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Give babies peanut butter to cut peanut allergies, study says

bbc.com

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Re: Give babies peanut butter to cut peanut allergies, study says

#251

Earlier quoted context omitted.

however, there are other factors to keep in mind. you mention giving your chewed up food: I read a few years ago that babies who sleep in the same bed as the parents have a much higher mortality rate; assuming it's true, I guess that with mouth to mouth germ exchange it would be even worse. Also, a lot of food today is full of chemical residues etc that are tolerated by adults, not quite so by babies.

SIDS is very poorly understood, but highest probability seems to be that it’s not germ related but related to breathing (more like complex sleep apnea for infants, where sometimes a baby has a messed up breath response. This tracks with SIDS seeming to have a strong genetic component). For what studies we do have, yes sleeping with the parent seems to have a marginal increase in SIDS, although less of one than things…

Afaik, babies have weak neck muscles and can't lift their heads. I remember also reading that really small babies can't breathe through their mouth. So it seems easy to imagine a situation where the babies airway is blocked and it can't help itself.

Re: Give babies peanut butter to cut peanut allergies, study says

#252
post #42
post #16

This is not new news, but nonetheless important to replicate and keep studying. I think the first often-cited study about this was in 2008 [1]. There are several more, including one in the New England Journal of Medicine in 2015 [2]. Basically, the original study looked at Jewish kids in Israel versus the UK and saw that peanut allergies were about 10x lower in Israel, even though Jews of European background (Ashkena…

For anyone wondering, Trader Joe's sells these in the US! They're great, and they're "real" Bamba and not a TJ's replica.

I love those things! I usually end up always grabbing a bag when I go shopping there.

Re: Give babies peanut butter to cut peanut allergies, study says

#253
post #233

Earlier quoted context omitted.

It's absolutely not backwards. More children developed allergies (almost definitely because of the lack of exposure), but it wasn't known that would happen. What we did know is not exposing children to a trigger of anaphylaxis would prevent them from dying from anaphylaxis, so, similar to many dangers, the most logical course of action is to remove the risk altogether. Yes, it's well known doing that with anything ca…

> It's absolutely not backwards. But it is. The best population-level guidance (now) is early exposure. We told people to do the opposite. The result was a lot more kids with anaphylaxis-level allergy. (I don't know if this increased the total number of people who died. That'd be an interesting question, but given that we reversed the guidance, I assume from a public health perspective people now believe the original…

> I think you mean that it's intuitive, but I don't think it's logical, for exactly the reason that it turns out not to be a good idea.

If operating with the best model you have is intuitive and not logical, then everything in science it intuitive and not logical, so we might have to redefine your use of "logical" to be more useful.

Peanut exposure caused anaphylaxis in some kids. Many kids in the world are never exposed to peanuts with no ill effects (in fact, a large portion of the globe went all of recorded history up until the Columbian exchange without exposure to peanuts). If we still want peanuts in anyone's diets, waiting until the child is older for controlled exposure is a logical response. Yes we didn't know how that would affect developing allergies, but as I mentioned in my comment, we still don't understand how allergies develop, so the only difference is we conducted a massive peanut exposure experiment with other countries operating as incidental controls.

> I don't know if this increased the total number of people who died. That'd be an interesting question

In fact, this (plus quality of life + cost of prevention/treatment) is the only measure on which the old guidance could be "exactly wrong", which hopefully gives some insight on why talking about it being "backwards" is itself wrong. It's not Thalidomide. Exposure at 6 months isn't the opposite of exposure at age 3. And whatever harm metric you can define is going to be a result of a mixture of effects, including allergic kids that weren't exposed and kids that (probably) developed an allergy because of the lack of exposure. It's almost certainly on the cost side that it's come out negative, because treatment has improved and exposure prevention has become so widespread.

> It's based on a wrong model of how the world works. Yes, that wasn't known. But I feel like we have to account for the fact that we might not know everything. (Admittedly, this drives me particularly nuts because I think this fallacy pervades so much public health advice, especially for kids.)

I mean, all models are wrong, some are useful. We'll never know everything and you have to work with the evidence you have. Delaying exposure to something that could kill 1% of kids is categorically different than some new study saying "we detected a small magnitude but statistically significant result on speech acquisition due to magnesium supplementation".

If you instead mean we need to better communicate uncertainty in developmental and health recommendations, I completely agree. You can see it in this thread, for instance, assuming that early exposure prevents all peanut allergies. Even if you assume exposure is the only causal variable here (almost certainly wrong), we can observe a baseline level of peanut allergy incidence, so, no, early exposure is not a panacea, but that doesn't seem to have been communicated well.

Re: Give babies peanut butter to cut peanut allergies, study says

#255
how anout we instead pull literally all stops and figure out why so many people are developing a condition when their own inmune system tries to kill them when food enters their mouth??? The incidence is increasing dramatically. That’s a far bigger problem.

Re: Give babies peanut butter to cut peanut allergies, study says

#256
post #125

I have a two year old with a moderate peanut allergy. I'm convinced that early introduction at 6 months and oral immunotherapy have saved him from a more severe allergy. Interestingly, multiple allergists we've spoken to have alluded to a recent theory (not sure if supported by the literature) that a child is more likely to develop an allergy if the allergen is first introduced through the skin than through the gut,…

How and why would peanuts get all over the skin? Are there peanut-based creams or something?

Re: Give babies peanut butter to cut peanut allergies, study says

#257
post #256
post #125

I have a two year old with a moderate peanut allergy. I'm convinced that early introduction at 6 months and oral immunotherapy have saved him from a more severe allergy. Interestingly, multiple allergists we've spoken to have alluded to a recent theory (not sure if supported by the literature) that a child is more likely to develop an allergy if the allergen is first introduced through the skin than through the gut,…

How and why would peanuts get all over the skin? Are there peanut-based creams or something?

Oh man! Let me tell you something…I have 3 kids 3 and under and spaghetti nights are crazy. My 3 year old is better but my 1.5 year old is a hot mess. He has to be shitless during most meals or else the shirt isn’t going to last. Everything is smeared on his face and arms when he eats, even with a watchful parent it only takes half a second.

We’ve noticed spaghetti sauce will start to give him a rash on his belly only.

My 5 month old had beets last night for the first time and a full bath was not optional.

Re: Give babies peanut butter to cut peanut allergies, study says

#258
post #256
post #125

I have a two year old with a moderate peanut allergy. I'm convinced that early introduction at 6 months and oral immunotherapy have saved him from a more severe allergy. Interestingly, multiple allergists we've spoken to have alluded to a recent theory (not sure if supported by the literature) that a child is more likely to develop an allergy if the allergen is first introduced through the skin than through the gut,…

How and why would peanuts get all over the skin? Are there peanut-based creams or something?

Because peanuts are oily as all get out and every young kid that eats peanut butter is literally covered in it and will rub it on everything they touch, including kids that don't eat peanuts yet.

Re: Give babies peanut butter to cut peanut allergies, study says

#259
post #16

This is not new news, but nonetheless important to replicate and keep studying. I think the first often-cited study about this was in 2008 [1]. There are several more, including one in the New England Journal of Medicine in 2015 [2]. Basically, the original study looked at Jewish kids in Israel versus the UK and saw that peanut allergies were about 10x lower in Israel, even though Jews of European background (Ashkena…

I always joke to new parents that they should adopt this strategy. Glad to see I was right!
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