Eating Peanuts While Pregnant = Peanut Allergy?

I hesitated in posting this, but it's a study by a reputable researcher.

Peanuts During Pregnancy May Lead to Later Allergy

Heavy emphasis on the MAY.

I know folks who avoided completely with their second pregnancies and still had a PA child. 

The research goes back and forth and frankly I'm not sure what to believe.  All I know is that I can't beat myself up over something I may or may not have done 'right' during my pregnancy.

And you shouldn't either.

Is Birth Month Associated with Higher Allergy Risk?

Interesting article on BBC News: Winter Babies Are More Prone to Food Allergies. The gist of it:

Babies born in autumn or winter are more likely to develop a food allergy than those born in spring or summer, US researchers have found.

When was the mighty B born, you ask?

October (of course!). Blergh. But we live in California - and the October she was born was sunny and warm and gorgeous.

I never know what to make of these studies - and I always take them with a grain of salt. Or in the case, Vitamin D.

What month was your allergic child born?

ClinicalTrials.Gov

When B was first diagnosed it coincided with a piece on Good Morning America about Wesley Burks at Duke and his research involving oral desensitization for peanuts (and eggs).

I was a new PA (peanut allergy) mom and I wanted to know how I could get my daughter into a trial!

And that's how I found this site. What is it?

ClinicalTrials.gov is a registry of federally and privately supported clinical trials conducted in the United States and around the world. ClinicalTrials.gov gives you information about a trial's purpose, who may participate, locations, and phone numbers for more details.

We're about 3,000 miles away from Duke, so no luck for us. Maybe you'll be lucky enough to be close to (and eligible) for one of these? Some of you out there will make it possible for widespread treatment to become a reality.

Us, we're not so lucky.

Because Moms of Allergic Kids Need MORE Guilt

I'm not the first allergy blogger to link to this, but just in case you missed it, the Journal of Allergy and Clinical Immunology just released an article that finds that delaying feeding your child peanut products might now increase the likelihood of a peanut allergy. What the...?

Look, I work in scientific publishing so I am definitely a fan of primary research literature. And to be honest, I've only skimmed this article, but the last paragraph caught my attention:

"Randomized controlled interventional studies,
such as the Immune Tolerance Network/National Institutes of
Health–funded Learning Early about Peanut Allergy Study
(further information is available at www.leapstudy.co.uk/ and
http://clinicaltrials.gov/ct2/show/record/NCT00329784), are
therefore required to determine whether peanut avoidance or
the early dietary introduction of peanut will prevent PA. Until
such evidence is obtained, current recommendations should
remain unchanged. "

So even though they have strong evidence to support this theory, it's still just a theory and their recommendation for the introduction of peanut products remains unchanged. But from the media reports, you'd think just the opposite.

Us moms can never win, and hearing these reports makes me frustrated, because news outlets forget to mention the last part. First it was if you didn't breastfeed then your child would get an allergy, then it was if you DID breastfeed your child would get an allergy via your diet. My pediatrician was adamant that I not introduce peanuts until Bella was 3 (!). And now I should have been feeding them to her along with her first bite of sweet potato puree at 5 months?

If you care to read the article, you can visit the site here. It's a free download this week (not sure if it will always be free, so download it now if you're interested)!

And if you're the parent of a newly diagnosed child (or heck a long time ago diagnosed child), don't beat yourself up when you hear these reports. You can't turn back time, so don't dwell on it. And the kicker is that this article just offers a hypothesis - even they say it is a possibility, that it might be the case. I lost countless hours of my life wondering what I did wrong and I still lose hours thinking of worst case scenarios when B is a teenager. Aye carumba!

I look forward to hearing more reports from researchers who are helping us manage the allergy and hopefully make it go away than I am from folks telling me what I should have been doing.

Finally, A Treatment for Peanut Allergy?

Well, yes and no.

A cure that eliminates Peanut Allergy? No.

A treatment that had been shown to work but was suppressed due to corporate greed and bickering? Well, then, YES.

