by: Jackie Semmens
How can this be happening? I thought to myself, watching my one-year-old’s body turn red as the hives spread across his chest. We had done everything by the book: I hadn’t avoided nuts during my pregnancy; I exposed him to peanuts early like the pediatricians recommend. But here we were, driving to the emergency room. The allergist later confirmed – my baby was allergic to both peanuts and tree nuts.
Thus began a new set of rituals at our house – meticulously reading each and every food label, digging wrappers out of the trash to find out if he can eat the crackers a friend offered him at a playdate, avoiding restaurants unless we can be sure of what they serve, giving each babysitter a detailed list of instructions on what to do if he has a reaction, and carrying an EpiPen with us wherever we go.
As my son starts preschool this year, we have rehearsed a certain interaction over and over. “What do you say if someone hands you food?” I drill him. “I say, ‘No, thank you! I’m allergic. I have my own.’” We quiz him again and again, reminding him that he is allergic to nuts and to dairy, and that he can never share food with a friend.
We confirmed with the teacher before he started that his room would be nut-free, and knowing that the teacher and fellow parents are willing to help give him a safe environment helps to ease some of my concern. Nut-free environments for our youngest learners helps ensure that all children, even those with food allergies, have access to education while remaining safe and healthy.
Although my son is also allergic to dairy, we’re typically more concerned about his nut allergies when he’s in public, not only because, for him, it’s a more severe allergy, but also because of the nature of nut allergies. As anyone who has ever made a peanut butter and jelly sandwich (or fed one to a toddler) knows, peanut butter is sticky and likely to end up spread across multiple surfaces before the meal is over.
Although it’s unlikely that an allergic child will have an anaphylactic reaction from mere contact, young children are forever sticking fingers, toys, and even crayons in their mouth, creating the potential for accidental ingestion. And for an unlucky few, even exposure to airborne particles can be enough to trigger a reaction. While severe food allergies are fairly rare, reactions to peanuts are the leading cause of anaphylaxis and death related to food allergy in the United States.
While some maintain that it’s the duty of families with allergies to prepare their child for the “real world,” the truth is that by the time they are old enough to enter that world, they will have a better understanding of the severity of their allergies and the steps they need to take in order to protect themselves.
We don’t send kindergarteners across the street alone just because they will need to do so when they’re older; we require that they hold our hands. It’s similar with allergies – we need to enlist the help of the community to create a nut-free environment while young children are still learning how to navigate their allergy independently.
I have a great deal of sympathy for parents who are frustrated at schools that don’t allow them to pack the simple and economical PB&J for their child’s lunch, or are annoyed at the difficulty of finding an allergy-friendly treat to bring in for special occasions. I share in those frustrations on a daily basis, and curse under my breath every time I see the price of SunButter.
I know what it’s like to have to deny your child something they desperately want to eat, like when they want to know why they can’t eat the same cookies everyone else at the birthday party is enjoying. I follow these restrictions on a daily basis, and without a second thought, because they could save my child’s life. I don’t wish to minimize what I’m asking other parents to do, because I realize I’m requesting that others make a sacrifice that doesn’t benefit them at all. But it greatly helps my child. And I do know this – I would do it for your kid in a heartbeat, especially if it meant saving their life.
While pediatricians do not recommend avoidance of nuts for children without the allergy, as it can actually increase the likelihood of peanut allergy, for children with the allergy, strict avoidance of the allergen is currently the only recommended way to prevent a serious reaction. Even if a non-allergic child attends a nut-free school, this does not prevent them from regularly enjoying peanuts and tree nuts when they are at home. However, there is no reason that consumption of nuts must be done around children who do have allergies. In fact, accidental exposure to peanuts and severe reactions are actually on the decline, likely due to greater public awareness and accidental exposure prevention strategies. As communities have become more conscious of food allergies, children have been made safer.
Raising children is never a solitary venture. We rely on the support of families, friends, and our community to help create safe environments for our kids. Just as we help our children safely cross the parking lot into the school, as a community, we should pull together to help make sure that all children, even those with severe food allergies, are safe when they arrive.
No, thank you.
by: Varda Epstein
I’ve heard (anecdotally) of a guy who dropped dead at a bus stop in my town after kissing his spouse. She’d eaten a cookie that had trace amounts of peanuts in it just moments before. He died so quickly that no one had time to find and use his EpiPen. That was in the 1980s when trace amounts of ingredients were not yet listed on food labels in my adopted country of Israel.
That has changed. By law, Israeli food labels must now include a warning of possible trace amounts of allergens in food products. Still, there was, and is no thought of banning nuts in Israeli schools, even today.
