Nav: Home

Reducing peanut allergy risks in children -- The Nurse Practitioner presents update

February 15, 2018

Feb. 15, 2018 - New prevention and treatment approaches can reduce serious health risks due to peanut allergy in children, according to an article in the March issue of The Nurse Practitioner, published by Wolters Kluwer.

Early introduction of peanuts into the diet can prevent the development of peanut allergy in high-risk infants, according to the article by Jaime Hopper, MSN, FNP-C, and Courtney Hopp, MSN, FNP-C, of Indiana University Health Methodist Center, Indianapolis; and Jessica Durbin, DNP-FNP-BC, of Indiana State University, Terre Haute. The authors also discuss the emerging role of oral immunotherapy and other desensitization approaches to reduce serious reactions in peanut-allergic children.

What's New in Peanut Allergy? Update for Nurse Practitioners

With the rising prevalence of peanut and other food allergies, nurse practitioners and other providers must be prepared to care for children with peanut allergy. "Peanut allergies are a significant public health issue and are the primary reason for food-related anaphylactic reactions that result in death," the authors write. Rates of peanut allergy in the United States have been estimated between 1.6 and 2.7 percent.

Children who have siblings or parents with known peanut allergy are at increased risk of developing peanut allergy, as well as other food allergies, asthma, or atopic dermatitis. Until recently, the American Academy of Pediatrics (AAP) recommended avoiding peanuts in high-risk children until age three.

However, a 2015 study (the LEAP trial) found that early introduction of peanuts into the diet led to a "compelling reduction" in the risk of peanut allergy in high-risk children. The updated AAP recommendations define a three-tiered exposure level, including introducing peanuts at about four to six months of age in high-risk children with severe eczema and/or egg allergy, with a recommendation for allergy testing. Other recommendations apply to children with mild to moderate eczema, and to those with no eczema or any food allergy.

For children who have developed peanut allergy, a technique called oral immunotherapy (OIT) is a promising approach to allergen desensitization. In one trial, OIT increased the threshold amount of peanut children could ingest before experiencing a reaction by at least 25 times.

"With desensitization for known peanut allergies, clinicians may be able to reduce the incidence and other severe reactions in the future for children by making the reactions less severe," Hopper and coauthors write. "Although OIT has not been shown to be 100 percent effective, it offers the potential for an increased quality of life for severe food-allergy sufferers."

Further studies will be needed to establish the short- and long-term safety and effectiveness of OIT. Sublingual and epicutaneous approaches to peanut immunotherapy are being studied as well.

The authors discuss the implications for evaluation and management of children receiving immunotherapy for peanut allergy, including assessment of asthma and other forms of allergic disease. Patients need ongoing education in recognition and emergency treatment of life-threatening allergic reactions, including the use of an epinephrine auto-injector.

The theory that early introduction of highly allergic foods could desensitize patients and lead to fewer adverse reactions could lead to major changes in the management of food allergies. "While currently utilized by clinicians in specialty settings and still experimental in nature, the potential exists for administration of OIT into other clinical sites," the article notes. "This would further advance the availability of lifesaving therapies to the most vulnerable individuals in our population."
-end-
Click here to read "Peanut allergy reduction in high-risk pediatric patients."

DOI: 10.1097/01.NPR.0000530210.24654.36

About The Nurse Practitioner

With a circulation of 75,000, The Nurse Practitioner is the leading monthly source for clinical, practical, cutting-edge information for advanced practice nurses and other primary care clinicians. Each issue presents peer-reviewed articles that range from clinical topics and research to political and practice issues. In addition, The Nurse Practitioner provides regular features, columns, continuing education, staff development education, and more. In addition, The Nurse Practitioner holds a biannual educational meeting--the National Conference for Nurse Practitioners (NCNP) -- which draws approximately 3,000 attendees annually.

About Wolters Kluwer

Wolters Kluwer N.V. (AEX: WKL) is a global leader in information services and solutions for professionals in the health, tax and accounting, risk and compliance, finance and legal sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with specialized technology and services.

Wolters Kluwer reported 2016 annual revenues of €4.3 billion. The company, headquartered in Alphen aan den Rijn, the Netherlands, serves customers in over 180 countries, maintains operations in over 40 countries and employs 19,000 people worldwide.

Wolters Kluwer Health is a leading global provider of information and point of care solutions for the healthcare industry. For more information about our products and the organization, visit http://www.wolterskluwer.com/, follow @WKHealth or @Wolters_Kluwer on Twitter, like us on Facebook, follow us on LinkedIn, or follow WoltersKluwerComms on YouTube.

For more information about Wolters Kluwer's solutions and organization, visit http://www.wolterskluwer.com, follow us on Twitter, Facebook, LinkedIn, and YouTube.

Wolters Kluwer Health

Related Eczema Articles:

Study casts doubt about link between eczema, cardiovascular disease
Despite mixed evidence recently about an association between atopic dermatitis and cardiovascular disease, a new study that analyzed more than 250,000 medical records suggests there is no link.
Reasons for eczema susceptibility uncovered
Scientists have uncovered evidence that a deficiency in the skin's barrier is key to triggering eczema.
Silk clothing offers no benefit for children with eczema, study finds
Wearing silk clothing offers no additional benefit for children who suffer from moderate to severe eczema, a study led by researchers at The University of Nottingham has found.
Silk clothing did not improve eczema in children
No significant differences were observed in eczema severity for children with moderate to severe eczema who wore silk garments compared with those who wore their usual clothing, according to a randomized controlled study published in PLOS Medicine by Kim Thomas from University of Nottingham, UK, and colleagues.
Antibiotics not effective for clinically infected eczema in children
Estimates suggest that 40 percent of eczema flares are treated with topical antibiotics, but findings from a study led by Cardiff University suggest there is no meaningful benefit from the use of either oral or topical antibiotics for milder clinically infected eczema in children.
Antibiotics not effective for clinically infected eczema in children
There is no meaningful benefit from the use of either oral or topical antibiotics for milder clinically infected eczema in children.
Protecting babies from eczema with low-cost Vaseline
A Northwestern Medicine study published today (Dec. 5) in JAMA Pediatrics found that seven common moisturizers would be cost effective in preventing eczema in high-risk newborns.
Got eczema? It may just be bad evolutionary luck, study finds
A new study probes the evolutionary history of eczema, examining a genetic variant strongly associated with the most common form of eczema, atopic dermatitis.
Early life exposure to antibiotics is related to increased risk of allergies later in life
Research presented Sept. 6, 2016, at this year's European Respiratory Society International Congress in London, UK, shows that exposure to antibiotics early in life is related to increased risk of developing allergies later in life.
Daily 'soak and smear' or steer clear?
For at least 100 years, parents of kids who have eczema have asked doctors how often they should bathe their child.

Related Eczema Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Jumpstarting Creativity
Our greatest breakthroughs and triumphs have one thing in common: creativity. But how do you ignite it? And how do you rekindle it? This hour, TED speakers explore ideas on jumpstarting creativity. Guests include economist Tim Harford, producer Helen Marriage, artificial intelligence researcher Steve Engels, and behavioral scientist Marily Oppezzo.
Now Playing: Science for the People

#524 The Human Network
What does a network of humans look like and how does it work? How does information spread? How do decisions and opinions spread? What gets distorted as it moves through the network and why? This week we dig into the ins and outs of human networks with Matthew Jackson, Professor of Economics at Stanford University and author of the book "The Human Network: How Your Social Position Determines Your Power, Beliefs, and Behaviours".