allergies | Unmotherly Insights

STOP BLAMING THE DAMN PEANUT!

Poor parents. We’re so misunderstood. We’re just trying to do the right thing and protect our kids from a devastating legume and then someone, well, a lot of someones actually, comes out and throws a bunch of annoying facts around and we have to face the truth. We are responsible for the plethora of peanut anaphylaxis plaguing our offspring.

I know, it’s like so hard to swallow (tee hee). Here we are delaying introduction of the dreaded edible in order to protect our youngsters, when incontrovertible research now shows that it is in fact this late introduction that causes the dangerous allergic reactions we are trying so hard to avoid. What was that? It’s true. The research shows that it is precisely our delaying the introduction of peanuts into our kid’s diets that’s responsible for the unprecedented surge in peanut allergies.

You see, there is a window theory that has dominated our nation’s feeding philosophies for years. It says that if you introduce foods too early, or too late, you will increase allergic diseases later in life. These allergic diseases include: Food allergies, Eczema (Atopic Dermatitis), Hay Fever (Allergic Rhinitis), wheezing, and Asthma. Many of us remember the dire warnings to avoid eating peanuts during pregnancy and to never feed a baby anything peanut tinged until at least 3 years of age.
In December 2008 the AAP released a policy statement saying that although solids should not be introduced before 4-6 months of age, there is no current convincing evidence that delaying their introduction has a significantly protective effect. This includes foods considered to be highly allergic, such as fish, eggs, and foods containing peanut protein.
Many studies now confirm this finding. One of the more comprehensive 5 year studies showed that delaying introduction of peanut protein to 2 or 3 years of age did not decrease the rate of allergies at all. In fact, there are convincing studies that show that earlier introduction of these foods actually decreases allergies. The best study that demonstrate why feeding early makes sense is a study done by Du Toit, et al in the Journal of clinical immunology, nov 2008. This study followed 5615 kids in Israel and 5171 kids in the United Kingdom, all of Jewish descent to assure a similar genetic makeup. The Israeli kids ate peanuts earlier and in larger quantities than the English children and had a 10 fold lower rate of peanut allergies than the UK kids.
Another paper, recently published in the January 2010 issue of Pediatrics by Bright, Et al., was a Finnish prospective cohort study. It concluded that late introduction of solid foods was associated with increased risk of allergic sensitization to food and inhalant allergens. Specifically, the study showed a significant increased allergic risk by delaying fish past 8.2 month and eggs past 10.5.
Here are a few convincing tidbits of information from various studies:
– Pediatrics July 2008; Snijders, et al: Delayed introduction of cow’s milk and other foods was associated with a higher risk of eczema (a type of skin allergy)
– Pediatric allergy Immunology, Feb. 2008; Prescott, et al: Tolerance to food allergies appears to be driven by regular, early exposure to these proteins during a critical early “window” of development.
– Acta pediar. May 2009; Wennergrad: Elimination of food allergens during pregnancy and infancy failed to prevent food allergy. Instead several studies indicate early introduction of foods like fish and peanuts may be beneficial. Conclusions: early introduction rather than avoidance may be a better strategy for the prevention of food allergy. (This was a meta analysis)
– Pediatrics Feb. 2006; Zutavern : Cohort study- no evidence to support delayed introduction of solids beyond 6 months of age to prevent Atopic disease.
Archive of Childhood Diseases 2004; Zutavern: late egg introduction increased eczema and wheezing.

The fact remains that food allergies are increasing at an alarming rate. (20 years ago we had never heard of “peanut free zones”). According to the Center for Disease Control (CDC), in 2007, approximately 3 million children under age 18 (that’s almost 4 out of every 100) were reported to have a food allergy. The prevalence of peanut allergies has doubled in the 5 years from 1997 to 2002 (Journal of Allergy & Clinical Immunology Dec. 2003.)

