Australia starts peanut allergy treatment for babies • Hacker News Board

Re: Australia starts peanut allergy treatment for babies

#221

Post by nostrademons » Sat, Aug 03, 2024, 3:27 PM UTC

nathancahill wrote: post #194

eskibars wrote: post #45

Earlier quoted context omitted.

With. First they did a blood test (instead of a scratch test) to identify possible allergy levels. Then the allergist had us come into the office to take e.g. a few micrograms of peanut powder and watch him for reactions. Then we maintained the dose at home every day for the next couple weeks, taking zyrtec with it to avoid hives, etc. Then we'd go back in, try doubling the dose as a challenge. If he had a bad reacti…

Our son is allergic to nearly everything (peanuts, nuts, dairy, eggs, sesame, wheat) and we haven't found an allergist willing to work with us. Do you know if there's an age factor for immunotherapy effectiveness? He's 2 1/2 yo.

2 1/2 is right in the window, with the general consensus being that the earlier you start, the better the results. Studies found the best results with 1-year-olds, then it exponentially decreases with each year, until there's little benefit with 4+ year olds.

We did it with Latitude [1], with the support of our allergist, who had sent his son through them with successful results. It's not covered by insurance, and is expensive in all of time, money, and attention. The field is very new and data is still sparse - our allergist actually was very curious to hear results because he's adapting his practice as new data comes out from actual treatment.

[1] https://latitudefoodallergycare.com/

Re: Australia starts peanut allergy treatment for babies

#222

Post by MobileVet » Sat, Aug 03, 2024, 3:39 PM UTC

compumetrika wrote: post #216

eskibars wrote: post #178

Earlier quoted context omitted.

Yeah, we hadn't heard of this when our son was born, but the allergist mentioned it. When our daughter was born, we gave her something like this at his recommendation. The ones we got were some puffs that have a whole pile of allergens in tiny doses. Causation vs correlation and all that, and a small sample size, but our daughter doesn't have any issues with any allergies.

The economist Emily Oster wrote an excellent series of books about pregnancy anf early kid years, where she dives into details about various studies, whether they are causal, etc. It's one of the best practiacl explainations of reading research I've encountered targeted at non-academics, really well done. She has a chapter on peanut exposure allergies and i think inrecall that these early-exposure results are in fact…

Emily Oster is a national treasure that is still flying under the radar for most people.

As above, she presents excellent science in an approachable manner for non-science minded folks. She also has enough of the technical details for this with the knowledge to be confident she has done a strong analysis.

If you are a parent and haven’t checked her stuff out, please do. (Zero affiliation or connection)

Re: Australia starts peanut allergy treatment for babies

#223

Post by mrmetanoia » Sat, Aug 03, 2024, 3:52 PM UTC

dminor wrote: post #132

eskibars wrote: post #9

Our son is very allergic to peanuts and less so to cashew, and sesame. We went through oral immunotherapy and it's been absolutely life changing. He used to need an epi pen in case of chance encounter, but now he eats 2 whole peanut m&ms every day to keep his dosage up. It's been difficult finding an allergist in Germany that's willing to accept this and move forward Obviously everyone's mileage will vary, but I'm ha…

I asked our allergist about oral immunotherapy for my daughter and he cited a study that found that avoidance was more effective in preventing severe reactions.

We asked about swim lessons and were told avoidance is the best way to prevent drowning.

Re: Australia starts peanut allergy treatment for babies

#224

Post by Yawrehto » Sat, Aug 03, 2024, 4:00 PM UTC

eskibars wrote: post #9

Our son is very allergic to peanuts and less so to cashew, and sesame. We went through oral immunotherapy and it's been absolutely life changing. He used to need an epi pen in case of chance encounter, but now he eats 2 whole peanut m&ms every day to keep his dosage up. It's been difficult finding an allergist in Germany that's willing to accept this and move forward Obviously everyone's mileage will vary, but I'm ha…

Me too. My younger sibling, as a child, had (and still has) allergies (at the time, peanuts, tree nuts, eggs, sesame & sunflower). About a year, maybe 2, after starting to eat small amounts, they could do sesame, stovetop (!!) eggs, and nut butter. The problems went from 'allergic reaction' to 'won't eat the eggs and nuts'. (I think at one point the solution was pancakes with nut butters and sprinkles. Kid still had a hard time eating it.)

I don't know why it's taken so long for this to gain broader acceptance.

Re: Australia starts peanut allergy treatment for babies

#225

Post by hinkley » Sat, Aug 03, 2024, 4:09 PM UTC

shmichael wrote: post #173

eskibars wrote: post #9

Our son is very allergic to peanuts and less so to cashew, and sesame. We went through oral immunotherapy and it's been absolutely life changing. He used to need an epi pen in case of chance encounter, but now he eats 2 whole peanut m&ms every day to keep his dosage up. It's been difficult finding an allergist in Germany that's willing to accept this and move forward Obviously everyone's mileage will vary, but I'm ha…

In Israel this is done naturally by feeding children Bamba, a puffed peanut snack, at a very early age. Research shows significantly decreased levels of peanut allergy. https://www.npr.org/sections/thesalt/2015/02/23/388450621/fe...