I've noticed some of the newer allergy bloggers getting really excited about new research in Peanut Allergy - that a cure is right on the horizon - it is so close! And I am right next to them cheering on the folks in New York and North Carolina that are pushing to the forefront of oral desensitization.

But did you know, that just a few years ago, there was a drug in clinical trials that was proven effective at reducing accidental exposure risk? That it was a drug you could give your child to guard them in the case of accidental exposure? It's called TNX-901. But don't try to get it for your child because you can't.

Yup. It's true.

Here's what I have gathered from my own (frustrating) research. It is probably full of some holes, but I'll try and keep it short and sweet.

Basically a company called Tanox developed a drug called TNX-901 that was an anti IgE antibody. It bound to IgE antibodies in the blood and prevented allergic reactions to peanuts. The FDA even fast tracked it in an effort to bring it to market faster. The clinical trials went really well (if you don't believe me, check out the abstract at the New England Journal of Medicine site and make sure you are sitting down when you read the Conclusions portion of the abstract). Going from sensitivity at ingesting half a peanut to sensitivity after NINE?!? That, my friend, is progress.

But two drug companies, Genentech and Novartis, claimed that the drug was too similar to their drug Xolair (you've heard of that, right?) and tied up TNX-901's progress in legal battles. Eventually, Tanox gave up and were paid to stop researching it. I guess Tanox couldn't afford the fight.

Here's a link to the copy of a Wall Street Journal article that goes into greater detail on the fight and ultimately how financial power was the ultimate decider of this promising drug's fate. (I couldn't link to the original WSJ article - sorry).

So what does that say for Xolair and it's use as a preventative measure for accidental exposure to peanuts? That remains to be seen. Xolair clinical trials were halted in 2006 after two children suffered severe reactions before actual testing of the drug even began.

So why don't Genentech and Novartis get to work on TNX-901 (or a variant of it)? I mean, they own it, now, right? Is it a blow to their pride that a little company got somewhere they couldn't? Your guess is as good as mine.

Something to think about. I'm not trying to be Erin Brokovich here, but how frustrating is this?!?

If you know anything about this drug (or would like to correct anything I've written here) please leave a comment.

FAAN Walk - San Francisco, CA

My allergy support group has started a team to walk in the Food Allergy & Anaphylaxis Network (FAAN) Walk for Food Allergy this September in San Francisco.

What's the Food Allergy Walk? Here's a great description from their site:

The Food Allergy & Anaphylaxis Network (FAAN) is the world’s leading nonprofit organization in the fight for food allergy awareness, education, and research. Over the past four years, thousands of walkers and volunteers have gathered in communities around the country to build awareness of food allergies and to raise funds to support research and education programs. The FAAN Walk for Food Allergy events have raised $4 million, with an additional $2.5 million forecasted for the 2008 season.

We walk to find a cure for food allergies for your family member, friend, student, or colleague! We walk to increase awareness of food allergy and the effect it has on a community. We walk to provide understanding, hope, and an opportunity for a child with food allergy to simply be a child. We walk to save a child’s life!

To learn more about our team (or to join us!), visit our page on the Food Allergy Walk site.

Can't walk with us? How about making a donation to help us meet our goals? You can donate via my personal page and all donations will count towards the team's goal of $2500.

Want to find a walk in your city? Visit the FAAN site for a list of locations.

Any type of support is appreciated no matter how big - even a shout out on your blog or website (regardless of what your site is about)! Thanks in advance for your support!

Oh Yeah, and about those RAST results....

Some of you might remember a little post I wrote about a month ago, detailing Bella's RAST test. And I never actually got back to you all on the results?

You KNEW there had to be a reason behind that, right?

Well, there was. We got her results. Oh boy, did we get them. Got a minute?

My sweet, sweet allergist phoned me with the news a month of Fridays ago, taking up two messages on my machine! I had come home from my parents' place that night, Bella asleep in my arms. I put her to bed, exhausted myself, anxious because it had been over a week since her blood draw with no word and a couple of messages in to their offices.

With Bella settled, I walked into our dining room and there was Mark with his excellent poker face. "Dr. B-- called", he said, "with Bella's results."

At this point, I was terrified. "And??" I stammered.