In fact, far from banning nuts from schools and daycare centers, the peanut is urged on babies and children in the form of a peanut-flavored snack called Bamba. Bamba are exactly like Cheese Doodles without the cheese. Or rather, instead of cheddar, the little puffs are flavored with peanut butter.
Bamba takes the place of the Cheerio for Israeli babies. They fit nicely in a baby’s fist and when gummed, melt into goo for easy swallowing. Because they’re so much a part of the infant diet, the Osem company, which produces the little snack puffs, fortifies them with vitamins.
Which is a good thing. Because I don’t know about your babies, but most of mine went through a picky period where they didn’t like anything I tried to feed them. Other than Bamba, that is. Even when they were cranky from teething, they’d eat Bamba. With Bamba I knew my kids were getting their vitamins, eating something, and I didn’t have to worry.
So here’s where it gets really interesting: my second child (of 12) was and is allergic to several foods, including peanuts and other nuts. Yet as an infant, I had no clue this was the case, as she too, did just fine on Bamba. Her allergies never developed to the point of anaphylactic shock, thank goodness, and in light of a March 2015 study that appeared in the New England Journal of Medicine, I do believe that we have Bamba, the peanut-flavored snack, to thank for this fact.
The study in question was the Learning Early about Peanut Allergy (LEAP) trial; an attempt to discover whether the “early introduction of dietary peanut could serve as an effective primary and secondary strategy for the prevention of peanut allergy.” The LEAP researchers, based in the United Kingdom, used Bamba, purchased at a discount from Osem, as their primary source for peanut protein.
The findings of the LEAP study suggest that medical advice calling for avoidance of exposure to peanuts had actually caused the rate of peanut allergy among American children to skyrocket. Meanwhile, feeding babies Bamba during an infant’s first year of life, beginning at around age seven months, appeared to lower the risk of developing peanut allergies by 81%. Furthermore, in those children who ate Bamba as babies and then went on to develop peanut allergies (like my daughter, for instance), the allergic responses appeared to be far milder in nature.
This study was groundbreaking. For the first time, researchers had proof that early exposure to allergenic foods could prevent or lessen allergic reactions. The hope going forward is that research will manage to produce similar results using allergenic foods like soy, eggs, and dairy, for instance.
The study of immunization and food allergies has a long way to go, of course. As a teenager, I received allergy shots for pollen and other airborne allergens. But I was told no such therapy was available for food allergies. The Bamba study seems to have blown that myth right out of the water.
But if that’s the case, why are we banning peanuts from all places where children congregate? Places like schools, daycare centers, and yes, summer camps? Here’s the truth: we’ve created a nut-free society because of poor – or at least outdated – medical advice.
Schools would not tremble at the sight of a peanut butter sandwich had we not stopped feeding kids peanut butter. So how did it happen? When did we decide peanut butter was dangerous to the point that we made it dangerous?
It began in the 1990s when a slew of newspaper headlines such as, “Little Girl Drops Dead After Eating PB&J,” appeared. Parents read those headlines and freaked. At the same time, medical journals began to be full of articles about serious peanut allergies. Soon we had an epidemic on our hands.
Or did we? Researcher Miranda Waggoner, is convinced the epidemic was more a peanut “panic” than an actual rise in severe peanut allergies. According to Waggoner, severe peanut allergies remain rare. The reported tripling of the rate of peanut allergies was, she says, a social construct (with the aid of experts who spread the fear among the public), rather than an actual contemporary public health issue.
In other words, experts and the media raised awareness of severe peanut allergies to the point of hyper-awareness. As a result, peanut bans were instituted, and this in turn affected the immune systems of our children because we avoided exposing them to nuts. We prevented them from developing their immune systems to the point of resisting peanut allergy, by depriving them of peanut butter.
While the LEAP trial involved giving children Bamba at a very young age, rather than school age, it is quite possible that nut-free schools may actually contribute to nut allergies, by limiting exposure to nuts. No one can say this for sure, right now. What we can say is that if you look at the actual number of children experiencing severe reactions to peanuts, you will find it is a very low number, indeed.
Trying to find the actual number of school children with peanut allergies was like looking for a needle in a haystack. Waggoner found that only 1% of the American population has a reported allergy to peanuts. If you look at how many of those Americans are children, you are looking at a number that is less than 1%.
The American College of Allergy, Asthma and Immunology (ACAAI) says that 400,000 American school children have peanut allergies. The National Center for Education Statistics (NCES) puts the total number of American school children at 50.4 million. That means that .79% of school children have peanut allergies, but this figure says nothing of the severity of their allergies. How many of those children are going to have a severe anaphylactic shock in response to someone eating a peanut next to them?
If your child has a known, severe allergy to peanuts, it makes sense you’d approach the school and ask that precautions be taken. But nut-free schools in general? They’re hurting more kids than they’re helping.