I thought there was a study that suggested the weapon of first resort should be breastfeeding mothers eating the allergen-triggering foods so the kids get exposed to them indirectly.

Makes me wonder if there is something we should be doing with baby formula.

Re: Australia starts peanut allergy treatment for babies

#226

Post by DebtDeflation » Sat, Aug 03, 2024, 4:14 PM UTC

nostrademons wrote: post #219

shmichael wrote: post #173

Earlier quoted context omitted.

In Israel this is done naturally by feeding children Bamba, a puffed peanut snack, at a very early age. Research shows significantly decreased levels of peanut allergy. https://www.npr.org/sections/thesalt/2015/02/23/388450621/fe...

Bambas are recommended in the U.S. as well, but our kid entered anaphylaxis after eating just 5 bambas his first time, at about 6 months of age. It's certainly possible to have a peanut allergy despite early exposure. Recommendation in the U.S. is now for pregnant women to eat peanuts to expose the fetus in utero, but even this doesn't always work. Kid is desensitized now after a year of oral immunotherapy, so add us…

It's not just about early exposure to allergens, it's also early exposure to pathogens. There's a growing body of research that constant disinfection of hands and surfaces is what really caused the allergy outbreak. Humans need to prime their immune systems with exposure to pathogenic bacteria at an early age so that it can learn to fight them and not other substances which leads to allergies.

Re: Australia starts peanut allergy treatment for babies

#227

Post by hinkley » Sat, Aug 03, 2024, 4:14 PM UTC

theNJR wrote: post #101

ecshafer wrote: post #49

Earlier quoted context omitted.

I am not sure if you had a child or not, but you don't give the baby food before 4 to 6 months. So its not that you aren't exposing them at all, but not feeding them the food.

There are powders to add to your formula / breast milk to introduce allergens early (we used Ready Set Food but easy to DIY). Kind of annoying since they often clog the nipple of the bottle, but we did it with my daughter who is now 20 months and her favorite breakfast is a spoon of peanut butter. Sesame gives her a slight reaction still, we unfortunately don’t eat it very often.

Clogging because it’s gelatinous or because it needs to be screened?

Re: Australia starts peanut allergy treatment for babies

#228

Post by DebtDeflation » Sat, Aug 03, 2024, 4:23 PM UTC

darth_avocado wrote: post #3

I always think about the low incidence of peanut allergies in developing countries and wonder if the mother's diet during pregnancy has an effect on allergies in children? Has this been researched? Because instead of introducing peanuts and eggs to babies, introducing it to mothers is almost a no brainer.

>the low incidence of peanut allergies in developing countries

https://en.wikipedia.org/wiki/Hygiene_hypothesis

The human genome didn't evolve in a sterile environment, it evolved in an incredibly hostile environment and developed some nasty defenses as a result. If you don't expose children to pathogenic microbes at an early age to train the immune system on what to attack, it will find other things to attack. Allergies are the result. Stop the constant use of antibacterial hand gels and surface sanitizers and for bonus points get a dog.

Re: Australia starts peanut allergy treatment for babies

#229

Post by mensetmanusman » Sat, Aug 03, 2024, 5:08 PM UTC

dminor wrote: post #132

eskibars wrote: post #9

Our son is very allergic to peanuts and less so to cashew, and sesame. We went through oral immunotherapy and it's been absolutely life changing. He used to need an epi pen in case of chance encounter, but now he eats 2 whole peanut m&ms every day to keep his dosage up. It's been difficult finding an allergist in Germany that's willing to accept this and move forward Obviously everyone's mileage will vary, but I'm ha…

I asked our allergist about oral immunotherapy for my daughter and he cited a study that found that avoidance was more effective in preventing severe reactions.

This type of advice makes sense in an absolutely litigious risk free training context.

Re: Australia starts peanut allergy treatment for babies

#230

Post by namibj » Sat, Aug 03, 2024, 5:20 PM UTC

onli wrote: post #186

ekianjo wrote: post #184

Earlier quoted context omitted.

> avoidance of the allergen whats the point of the allergist then?

My question exactly. To be fair, for hay fever the therapy was offered. And reading it up back then, the treatments against animal hair are often not successful, and they have a certain risk. Plus no standardized medication, so there are problems with keeping the exact dosage needed. All that combined made me conclude that not wanting to lead such a treatment is not a completely unreasonable position for a doctor. On…

For cats, just feed them egg from chickens that live with cats, as the egg has antibodies against the allergen in cat saliva, and the egg will cause those to get neutralized before the cat spreads them to its fur.

There are commercial products for this that have such egg powder.