Peanut Allergies In Children: What Singaporean Parents Must Know About It

helo.my: While enjoyable, peanuts can cause one of the most common and deadly forms of allergies in children; and its prevalence has only increased in the last decade.

This was proven by a recent study published in Asia Pac Allergy as a part of a five-year retrospective review of children with peanut allergy (PA) in Singapore. It uncovered that although its prevalence in children on the little red dot is lower as compared to western countries, “peanut is the top trigger for food-induced anaphylaxis in Singaporean children.” 

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The report further suggested that “Within two decades, peanut anaphylaxis had risen from a rare entity to the commonest trigger of food anaphylaxis in Singapore.”

This could be credited to the fact that most Asian households consume a large amount of peanuts in either “boiled, braised, fried or roasted whole nuts” form. Alternatively, they are also crushed into powder form and made into a sauce of spread and used as a culinary ingredient in a variety of dishes.

This type of large consumption makes it necessary to get children checked for potential peanut allergies and reactions. 

However, even with that being a reality in most Asian households, a new study suggests that parents are not well informed when it comes to peanut allergies.

This was based on research that was done and presented at the American College of Allergy, Asthma and Immunology Annual Scientific Meeting. 

Parents Still Not Well Informed About Peanut Allergies In Children: Study

The research revealed that only 58% of study participants reported that their child’s paediatrician discussed early peanut introduction. Only about 40% received a recommendation to introduce it early.

Earlier parents were advised against introducing peanuts early, but now the recommendation states early introduction.

This can help prevent an allergy from forming. The lead researcher of the study, Christopher Warren, said that their findings suggest that doctors are also talking about the importance of introducing peanuts early to infants, but they are not officially recommending it to parents. 

The study elaborated that when peanuts are introduced at the time when a baby starts solid food, you can prevent the development of an allergic reaction.

While parents should may be aware of this, the recommendation should come from their medical provider. 

Parents of children with eczema were most educated about peanut allergies in children

As part of the study, the researchers gathered surveys from more than 3,000 households during a 3-week period in 2021.

The children were between the ages of 7 months and 3.5 years old. Out of this, 11 per cent had eczema, which is usually a precursor to developing allergies. 

It was found that parents who had children with eczema were most educated on the guidelines surrounding introducing peanuts at an early age.

Out of all the parents, only 44% had given their babies peanuts before they were even 11 months old. This is because there are still a large number of parents who may fear introducing peanuts in babies and toddlers. 

If you are thinking about the right time to introduce your baby to peanuts, here’s what you need to know. 

Causes Of Peanut Allergy In Young Children

Peanut allergy in babies is caused when the immune system mistakenly identifies peanut proteins as something harmful.

So, any direct and indirect contact with peanuts can cause your child’s immune system to release symptom-causing chemicals into their bloodstream.

Here are three possible ways in which your child can be exposed to peanuts:

• Direct contact: This is one of the most common causes of the allergy. It happens when your baby comes in direct contact with peanuts. 
• Cross-contact: It is the unintended introduction of peanuts into a product. This is usually the result of exposure to a food with peanuts during the processing or the handling stage.
• Inhalation: This is also one of the other probable causes. An allergic reaction can take place if one inhales dust or aerosols containing peanuts, from a source such as a peanut flour or peanut oil cooking spray.

Symptoms Of Peanut Allergy In Young Children

An allergic response to peanuts usually starts within minutes after exposure and takes full form within an hour, as is also proved by this study. 

Here are some of the signs of peanut allergy:

• Tightening of the throat
• Runny nose
• Itching or tingling in or around the mouth
• Shortness of breath
• Diarrhoea, stomach cramps and even vomiting. 

In addition to these, it is also crucial to watch out for Anaphylaxis’ life-threatening symptoms, commonly caused by a peanut allergy. Some of the signs of Anaphylaxis include:

• Rapid pulse
• Dizziness and loss of consciousness
• Drop-in blood pressure
• Swelling of the throat may make it difficult to breathe. 
• Constriction of airways

Since these are severe complications, it is always best to consult with your child’s medical practitioner before you introduce peanuts into their diet. 

Diagnosis Of Peanut Allergy

The discussion that you and your doctor have about your child’s symptoms and their medical history will start the process of diagnosis. 

The doctor may do a physical examination. 

• Food diary: You may be asked to maintain your child’s food diary, their eating habits, and even track any possible symptoms and their medication schedules.
• Elimination diet: In case the doctor is sure that peanuts are causing the symptoms, or if they think your child has had a reaction to it, they may recommend an elimination diet. You may be asked to eliminate peanuts from their diet for a week or two. 
• Skin test: For this test, a small amount of food will be placed on your child’s skin. It is pricked with a needle. In case your child is allergic to a particular substance, they will develop a raised bump or reaction.
• Blood test: This method can help measure your child’s immune system’s response to particular foods by checking the amount of allergy-type antibodies in their bloodstream, known as immunoglobulin E (IgE) antibodies.

Treatment For Peanut Allergy In Children

Even though the standard approach to care for peanut allergy is to avoid exposure, researchers continue to study different therapies, including oral immunotherapy.

This involves giving children suffering from peanut allergies– an increased amount of food containing peanuts over time. But do note that oral immunotherapy is not a cure for peanut allergy.

In fact, this kind of therapy is aimed to reduce the risk of severe reactions, including anaphylaxis shocks that could occur with exposure to peanuts.

The US Food and Drug Administration also approved the first oral immunotherapy drug, Peanut (Arachis hypogaea) Allergen Powder-dnfp (Palforzia), to treat kids between the ages of 4 and 17 years with a confirmed peanut allergy.

However, do note that this medication isn’t recommended for people suffering from uncontrolled asthma or similar serious conditions. So its best to consult with your doctor before moving ahead with any medication. 

5 Things To Remember Before Introducing Peanuts To Children

• You should ideally give your child the peanut-based food only when they are healthy and you know that they do not having any illness. 
• A peanut-containing food should never be your child’s first food. 
• Whole peanuts aren’t recommended for kids who are under 5 years of age, since they pose a choking hazard.
• Always give your child the first taste of peanuts at home, and not at daycare or at a restaurant.
• You should always ensure that at least one parent can give his or her full attention to the child, the first time a peanut-containing food is given. 

It is very important to make yourself aware if you or your child is allergic to peanuts. This can prevent any sudden allergy attacks and help you care for your child if they do have an allergic reaction. 

Source: Mayo Clinic, ACAAI