First, an interesting insight into determining who is most likely to have an anaphylactic reaction. In a brand new article in the New England Journal of Medicine, researchers found that:
People who suffer anaphylaxis have higher levels of platelet-activating factor (PAF) than those who don't get such severe reactions.
As well as lower levels of an enzyme that breaks down PAF. This is a great discovery--it will be easier for docs to figure out if anaphylaxis is truly occurring (sometimes the symptoms are ambiguous) and figure out which people are most likely to have an anaphylactic reaction. Wouldn't it be great if you knew, based on a blood test, that you are Not Likely, Somewhat Likely, or Very Likely to have a full-blown anaphylactic reaction--before you have one? You could get that determination for yourself (or your kid) at the time of the diagnosis. This is really, really great news.
Let's see, what else? This news has been pretty widespread, but I think it's important to share again. A study was done in the UK that demonstrated that kids with a food allergy (egg or peanut, in this case) who were exposed to peanuts in their environment at home were more likely to develop peanut allergy than kids with a peanut-free home.
Interestingly, the link applied not to nuts eaten by children themselves, but to those eaten by family members. It is thought that oil and dust from nuts eaten by relatives enters a child's body through the skin or nose, disrupting its immune system and leading to an allergic reaction the first time the youngster eats peanuts itself. (emphasis added)
Obviously, more research needs to be (and probably is being) done, since the results appear to contradict some evidence that early exposure to peanuts prevents peanut allergy. The results of this study (about which I have no other information as to sampling, sample size, etc. so take with a grain of salt, please) do point to the importance of keeping the food-allergic person's environment as free of the allergen--and potentially other allergens--as possible.
Finally, more evidence that breast milk is best.
Breast-feeding helps prevent babies' allergies, but there's no good evidence for avoiding certain foods during pregnancy, using soy formula or delaying introduction of solid foods beyond six months.
That's interesting--that mom doesn't necessarily need to avoid allergens during pregnancy. This is probably another area where more research will be helpful. The very first thing I read about after Ryan's Big Peanut Kaboom was that it was all probably my fault because I didn't avoid peanuts during pregnancy and while he was nursing. Oh that was so hard to read, I can't explain. But don't let guilt plague you (I haven't for a long time):
"They say, 'I shouldn't have had milk in my coffee,"' said Dr. Scott Sicherer of the Mount Sinai School of Medicine's Jaffe Food Allergy Institute in New York. "I've been saying, 'We don't really have evidence that it causes a problem. Don't be on a guilt trip about it."' (emphasis added)
Now that I'm pregnant again, I still avoid peanuts, but mostly due to the known danger to my son. We just don't even have them in the house (and good thing, too, according to the research above!). I knowingly eat tree nuts only very occasionally (partly due to the risk to Ryan and Morgan), and fish and shellfish, too.
It's so difficult to know what the right thing to do is. I remember having multiple conversations with an acquaintance who was pregnant with her first child, about whether she should eat peanut products or not. My advice to her--as a food allergy mom, allergy sufferer, and incessant researcher, NOT as a doctor--was that if there weren't any allergies in her family, then to not worry about it.
I'd be interested in hearing from some of you food allergy moms out there--did you eat the allergens during pregnancy? Did you breastfeed? How did you handle subsequent pregnancies?
Oh! And finally, finally! If you are in the Atlanta area, please consider joining a new online support group called Support for Atlanta Families with Food Allergies. Lots of nice, friendly people, and good advice, too. I hope to attend the next Mom's Night Out.
Whew! That's it! Now that I've got all that out of my system, I can get on with other important things, such as abusing the Census Bureau and reading my Triple 8 book list and finding a new property manager for the cabin. I haven't mentioned that--I found out yesterday that our property management company is dropping us because our cabin is in a different county, the next one over! Sigh. Oh well, I was in Evaluation mode with them anyway.
And with that, I bid you, buh-bye! (For now.)