Does avoiding help outgrow? Child mag

Posted on: Sun, 04/15/2007 - 6:46am
GinaC's picture
Joined: 11/11/2006 - 09:00

Hi All,
I know this was a big topic of discussion. some of you may find Dr Scott Sicherer's comments on the Child Magazine forum of interest.

Here's a quote from him:

"There is a notion that strict avoidance of the food speeds recovery from the allergy. Believe it or not, as of today it is not so clear thatthis notion is entirely correct. "


Take care,


Posted on: Sun, 04/15/2007 - 7:35am
anonymous's picture
Joined: 05/28/2009 - 16:42

I didn't read the article, but the quote you posted makes snse. He didn't say that avoidance doesn't help, just that it is unclear. Considering all the differing opinions of "experts" and studies that are inconclusive or contradictory, I certainly can understand doubt. In fact, I think it would be foolish NOT to have SOME doubt, even if you do think avoidance is the key.

Posted on: Sun, 04/15/2007 - 8:21am
Corvallis Mom's picture
Joined: 05/22/2001 - 09:00

But in kids with a clear history of anaphylaxis, 'avoidance' [i]does[/i] avoid reactions... not exactly a stupid move, if I do say so myself. [img][/img]
Immunotherapy works for insect venoms... works amazingly well, in fact. But nobody in their right mind would ever suggest to someone with a vespid allergy that they should hang around wasps more often!!

Posted on: Sun, 04/15/2007 - 11:55pm
bethc's picture
Joined: 04/18/2005 - 09:00

Here's a weird thing: one of my DH's high school teachers was a bee keeper. His son was allergic to bee stings. The Dr. told them that the kid needed to be stung by a bee regularly (once a month?) to keep his allergy under control if they were going to continue to keep bees, so that's what they did. I know there are allergy shots for bees; this was somewhere around 1980. It's one of the strangest allergy treatments I've ever heard of, and I'd never be willing to go through that pain and risk, but apparently it worked for them.

Posted on: Mon, 04/16/2007 - 3:03am
Momcat's picture
Joined: 03/15/2005 - 09:00

File this under
"What doesn't kill you makes you stronger."

Posted on: Mon, 04/16/2007 - 12:53pm
Gail W's picture
Joined: 12/06/2001 - 09:00

The links sometimes go bad, so I thought I'd cut/paste the content:
Dear Dr. Sicherer,
First of all, thank you so much for all of your incredible work in food allergy research.
My son is almost 3 and was diagnosed with peanut allergy just after his 2nd birthday (RAST >100). His first and only known reaction/exposure was at 12 months (cough, vomiting, hives). My question is: Is there anything I can do as a parent to improve his chances of outgrowing this allergy? He has mild eczema and appears to be developing some environmental allergies.
Thank you again,
Dr. Sicherer replies:
I will address this question in a few different ways. Space
does not allow me to elaborate excessively on these topics, so please consider this an overview.
Many parents ask if there is a way they could "build up" or strengthen their child's immune system to fight away food allergy. The odd issue here is that allergy sort of represents the outcome of an over-active immune system. That is, the body is actually attacking things (protein
in a food) that it should not be fighting against. The types of medications we use to fight allergies usually try to weaken the immune response rather than strengthen it, for example the corticosteroid medications in some types of asthma inhalers or some types of allergy nose sprays lessen the immune response. So actually, allergy is a
strong but misdirected immune response. I am a firm believer in a healthy diet, but I am not aware of an immune-strengthening diet or immune strengthening treatment that speeds recovery from an allergy.
Many young children with food allergies follow what is called the "allergic march" meaning as infants and young children they have food allergies and atopic dermatitis (eczema) that often improves or resolves, but they later develop hay fever and asthma along with allergies to things in the air like pollen, animal dander and dust.
Trying to prevent that progression or reverse allergies is an active area of research but the answers are not so clear and more needs to be done. The "Allergy Nation" article, for example mentions several theories to account for the apparent rise in allergy and food allergy but none are certain and many examples and counter-examples exist.
There is a notion that strict avoidance of the food speeds recovery from the allergy. Believe it or not, as of today it is not so clear that this notion is entirely correct. However, for a food like peanut and many others there is really no choice but to strictly avoid it to prevent reactions. I have had parents feel guilty that they must have done something wrong because their child's allergy test score rose or did not improve and they worry that they were not strict enough or let some accident happen. However, I do not think they should feel guilty!
In our studies on this topic, when we perform doctor-supervised feeding tests in children we had hoped would tolerate the food and it turns out a child has a reaction, well, we have not seen their results get worse
and often down the road they go on to resolve their allergy. Similarly, we see tests rise in persons whom for all intents and purposes really had no apparent exposure.
On a related topic (of exposure and parents' feeling guilt), there are so far no clear studies saying that what a mother ate during pregnancy or during breastfeeding "caused" an allergy. More studies are also needed to sort this out. There are brewing theories because at least one study in the UK showed that skin exposure to peanut in infants
through use of eczema creams containing peanut oil was a risk factor to develop peanut allergy while, in contrast, what the mother ate during pregnancy or breast feeding was not a risk factor. Such creams are not readily used in the US so it does not explain the apparent rise in peanut allergy noted in the US.
You read about the "hygiene hypothesis" in the "Allergy Nation" article. The theory goes that our society's use of vaccines, antibiotics and clean living conditions leaves our immune system more apt to attack innocent things, like foods. Though experts agree that vaccines and appropriate antibiotics must be used for the good of all, the underlying theory has raised interest in "probiotics" or giving "good bacteria" that may stimulate healthy immune responses. I mention that here because many families ask me about this as a possible way to improve
allergy recovery. So far, a few studies showed people had less eczema on these treatments but already counter-studies have emerged. Also, studies so far have not shown less food allergy/specific allergies and though studies are very few so far, a couple unfortunately hint at a slightly higher rate of positive allergy tests developing in treated children. I think the jury is out on this but I still look at this approach with caution and await more studies. Also, for persons with milk allergy I advise caution as some preparations have milk protein.
Although I do not have a magic recipe to promote outgrowing a food allergy, I would still say to keep hope. We used to think no one outgrew a peanut allergy but now we know 20% of young children do, at least by
around school age. Indeed, it is harder or less likely to outgrow it when the allergy tests are in the test range as you describe, but no one has studied children for very long time periods so it may still occur. Even if the allergy is not outgrown, it seems very likely that better treatments or cures will be available.
Scott Sicherer, M.D.

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