With his best 'serious' face, he said, "All negative. To all nuts. Bella's RAST results for her peanut allergy (all and other nuts for that matter) were NEGATIVE. And he wants to know if we want to do a food challenge."

At this point I burst into tears and fell into his arms. Uncontrollable sobs. I could NOT believe it. I was expecting a low level at best. But negative? Unbelievable.

I called my folks (my mom is anaph. to shellfish so she REALLY 'gets it'), while my wonderful husband opened a bottle of wine to celebrate, and we sobbed together. It really was like seeing the light at the end of the tunnel (without a train at the end - ha ha - love that expression). The feeling of relief that I had was incredible.

But I knew this wasn't the end of this.

The next Monday I made an appointment for Bella's food challenge. Yesterday was the big day. I actually bought peanut butter this week (it was terrifying!). We got a big bag of supplies ready for the 3+ hour appointment that awaited us. We were filled with hope and excitement.

Fast forward to this morning.

I was hoping that this post would be my goodbye to you all, my fond farewell, my 'see you later', 'adios', and 'adieu'. But I hate to break it to you all.

You're stuck with me for the time being.

Bella reacted to her skin test. Aw nuts!

Were we upset? Of course! Not crying upset, mind you. Just bummed out for Bella.

Was Bella? Not so much. She didn't seem to care at all that she wasn't trying out peanut butter that day (although she did ask last night "now when can I have a peanut butter and jelly sandwich?"), but was pretty psyched at the three (yes three!) lollipops the nurse gave her at the appointment.

But there is good news here. Really, I swear there is.

Bella has a NEGATIVE RAST result. And even though she reacted, her wheal size was smaller than last year's (which was also smaller than the previous year's). Her allergist is confident that she will outgrow this fairly soon (and he's an allergist that ALWAYS stays on the cautionary side of things - he is not a risk taker or nonchalant about allergies, suffering from them himself - so I was shocked by his comment). So we left the appointment feeling good, even though we didn't come out with the exact result we wanted.

I can't say I was totally shocked that she reacted though. I've read enough of the scientific literature to know that it was a possibility. I just hope, hope, hope that we make it through to the other side of this. A beginning, middle, and happy ending to our peanut allergy adventure would be awesome.

So are we changing anything? No. We're still being just as cautious as we always have. And in the new year we'll schedule another challenge. I hope she passes.

But even when she passes, you'll still be stuck with me. So many of you have proven to me that you are true friends - I wouldn't give you up that easily. I feel like I know so many of your kids already through your posts, emails, and IM's that I'll still be advocating for this, even if (and long after) Bella's peanut allergy resolves.

Have any of you gotten to the same point as us? I'd love to hear from you either in the comments or via direct email.

Parents: June 2008

When Bella was born I somehow started receiving free subscriptions to both Parents and Parenting magazines. I usually toss (err, recycle) them when I get them, but a cover article in the June issue caught my eye:

Oh Nuts!
Food Allergy News You Need
Forbidden Foods, by Jan Sheehan
p. 146

So I took a look, expecting a dumb article about peanut butter alternatives (like almond butter - d'oh!). But you now what? It's actually really good and gives a good overview of food allergies, research, etc.

Unfortunately the folks at Parents Magazine haven't linked to the article online, but I encourage you to pick up a copy (or read through YOUR recycled one) and take a look.

I'll try to scan the pages today and/or find a link to the article (somehow).

News from the AAAAI Annual Meeting

AAAAI: Gradual Exposure Reduces Kids' Peanut Allergy

PHILADELPHIA, March 17 -- Children with clinical peanut allergies became at least modestly tolerant after a program of oral immunotherapy, a researcher said here.

Of 20 children, 18 were eventually able to eat the equivalent of 13 peanuts with few or no allergy symptoms, reported Scott Nash, M.D., of Duke University, at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

Read More

----------------------------

This is so encouraging! I wish so badly that there were clinical trials going on in California (or even the West Coast). I would enroll Bella in a second.

What about you guys?

Interested in Following Primary Research Regarding Food Allergies?

