EF writes: My two-year old son was just diagnosed with peanut and tree nut allergies. Since I am new to this, I have several questions.
1. Is there a different trigger level for the allergy flare up in each individual? Can or will new blood tests show this level?
First of all, good luck. We and our colleagues in the specialty of Allergy and Immunology will do our best for you and your child.
30% of the standard blood tests which are reported as positive are really falsely positive, and, therefore, the true gold standard for testing in allergy becomes the double-blind placebo controlled food challenge, known as DBPCFC for short, although the abbreviation is hard to memorize. What you really want to know is whether we can do a test which will tell us whether we can accurately predict the severity of food allergy, and the answer is “they are working on it”, but as of yet “no.”
2. What is the best way to talk to my child about this allergy, what is the best age to start educating him, and what advice do you have for talking to others about it?
Most parents find that by three years of age the children understand that certain foods are not good for them, and they can learn quite early to ask anyone who offers them food of any sort, “Does it have, (food type) in it?” The broader answer to the question, explain to each child and anyone who cares for her/him the consequences of eating a food to which they are allergic. And don’t sugar coat it. By now, most pre-schools are conditioned to be sensitive to the needs of food allergic children. Closer to home, babysitters and grandparents require special attention in this regard.
For a very sympathetic discussion of these issues, see “Guide to the Worry Years” and the rest of “Food, Glorious Food?” Chapter 5 of Asthma Allergies Children: A Parent’s Guide, and Chapter 14, “Mom and the Rest of the Family.”
3. Show me a detailed/comprehensive list of OK FOODS to eat.
No can do. It all depends on the history and the tests. There may even be a tree nut or two that this child can eat.
4. What research is being done to get closer to a cure?
There’s too much to describe here, but Food Allergy Initiative and Food Allergy and Anaphylaxis Network (FAAN) will keep you up to date. Research on one drug that was considered promising for peanut allergy has been discontinued for economic reasons. In the meantime, teach your son, his caregivers, and your family well.
(Note: These questions were answered by Dr. Larry Chiaramonte)