| 25 Mar, 2007 |
Kids and allergies: When PB&J turns dangerous
At a routine breakfast nearly eight years ago, Maureen Yandrisevits spread peanut butter and jelly on her bagel, wiped off the knife and then spread jelly on her 11-month-old son's bagel.
Seconds after Frankie bit into his bagel, he began projectile vomiting and breaking out in hives.
"The scary part was the breathing ... and he was getting lethargic and mushy, he was barely moving around in my arms," Yandrisevits recalled during a phone interview from her rinceton, New Jersey, home.
She immediately suspected a dangerous allergic reaction, an instinct perhaps guided by her 29-year-old sister-in-law's death from a bee sting.
The family pediatrician confirmed the baby's reaction was caused by a trace amount of peanut butter on the knife. Frankie was diagnosed with allergies to peanuts and tree nuts, uch as almonds, walnuts, cashews, pecans and pistachios. Frankie, who is now 9 years old, is also allergic to milk, tree pollen and ragweed and suffers from asthma.
The Yandrisevits' story is becoming a familiar one to scores of parents across the United States, statistics show.
The number of young children with peanut allergies doubled between 1997 and 2002, according to a national telephone survey conducted by the Department of Pediatrics at the Mount Sinai School of Medicine in 2003.
About 2.2 million U.S. school-age children have food allergies and 1 out of 17 children under the age of 3 has a food allergy, according to the advocacy group Food Allergy and Anaphylaxis Network (FAAN). (Hidden sources of food allergens)
Meanwhile, children's allergies across the board -- from asthma and allergic skin diseases to hay fever and allergies to eggs, wheat and dairy products -- have increased worldwide, according to a survey released in August 2006 by the International Study of Asthma and Allergies in Childhood that looked at more than 700,000 children in 56 countries since 1991. (Chart: Allergies vs. colds)
The reasons behind the rise are unclear.
The "hygiene hypothesis" holds that life in the Western world has become so clean and antiseptic that the immune systems of its children are not being challenged sufficiently and have become less resistant.
"The big joke for me is always that he'd be better off in a Third World country in Africa battling malaria," Yandrisevits said with a laugh. "He might be dead from that, but he wouldn't have any food allergies."
Another theory holds that antibiotics frequently used to combat childhood infections could be the culprit, according to Dr. Paul Williams of the Northwest Asthma and Allergy Center. The antibiotics might hinder the development of friendly bacteria typically found in the intestinal tract, which aid the immune system in warding off allergens.
An increase in environmental pollutants, diet changes and food-processing procedures could also play a role.
Another reason could be simply that doctors are diagnosing more allergies now than in previous generations.
There is going to be peanut butter in the world
In addition to enduring rashes, sneezing, coughing, itching and difficulty breathing, allergy sufferers also live under the threat of going into anaphylactic shock -- which can be fatal.
Peanut allergies are causing most of these deadly reactions, FAAN's Anne Munoz-Furlong said.
The threat of a child dying from an allergic reaction can be terribly frightening to parents. Triggers can be found everywhere: a birthday party, a school lunch, an outing at a restaurant or a trip to a grocery store.
"I was paranoid beyond my wildest dreams," Yandrisevits said. "I wouldn't let people touch him. I wouldn't go to parties. I wouldn't go on play dates.
"But that's not the real world," she added.
She is teaching her son to adapt, especially now that he is a third-grader at a public school.
The family has developed emergency plans with Frankie's school and the faculty has been taught how to monitor symptoms and administer potentially life-saving epinephrine shots. Frankie is shielded from other kids during lunch and shares a table with a classmate who is allergic to fish.
Some American schools have banned peanuts and related substances, but that has led to criticism that kids' rights are being infringed.
Yandrisevits said she is against such bans.
"I'm trying to make him understand that there is going to be peanut butter in the world and there are going to be nuts, and you are going to have to be able to deal with that," she said.
Treating kids
Researchers are looking at ways to either prevent allergies or, at least, lessen their severity.
Dr. Wesley Burks of Duke University is exploring the possibility of desensitizing kids to food allergies by administering a small dose of the allergen over a long period of time.
This is similar to the way allergy shots work, but they are usually effective only for inhaled allergens, such as pollen.
In Burks' initial research, children with peanut allergies became less sensitive, he said. However, he cautioned, "It's not something people would want to do at home yet."
A study at Mount Sinai School of Medicine is hoping to develop a vaccine that isolates the offending peanut protein and re-engineers it. The engineered protein would then act as a vaccine that elicits a protective immune response.
Doctors said other hopes include interrupting the common escalation from eczema to hay fever to asthma -- called the atopic march.
For now, the best treatments are still avoiding allergens, getting allergy shots and using steroids and treatments like epinephrine.
If there is a cure out there, however, it cannot come fast enough for Yandrisevits' son.
"He doesn't want to be known as the food allergy kid," she said. "He just wants to be known as Frankie."
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