Maybe it’s time to reexamine our feeding philosophies. The facts are clear. Early introduction of high risk foods is the best way to avoid allergies later in life. But we’re all so darn afraid of making a mistake that we overcompensate and choose to delay, or even decline, the introduction of certain foods, like peanuts, and we miss the critical window of opportunity for safe introduction. Our fears are actually causing more harm than good.

And because this is such a hotly debated issue in our culture, the media has shied away from reporting these findings.
Maybe it’s time to tell the truth about peanuts and offer an alternative view of the beleaguered legume. Especially when that view is based on solid research, clear clinical data, and scientifically sound evidence.
So dare to stand up for the unfavorable protein! Go on, I say, break out the pb and j for junior; and the sooner the better.

In April’s edition of “The Atlantic Monthly,” Hanna Rosin raises the question of whether breastfeeding is really the elixir it’s been made out to be, or merely an instrument of torture to suppress women and start them down the road to domestic inequity.

Breastfeeding, she argues, sets up an unequal dynamic in a marriage. And while I realize that this is an unpopular belief, I tend to agree with her. Rosin explains throughout the piece that most of us grew up with the idea of co-parenting being a reasonable, attainable goal. However, the domestic responsibilities, she suggests, begin to shift (incrementally and unconsciously) with the introduction of breastfeeding. According to Rosin’s hypothesis, once a woman becomes the sole parent responsible for her baby’s sustenance, a host of other domestic duties shift onto her side of the ledger. “She alone fed the child,” Rosin’s argument goes, “So she naturally knows better how to comfort the child, so she is the better judge to pick a school for the child and the better nurse when the child is sick, and so on.”

In addition to the disparity in domestic responsibilities, Rosin offers incontrovertible evidence to contradict the commonly held belief that breastfeeding is better than bottle feeding for the health and well-being of the baby. The truth, she concludes, after reviewing hundreds of studies and meta-analysis (reviews of existing studies), is that there is no conclusive benefit to breastfeeding. She sites numerous studies, including a well known 2005 paper in which statisticians compared data on 523 sibling pairs who were fed differently. The results looked at diabetes, asthma, allergies, childhood obesity, mother-child bonding and IQ and found no statistically significant differences. The researchers, (who in my opinion were afraid to face the wrath of breastfeeding advocates), gently concluded, “The long-term effects of breastfeeding have been overstated.”

The other issue into which Rosin insightfully delves, is the premise that breastfeeding passes necessary disease-fighting antibodies from mother to baby. “Even many doctors,” she affirms, “believe that breast milk is full of maternal antibodies that get absorbed into the baby’s bloodstream.” While this is true for most mammals, Rosen asserts that human babies are born with antibodies already in place from the placenta. Breast milk antibodies are not transferred into the baby’s bloodstream at all, but rather pass through to the gastrointestinal tract. The overall benefit, she claims, amounts to one less episode of diarrhea for breastfed babies.

Rosen elucidates that the flaws of most breastfeeding studies is that they fail to account for the multitude of socioeconomic, cultural, and intellectual variables that go along with a woman’s decision to breastfeed. “It is impossible,” writes Rosin, “to separate a mother’s decision to breastfeed – and everything that goes along with it – from the breastfeeding itself.”

Overall, Rosin, who continues to part-time breastfeed her third child, insists that the cultural bias towards breastfeeding that paints the practice as some kind of magic vaccine, is not only misleading, but also serves to entrap women and psychologically damage them by making them feel guilty, anxious and selfish if they can’t, or simply don’t want to, breastfeed.

As a loving mother who was unable to breastfeed her first child, and chose not to even try for her second, I think Rosin’s arguments are astute, thoughtful and right on. I’m not suggesting that it’s wrong to breastfeed or that it isn’t the right choice for many people. But I agree with Rosin that it’s not a choice without costs. “It is a serious time commitment that pretty much guarantees that you will not work in any meaningful way,” concludes Rosin. “When people say that breastfeeding is ‘free,’ I want to hit them with a two-by-four. It’s only free if a woman’s time is worth nothing.”