Blueberry Pediatrics Podcast: The growing prevalence of food allergies – and what parents can to do prevent them
Mission MightyMe co-founder Dr. Gideon Lack, a leading researcher and world-renowned pediatric allergist, recently joined the Blueberry Pediatrics Podcast with Dr. Whitney Casares for a fascinating conversation about food allergy prevention.
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Now back to the fascinating interview with Dr. Whitney and Dr. Lack – these two brilliant medical minds chatted about a range of important topics for parents, including:
- The rise of food allergies – and how we can prevent them
- Practical strategies for introducing allergens early to safeguard your child’s health
- The importance of pushing past common fears surrounding allergen introduction
- How new research changed feeding guidelines globally and reshaped how pediatricians approach prevention
- The critical link between skin health and the development of food allergies
Listen to the full podcast episode here, and keep scrolling for our full recap with some bite-sized key takeaways!
Food allergies are on the rise / What we got wrong
A recent publication in the UK showed rates of allergies in school-aged children had tripled or quadrupled in the last 10 years, a trend we see in many countries around the world. While some childhood food allergies (most often egg and milk allergies) can be outgrown, about 80% of nut allergies persist into adulthood and create a lifelong burden for those affected. Several factors – including a shift away from introducing nuts early, exclusive breastfeeding and introducing solid foods later, and a surge of dry skin and eczema in babies over the last 20-30 years (for reasons we still don’t fully understand) — created the “perfect storm” that led to this epidemic.
As the medical community encountered more food allergies in young children, doctors started to think: if a baby has a peanut allergy and eats peanuts, that causes an allergic reaction, so obviously a baby with that severe allergic reaction should avoid peanuts. That makes sense! But then that line of thinking extended incorrectly to: in order to prevent peanut allergies, we shouldn’t give ANY babies peanuts – and same with other commonly allergenic foods. That erroneous assumption was confusing the trigger of an allergic reaction, i.e. eating a peanut, with the cause of developing a food allergy.
A lifelong burden
Food allergies are debilitating. If you look at a child with food allergies in front of you, they look healthy, so most people simply don’t realize or understand the extent that these children and their families’ lives are affected. Accidents happen, always unpredictably, and even when kids and parents are especially careful or vigilant.
Food allergies can restrict socialization – for example, sitting at different tables at school, not attending birthday parties out of fear, avoiding restaurants, even leading to bullying – and cause higher levels of anxiety and a reduced quality of life. Seemingly simple tasks like grocery shopping can be more difficult and expensive. Travel is tricky, seeing the right specialists can be stressful, childcare or summer camps can feel impossible, and getting the right nutrition is tough.
Food allergies can also in rare instances, be fatal – and peanut allergy is a leading cause of death in this group – so parents and children live in constant fear of the consequences of a minor mistake. Thankfully, treatments such as oral immunotherapy have been developed that can help mitigate the risk, but it would of course be best to prevent food allergies from developing in the first place.
The good news: we now know that prevention is possible.
Guidelines have changed globally, but public uptake can be slow
After the LEAP Study, led by Dr. Gideon Lack, was published in 2015, guidelines started to take a big U-turn from “avoid” to “introduce early.” The NIH and NIAID guidelines changed first, later followed by the American Academy of Pediatrics, the USDA and international guidelines in Canada, Australia, Japan and the UK.
Today, most pediatricians recommend introducing allergenic foods when a baby starts solids, especially peanuts. The guidelines recommend starting peanut foods as early as 4-6 months of age, especially for high-risk babies with eczema. Though it’s currently recommended that high-risk babies see a doctor and undergo possible allergy testing first. Read more about the latest clinical guidelines here.
While there’s certainly been a profound shift over the last decade, it’s one thing for policy to change and quite another to put these guidelines into practice. There’s still plenty of room for improvement to educate the public at large in order to reap the benefits from a public health perspective.
The Risk is Actually in Waiting
If you’re a parent and afraid of introducing nuts or other allergens, you aren’t alone! As Dr. Whitney pointed out, there is still fear over introducing allergenic foods. Many parents can understand that recommendations have changed but still have a huge fear of following the new guidelines that totally contradict what they’ve been told for so long. She’s even heard parents talk about sitting in their cars in the parking lots of doctor’s offices to introduce nuts.
Dr. Lack says parents in his practice can be terrified of causing an allergic reaction in their child – especially if a parent has eczema, or if there’s a family history of food allergies. If there is an eczema flareup, which could be unrelated to the food, many parents’ first reaction is still to withdraw the food, which can lead to a self-fulfilling prophecy of actually then developing a food allergy. He tries to reassure parents and overcome that shorter-term fear for the sake of food allergy prevention in the long-run.
