peanuts, eggs and nuts. Later on, you may have an allergic reaction when you eat a peanut butter sandwich for the first time. Eating peanuts and eggs does not aggravate eczema.

If you or your partner has a food allergy or asthma, there is an increased risk that your child will also be predisposed to it. Similarly, if a sibling has asthma or an allergy, your next child is more likely to have an atopic predisposition. The more family members are affected, the greater the likelihood. By the way, not all children with atopic predisposition actually suffer from a food allergy.

Allergy symptoms

Peanut allergy can lead to various symptoms. Some people have a mild allergy to peanuts and only experience (severe) itching when eating. The different symptoms can be divided into skin discomfort, swelling and fluid accumulation (angioedema) and breathing problems:

Skin discomfort:

  • Redness
  • Intense itching (for example, on the palms of the hands and feet)
  • Urticaria
  • Feeling of warmth and red skin

Angioedema:

  • Accumulation of moisture under the skin
  • Swelling under the eyes or on the cheeks
  • Swelling on the lips or tongue
  • Difficulty speaking or swallowing due to swelling around/inside the mouth
  • Inflammation of the throat and trachea can restrict breathing

Respiratory discomfort:

  • Itching in the mouth
  • Cough
  • Sneezing, runny nose, or watery eyes
  • Mucus formation
  • Itching in the throat
  • Shortness of breath
  • Wheezing
  • Asthma

When the body reacts violently in a short time (between minutes and an hour), anaphylaxis is spoken of. It causes tightness in the chest and a drop in blood pressure, which can cause the child to become pale, faint, or vomit heavily. This can be life-threatening. Fortunately, shock is rare in children. Children are more likely to become out of breath, have trouble breathing, and feel pressure in their throat. Therefore, if your child shows signs of anaphylaxis, the emergency room should be called immediately because it is necessary to act quickly and effectively.

What are the risks?

The risks of a peanut allergy depend on its severity of it. In the most severe case, if a dangerous allergic reaction occurs and is not recognized and treated in time, peanut allergy can even be fatal. Therefore, it is important to quickly recognize and treat an allergic reaction. Allergic reactions usually start out mild, with itching in the mouth, but worsen within a few minutes.

An allergic reaction can be stopped with an adrenaline rush. Adrenaline administration stops the reaction quickly in most children. The longer you wait, the sicker the child will be. Sometimes it is necessary to administer a second adrenaline pen since the effect of adrenaline disappears after half an hour. Always seek medical attention after administering the pen.

It is difficult to predict the severity of the allergic reaction. If a peanut allergy has been diagnosed, it may worsen over the years. Other children may no longer be allergic. The severity of the reaction may also depend on how much you have eaten. In the case of severe allergies, even a small amount can provoke an anaphylactic reaction, a crumb is already a risk. Therefore, products that may contain “traces of peanuts” are also dangerous.

Drugs

Your child doesn’t have to take medicine every day if he or she is allergic to peanuts. The important thing is that you avoid ingesting (products that contain) peanuts. In case of this allergy, your GP will probably prescribe antihistamine tablets. Be sure to always take them with you, or give them to your child when they go out. Your doctor will probably also prescribe an adrenaline pen, which you can use in case of an anaphylactic reaction.

How to use an adrenaline pen

You can ask your pharmacist or doctor for advice on which side of the adrenaline pen the needle is on. The pen is often used incorrectly and the person handling it is the thumb. This is quite painful and you will also lose the emergency medication.

Identification of peanut allergy

If you think your child has an allergy to peanuts or other foods, it can be diagnosed in three ways: through a blood test, a skin prick test, or a food challenge test.

First, a doctor will listen to your story and complaints. Based on this, you will decide whether a blood test or skin puncture is necessary. Allergy tests look for the presence of antibodies to peanuts. Antibodies are necessary for an allergic reaction to occur.

To know if the antibodies are activated, it may be necessary to do a food challenge test. Your child will take peanuts to eat at the hospital under the supervision of doctors and nurses. This is called provocation. If symptoms appear, it is a sign that you are indeed allergic. If the child’s antibodies to peanuts are elevated, it is advisable to provoke the reaction in the hospital and not at home.

If a child suffers an allergic reaction during a food challenge test, the allergy will not last a lifetime. It is advisable to re-determine the antibodies from time to time or perform another provocation in case the child grows up.

The dose of peanut a child responds to varies from child to child. Some children react to a very low dose of peanuts and should not eat even bits. Other children only react to one or two pieces. This is called a “threshold.” During a challenge test, you can hear what “threshold value” your child reacts to. This can be useful to know: should all traces be avoided or not?

 

Is there a medication or vaccine that cures peanut allergy?

If your child has a peanut allergy, there is a forty percent chance that it will pass. Therefore, in most cases, children continue to suffer from this allergy throughout their lives. Unfortunately, there is no medication that cures allergies. Scientists are doing a lot of research on peanut and nut allergies and are trying to develop a vaccine that should make the allergy milder. So far without success.

 

Give or not give peanuts to a baby?

Today it is recommended to introduce the baby to peanuts a little before one year of age. A few years ago the opposite was still said: peanuts should be avoided until one year or two years of age. Research has shown that this is counterproductive. The chance of developing a peanut allergy increases if they are avoided.

 

All the information we give you in this article is indicative as each child and each family is different and unique.

 

 

Carolina González Ramos

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