Peanuts
Photograph ©2015 by Brian Cohen.

Preventing Peanut Allergies: Hope for the Future?

P eanut allergies have long been a bane to passengers who dine aboard airplanes — which is just about everyone who travels by air — and what exactly should be done pertaining to passengers with peanut allergies aboard airplanes has been hotly debated for years, which included the consideration of banning products containing peanuts aboard airplanes altogether.

Kyson and Sara Dana claimed that they were forced to leave the airplane operated by Allegiant Air on the afternoon of Monday, May 2, 2016 prior to a flight out of Provo because the mother alerted a member of the flight crew upon boarding the aircraft that their son Theo — who was two years old at the time — is allergic to peanuts.

Where should the line be drawn with regard to peanut allergies — as well as nut allergies, as peanuts are legumes and not nuts — and what should be done about placating both sides of this issue so that as many people as possible can enjoy their travel experiences as much as possible?

One solution looks promising: reduce the development of peanut allergy by introducing foods containing peanuts as early as possible in the life of an infant.

Preventing Peanut Allergies: Hope for the Future?

New formal guidance from the National Institute of Allergy and Infectious Diseases of the United States suggests that foods in which peanuts are an ingredient should be introduced as early as possible into the diets of infants in order to prevent the development of an allergy to peanuts later on in life.

A study from the Learning Early About Peanut Allergy — from which results from a clinical trial conducted in February of 2015 were reported — demonstrated that regular consumption of peanuts which started during infancy and continued until five years of age led to the reduction of 81 percent in the development of peanut allergies in infants deemed to be at high risk because they already had contracted severe eczema; allergies to eggs; or both.

That study “clearly showed that introduction of peanut early in life significantly lowered the risk of developing peanut allergy by age 5. The magnitude of the benefit and the scientific strength of the study raised the need to operationalize these findings by developing clinical recommendations focused on peanut allergy prevention,” according to Daniel Rotrosen, who is the director of the Division of Allergy, Immunology and Transplantation of the National Institute of Allergy and Infectious Diseases — and is also a doctor.

“For many years, experts thought that the best way to fight peanut allergy was to avoid peanut products in the first years of life — that’s why in 2000 the American Academy of Pediatrics (AAP) recommended that any child at high risk of peanut allergy (like those with a family history of it, or with other food allergies, or eczema) not eat any before they turned 3”, according to this article written by Claire McCarthy — who is a primary care pediatrician at Boston Children’s Hospital — for the American Academy of Pediatrics, which first revealed the potential conclusions of the study back in May of 2016. “But that didn’t help, which is why in 2008 the AAP stopped recommending it.”

Development of the three addendum guidelines was prompted by emerging data which suggested that peanut allergies can be prevented by the introduction of foods which contain peanuts as an ingredient early on in life to infants:

  1. With severe eczema focuses on infants deemed at high risk of developing peanut allergy because they already have severe eczema; egg allergy; or both. A panel of 26 specialists recommended that these infants have foods containing peanuts introduced into their diets as early as four to six months of age in order to reduce the risk of developing peanut allergy. Parents and caregivers should check with the health care provider of their infant before feeding the infant foods containing peanuts. The health care provider may choose to perform an allergy blood test or send the infant to a specialist for other tests, such as a skin prick test or an oral food challenge. The results of these tests will help decide if and how peanut should be safely introduced into the diet of the infant.
  2. With mild or moderate eczema should have foods containing peanuts introduced into their diets at approximately six months of age to reduce the risk of peanut allergy.
  3. Without eczema or any food allergy have foods containing peanuts introduced freely into their diets.

Summary

Unfortunately, the guidance provided by the National Institute of Allergy and Infectious Diseases — as promising as it may seem to be — does not offer immediate relief or resolution to the peanut allergy debate aboard airplanes.

One solution might be a special patch for people who suffer from allergies associated with peanuts, which had reportedly been effective in extensive tests conducted throughout North America and Europe — the patch was introduced slightly greater than two years ago — and could potentially resolve the peanut allergy issue aboard airplanes in the future.

Having people who are allergic to peanuts equipped with an epinephrine pen — also known as an epi pen, which is used to help those people who suffer from severe allergies — is also a solution; but that did not seem to help Kyson and Sara Dana.

Another possible solution — although not a viable one — is having people who are allergic to peanuts avoid traveling on airplanes altogether.

In the meantime, this article — which I wrote back on Monday, December 14, 2015 — lists the detailed policies of 18 airlines based in the United States and Canada pertaining to passengers with a peanut allergy. Links are also conveniently provided in that article so that research can be performed in advance of a flight to best deal with a passenger aboard an airplane who has a peanut allergy.

Photograph ©2015 by Brian Cohen.

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