As parents, we do the best with the information we have. And the science is clear – especially with a randomized controlled study like the LEAP Study, which is a gold standard in terms of scientific evidence – that early introduction and consistent exposure is key to helping prevent peanut allergies from developing in the first place.
Check out our Mission MightyMe early allergen introduction guide for tips and context on how to introduce and regularly include allergens in your little one’s diet.
Solving a problem with Mission MightyMe
With early nut introduction, we’ve got a really powerful tool of prevention – but the key challenge for most busy parents is giving young babies the right amount of nuts in a safe, convenient and baby-friendly form.
Dr. Lack realized while looking at baby shelves that most baby foods are hypoallergenic, influenced by previous and outdated medical guidelines, long after they’d changed. Until recently, you didn’t have products that allowed parents to introduce nuts, egg and other allergenic products into babies' diets early enough. It was one reason he was inspired to team up with food allergy parents J.J. and Catherine Jaxon and FARE co-founder Todd Slotkin to develop Mission MightyMe Nutty Puffs.
Dr. Lack helped formulate the puffs as a dense, nutritious snack that’s more than 50% nuts but that would dissolve quickly on the tongue, taste delicious, and make it simple to keep nuts in the diet regularly, without crowding out the whole diet of babies and toddlers (after all, you want those fruits and veggies, too!).
While you can use nut butters or finely ground nuts, nut butters need to be adequately thinned out – with breastmilk, water, etc. Nuts must be finely ground into a flour and mixed into purees to prevent choking. In a lot of countries, nuts are chopped, roasted and sprinkled into baby food. It’s feasible but can be a huge hassle. As Dr. Whitney explained, Mission MightyMe is a practical tool that can be a lifesaver for a lot of families.
Early, Often, Ongoing & Enough
Another important takeaway from the interview is that the amount of peanut protein really does matter! In his LEAP and EAT Studies, Dr. Lack found that peanut exposure needs to be happening starting in the “magic window” of 4-6 months, on a regular, sustained basis with the right amounts of nut protein, until the child is 5 years of age. The EAT Study showed that 2 grams of allergenic protein is the minimum threshold weekly for protection in a mainstream population. For high risk infants, the AAP currently recommends 6 grams of peanut protein per week based on the LEAP Study. That’s the equivalent of one pouch of Mission MightyMe Organic Peanut Butter Nutty Puffs.
Early introduction is a dose-dependent process, and you need to get gram quantities of each food protein into a babies’ diet (not milligram quantities).
Mixed Nut Butter Nutty Puffs were purposely crafted to contain equal parts protein per each of 5 nuts. Two pouches per week delivers 2 grams per nut (peanut, walnut, almond, hazelnut and cashew).
Making a major impact
Dr. Lack believes that early introduction, be able to prevent more than 100,000 cases of peanut allergies every year. Over a 10 year period, that would save more than 1 million children from the burden of peanut allergies.
Long-lasting protection
Dr. Lack’s latest research, the LEAP-Trio Study, found that early peanut exposure provides lasting protection from peanut allergy that endures through the teen years. It provides conclusive evidence that starting babies on peanut foods early and keeping them in the diet regularly until age 5 achieves, long-term peanut allergy prevention through adolescence. The study followed the original LEAP participants until age 12 and older and found that children who consumed peanuts early and regularly for the first five years of life had a 71% reduction in peanut allergies in adolescence compared to the avoidance group, even if peanut foods were avoided after age five.
Bite-Sized Takeaways:
- Food allergies are on the rise, but early and often introduction to common allergens is a powerful tool.
- Don’t wait – introduce allergens early to reduce the risk of developing future food allergies.
- Early introduction = long-term protection (the latest research shows it lasts into the teen years!)
- Consistency and repeat exposure is key, and the amount of allergenic protein matters.
- There are a lot of ways to get nuts into babies’ diets, but Mission MightyMe makes it easy and stress-free. By following the latest guidelines and science, you can set your little one up for a mighty future.
- With more widespread adoption, we could prevent more than 100,000 cases of nut allergies every year (that’s 1 million over the next decade!)
Help out a friend and share this educational blog with another parent who needs to know! As Dr. Whitney pointed out, taking this conversation about early introduction to heart can truly change lives.
Please note: This blog post is for information purposes only and shouldn’t be used as personal, health, nutritional, or medical advice. Always consult your pediatrician with any questions about what to feed your child.
*FDA HEALTH CLAIM: For babies with an increased risk of peanut allergy (babies with severe eczema, egg allergy or both), introducing age-appropriate, peanut-containing foods as early as 4 months may reduce the risk of developing a peanut allergy. Caregivers should check with the baby’s healthcare provider before feeding the baby peanut-containing foods.
Mission MightyMe products must be avoided by anyone who has a known or suspected allergy to any of the ingredients. If you have any questions about what you’re feeding your baby, consult your pediatrician.