If you'd like to be notified when new primary research literature (research papers) surfaces regarding food allergies (or any other medical condition for that matter), you can set up a notification from PubMed.

What's PubMed?
PubMed is a free search engine for accessing the MEDLINE database of citations and abstracts of biomedical research articles.

By entering a search term and creating an update, you'll be notified when new articles are published that include your search term(s).

It's easy to do.

Visit the PubMed site and follow the instructions on the screen. Note: Registration is required.

Article of Interest

A tad dated, but the information is interesting and includes footnotes to support the facts.

The Nuts and Bolts of Peanut Allergy
The principles for successful management of peanut allergy include patient education, treatment of the acute reaction, and appropriate follow-up care.

Alex T. Vu, MD; Minh-Tri Duong, PharmD

Peanut and Tree Nut Survey

Just came across this on the PeanutAllergy.com site and wanted to highlight it here:

Peanut and Tree Nut Allergy Surveys

FAAN and researchers from the University of Michigan Food Allergy Center are conducting three surveys regarding allergic reactions to peanut and/or tree nuts.

We are seeking individuals with allergies to peanuts and/or tree nuts, or parents or guardians of children who are allergic to peanuts and/or tree nuts, to provide information about past reactions. Of primary interest are reactions that have occurred on commercial aircraft, in a school or childcare facility, or as a result of food provided by a restaurant or other food establishment. Those individuals who have had reactions occurring in more than one of these settings are eligible to participate in as many of the surveys as are applicable.

Luckily, we haven't had a reaction in any of these situations (actually at all) since Bella's diagnosis, so I don't have anything to add to the surveys. But if you or your child have, take a minute and help these researchers out.

Every little bit of data helps!

How we got here...

My husband and I have a little girl named Bella (Isabella). She'll be 3 in October. We found out she was allergic to peanuts the hard way when she was 18 months old - a reaction from eating. I suppose we were lucky in that she didn't go into anaphylaxis. She had a tiny bit of toast with peanut butter on it. Within minutes her eyes were swollen and her face covered in hives, nose running. We called the doctor immediately who told us to give her Benadryl and get her in to the office right away. Luckily it did the trick and it didn't go beyond that - her hives subsided and we made our way into the office. In hindsight, I was pretty blase about it. I mean, I even took the time to shower and put makeup on before I left for the doctor's office. I can't believe I didn't rush right in! What an idiot I was!

Anyhoo, to make a long story short, a few weeks later we had a skin prick test that showed positive for peanuts (the biggest welt), along with almonds, walnuts, and cashews. Fast forward to May 2007 for our second skin test. She showed negative for all tree nuts (yay) along with sunflower and sesame. But we're still dealing with the peanut allergy. Is it weird that eliminating the tree nut allergy was a relief to me? I felt as if there was some hope of her body chemistry changing to accept peanuts in the future too...

Even after a year (plus), we are still educatiing our families about what they can and can't do around our sweet little girl. No, you can't eat them around her; no she can't hold them; no you can't hug or kiss her if you've eaten them within the last few hours; no really you can't; yes, i DO need to ask the restaurant about their allergy awareness - i do need to ask what's in each dish (you know, peanut butter can be in everything from spring rolls to enchiladas!).

I'm sure I am seen as overbearing at times, but when you have someone with a peanut allergy who can't discern for themselves what they can and cannot eat and I have to be their voice (along with her father), then yes, yes we are overbearing. it's a struggle, but one we live with day to day and one that we are overcoming day by day.

We try to live as 'normal' a life as possible. I don't want to be an alarmist, but I can't downplay how important this is either. This proves to be difficult when we encounter people who think we are exaggerating her allergy or think that she'll just be a 'little itchy' if she has nuts. The best is when we hear people tell us 'she'll grow out of it'. I just smile and say, "we hope so, but for now you need to know how to use an epi-pen."

I try to keep up with the latest research, and I am confident that before Bella is a teenager, there will be some sort of preventative treatment. I have to be. It's one of the only things that keeps me optimistic about seeing my daughter through high school and college.

How do you cope? I hope that other moms (and dads too) find me - I know I'll be looking for all of you.