Doctor suggested that peanut cross contamination would be OK

My son is 5 with a severe peanut + other nut allergy and we've been aware of his peanut allergy since he was <2 years old. His CAP RAST score is 176. We have been very careful about what he eats and have not had any serious incidents reactions since we initially discovered the allergy. We have had a no tolerance policy: no peanut products in the house, no possible cross contaminated products, no direct contact or possible indirect contact.

Just recently our allergist said that now that he is around 50lbs, it is would be OK to allow for some exposure and that this may help his immune system over time. For example allowing him to eat foods that have come in contact with peanuts would be OK. My wife and I were shocked by this suggestion as it contradicts everything we had been told to date, and we strongly question the doctor's guidance.

We plan to maintain our no tolerance policy but I am interested in others' feedback on this, or if you have heard / experienced similar advice from doctors.

By Theresa DB on Tue, 01-28-14, 01:44

I am a Mom who has a peanut allergy. Even though this was at least 30 years ago I did go through many suggestions of doctors not only did the doctor thought that I would eventually build up and develop a gradual tolerance to peanuts. At my parents everyone in household did enjoy peanut butter daily. At school the students would bring peanut butter sandwiches. I had to endure very painful allergy shots twice a week where my arm would burn sting and swell up the size of a grapefruit where the shot was given, this suggestion and attempt lasted for six months before the doctor realised no I could not develop an immunity to peanuts. Even to this day the smell of peanut butter or peanuts in the air gives me an instant splitting Headache stuffed up nose and washing dishes that someone who used a knife to spread peanut butter causes rash on my hands. From my personal experience of suffering through allergic reactions and years of exposure to peanuts My parents and doctor should not have exposed me to such pain. If it hurts or there is a reaction don't expose anyone to intentional exposure to peanut. This is only my opinion and personal experience Don't make a decision on my experience every metabolism is different and may react differently. This was my experience 30years ago till this day. TODAY people recognize and have been educated on the importance of Zero Tolerance to peanuts. Education is the best prevention.

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By SneeZ on Mon, 01-27-14, 02:52

The new IgE test available will clarify what antigens in peanut are reactive with your child. Two of them are linked with the more persistent and severe reactions. This would be a good and helpful first step.

Depending on that result, a safe action plan may be created. If the test is Very Encouraging a challenge could be conducted in a medically supervised site with all necessary materials available to manage a bad reaction. Doing it at home is not wise.

Basically, more information is needed before considering a potentially tragic experiment.

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By Seamist on Sun, 01-26-14, 21:51

This is what I would do. 1. Ask the doctor to put his recommendation in writing, and sign it, so you can have it for your records. If he does this, meet with him and go over a copy in person, and make sure you all understand the recommendation the same way. 2. Get a second opinion, also in writing. 3. I would continue to have a no tolerance policy, and get new blood tests done at age 10. 4. Always have a prescribed epipen or perhaps two with you in case of accidental exposure. 5. After new blood testing at age 10, with a doctor you trust, decide if it would be appropriate to do a challenge test, and if yes, only do a challenge test under doctor's supervision in a hospital.

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By Mrsdocrse on Sun, 01-26-14, 21:44

Hi

I seems to me that your doctor had a reason for telling you this. I would also call him and ask him the basis for the change in stance about the allergy. If he has never had an actual reaction ( just tested positive) maybe he thinks that he is outgrowing it? Not sure, but I would definitely keep up the avoidance like you have been doing, call him and ask why he said that and share your concerns. It might make more sense once he explains. I would also get a second opinion and have a food challenge in a medical setting before I would just start eating anything that "may contain."

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By jap on Sun, 01-26-14, 16:59

what is the doctors name dr Jack Kevorkian ?
Ok no brainer under no circumstance and i would also consider reporting this to the board.

Everybody knows that any exposure should be done under close medical supervision and monitored for up to 4 hrs after, any exposure can kill you.

the other question is food with possible traces very often does not have any and this is for the added protection of the allergic and the company.
how the hell does this doctor know the amount of controlled exposure amount and frequency using this witchcraft.It is very dangerous for the highly allergic and research says once you stop the exposures you become allergic again.

Never liked Russian roulette

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By cmarie234 on Sun, 01-26-14, 16:31

FInd a new doctor. Any deliberate exposure to nut products should be done in a controlled environment and your son monitored for symptoms of anaphylaxis for several hours afterwards.

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By nhoehler on Sun, 01-26-14, 16:10

I would be hesitant too. My 12 year old son, was allergic to peanuts, treenuts, eggs, sesame, sunflower, red meat, mill and soy. He avoided everything. We never purchased any items if the label specified "may contain" or "manufactured with". Our doctor said it was not worth the risk and pure avoidance would help him out grow it. He has outgrown all allergies expect peanuts (he is currently in the peanut patch study). My son is too important for me to consume peanuts. I would never be able to live with myself, if I ate a pbj and he reacted. I think your doctor's mindset is coming from the oral desensization (sp) clinics. But everything i've read on that requires supervision and careful injestion.

Best of luck.

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By PeanutAllergy.com on Fri, 01-24-14, 01:32

Question of the Week: Answered!

Every week, PeanutAllergy.com is answering one of the questions posted in our community.

Our Answer:

It is understandable that you question your allergist’s advice. Cross-contamination can be dangerous; a small amount of an allergen can cause a serious reaction in someone with a peanut allergy.

There have been studies about diminishing the allergic reaction to peanuts. Your doctor most likely recommended that your son consume small amounts of peanuts to help lessen his allergy. You can read more on a study done last year by clicking here.

Voice your concern with your allergist. Ask him or her to fully explain the reasoning behind allowing your son to have small amounts of peanuts. If you still do not trust your doctor’s decision, try to get a second opinion from another allergist.

Until another doctor says that it is okay for your son to start eating small amounts of peanuts, here are some tips to avoid cross-contamination.

We asked our Facebook fans for their input, and you can read their responses here.

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By AmberC. on Fri, 01-24-14, 01:04

Here is also some great reading for you. Dr. Charles Richet won the Nobel Prize for his work on anaphylaxis. This is super interesting reading, basics for any allergy family:

http://www.nobelprize.org/nobel_prizes/medicine/laureates/1913/richet-lecture.html

(Remember the body is so much smarter than we give it credit for!)

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By AmberC. on Thu, 01-23-14, 23:46

I'd have to really disagree with your doctor.

Imagine that your son's allergy to peanut (or whatever) is the same as say immunity to measles. We know, for example, that if you get a shot for the measles, that your immunity will wear off, at some point. But, if you get a booster shot, you remind the body that it's supposed to fight measles.

Immunity and allergy are relatives, even twins.

So, right now your son's body thinks peanut is the enemy. It's had its wires crossed.

***

This is what I suggest: avoid that peanut until you get a blood test suggesting the IgE levels are like zero.

Also, avoid all skin prick tests.

***

You want the body to forget that peanut is bad.

And then try an oral challenge sometime down the road, like in 10 years.

I think careful avoidance of peanut could perhaps break the link.

***

This is just a mom's perspective; but I recently clearly saw the skin prick test make our child's peanut allergy worse (acting like a booster shot).

Since food allergy is still poorly understood, I don't see any harm in trying out one mom's rogue perspective on this.

It could help, while your doctor's advice could hurt! (and my advice is conservative)

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