Pediatricians knowledge of peanut allergies

Posted on: Wed, 05/19/1999 - 4:39am
susan's picture
Joined: 05/19/1999 - 09:00

In March when my son had turned 15 mos. and had his 15 month doctor visit I was told that I needed to get him to eat more table foods. so I decided to try a ritz bit peanut butter cracker because he didn't like any meats and I wanted to give him some protein amid all of the carbo's he enjoyed so much(cheerios, toast, etc.) At the time I offered the peanut butter, the baby was on antibiotics for an ear infection. He ate the cracker and reached for a second bite. That was when he began to cry and vomit. The vomiting lasted for about 5 minutes. My first thought was that the ear infection or his medication was making him sick, but it was so immediate I wondered if it was the peanut butter. when he stopped vommiting I put him in his crib and went to get a towel to clean him. I returned to find one of his eyes had become swollen and very red...just like mine around cats. That reinforced my thoughts about this being an allergic reaction, but I had no idea what that meant. His eye looked clear and he seemed fine within an hour of the episode. I called the doctor who agreed that he was probably allergic and told me that I might want to give him some benedryl if I had it. He didn't recommend that I get him tested...
2 days later I took him to our Nurse P to recheck the ears. I told her about the episode and she told me to get to an allergist immediately to check this out and that it was life threatening...Hello! What was the pediatrician thinking? In fact, why didn't our pediatrician recommend that we avoid introducing highly allergenic foods to our toddler until his immune system had a chance to mature? Are your pediatricians asking you if either parent has a history of allergies before they recommend toddler diets? Wish mine had..
Anyway, our baby is a class 4 for peanut allergy. We have 2 epipens to carry with us. He is also allergic to egg whites and beef. (My doctor also told me to try him on eggs at 10 mos.) Not sure how he was sensitized to the peanuts unless in utero since I didn't breastfeed.

I am switching to a pediatrician that has a background in allergy. I am still new to this and somewhat freaked out by the lack of knowledge in the pediatric community....any thoughts?


Posted on: Wed, 05/19/1999 - 9:46am
armiger's picture
Joined: 05/15/1999 - 09:00

Our pediatrician jumped right on the peanut allergy as serious (when I was still thinking it was no big deal...just a few hives!). However, Brady is allergic to dairy products too and the ped isn't concerned at all. I am amazed at all of you moms who have had there very small children allergy tested..noone here will do it until they are at least three. If I had known she was allergic to begin with, I would have never given her a peanut! It seems logical to me..but not to these doctors! At least I have epi-pens now so I know I can handle any other allergy that she may have lurking..just waiting to be discovered!! [img][/img] Tammy

Posted on: Wed, 05/19/1999 - 10:01am
dhumphries's picture
Joined: 02/02/1999 - 09:00

Hi Susan,
I wanted to relate my experience with my pediatrician and my son's first and only reaction. I would call this reaction full blown anaphylactic, as within five minutes of ingestion he had difficulty breathing, vomiting, intense sneezing, and hives. I called my pediatrician immediately, and he didn't even come to the phone. His nurse, who is only an LVN, said just to give him a 1/2 tsp of benadryl, and he would be ok! My maternal instincts didn't trust this opinion, and I immediately took him to a doctors clinic within a couple of minutes of my home. The doctor on call there realized the seriousness of this, and immediately took him in to an exam room, where he received two epinephrine injections and two doses of benadryl in about a two hour time frame. This same doctor gave me a prescription for an epi-pen and advised me to see my doctor. When I visited my pediatrician, he again said that I probably didn't need to worry, and advised me to wait until my son was five to see an allergist! Again, I didn't take his advice and saw an allergist, who reiiterated the seriousness of this allergy. Thank goodness I didn't heed my pediatrician's advice!
Good luck and Stay Safe,, Debbie

Posted on: Wed, 05/19/1999 - 12:24pm
susan's picture
Joined: 05/19/1999 - 09:00

Did either of your pediatricians ask about family history of allergies at the one year or subsequent visit when discussing foods for the baby?

Posted on: Wed, 05/19/1999 - 11:19pm
Shan's picture
Joined: 04/05/1999 - 09:00

I can totally relate Susan. Please read my post under this main discussion board titled Should I vent...I had alot of replies and good advice from everyone on here. It is amazing the amount of peds out there who don't have a clue. It just reinforces the fact we have to take matters into our own hands to keep our little ones safe. I wish you the best of luck. I'm even starting to question our allergist now. My dd's peanut skin test came back negative even though she had hives and swelling in her face for days within minutes after eating peant butter. He wants to do an oral challenge and I'm starting to wonder now if a RAST would be more in order. Keep us updated! Shan

Posted on: Thu, 05/20/1999 - 2:46am
Greg's picture
Joined: 01/16/1999 - 09:00

Just a quick note to let everyone know that at a forum held here in NY yesterday, that included a number of top figures in the food/peanut allergy field, one of the main topics brought up for discussion was indeed the fact that pediatrician's handling of food allergies appears to vary widely from one to another. It certainly seems some sort of uniform food allergy education needs to be offered.

Posted on: Thu, 05/20/1999 - 1:44pm
tracy's picture
Joined: 02/03/1999 - 09:00

I had a similar experience. When my son turned 1 year old, we asked the pediatrician what we needed to be concerned about when feeding our son -- should we avoid any foods? He said, no, that we could feed him anything. We had informed him of our family history of allergies when we interviewed him before I gave birth, so he was aware of that.
6 weeks later my husband gave my son a peanut butter cookie and 30 minutes later he vomited and his faced swelled up. The nurse on call told me to give him benedryl and that he'd be okay. I decided to take matters into my own hands, so I took him to an allergist. I didn't like the way this guy treated us, so I asked around and got recommendations for another person. I was prepared to pay for everything myself if I had to -- I didn't want to let the insurance companies dictate anything.
My son tested a 5 on the RAST test. That was 4 months ago and he hasn't had a reaction since, but we are careful about what he eats.
We still go to the same pediatrician, but I do my homework. I go in with a piece of paper that has questions and concerns and I don't let him leave the room until we've covered everything and I feel comfortable with his responses. I do this with every doctor I see. I also have realized that it sometimes doesn't matter how prepared and how much homework you do, you can't control everything. I feel confident that based on the knowledge I, and all the professionals I consulted had, we did the best we could. I have also tried to educate these professionals. My lactation consultant now lets all her clients know about the link between family history of allergies and potential food allergies. My ob/gyn was respectful when I told him what happened, but isn't changing the way he consels his patients about diet (his office still recommends peanut butter as a good source of protein for pregnant and lactating mothers). But our pediatrician is a bit wiser.
I also feel confident that the information about this problem will become more prevalent and people will become more understanding and careful. It will take some time, though.

Posted on: Mon, 05/24/1999 - 10:53am
Becky's picture
Joined: 03/05/1999 - 09:00

I had the same reaction from my ped. At 12 months I handed my son a ritz cracker with a small amount of PB on it. As soon as he touched it he started breaking out in hives and his eyes went red. I grabbed it and washed his hands, and called the ped. (I never heard about PB allergies before so I wasnt sure what was happening or how severe this was) I called the ped and said my son ytouched PB and he has hives what do I do? They replied someone will call you back!!! I called back in 10 minutes and demanded to talk to someone and they told me give him a tsp of Benedryl he will be fine. (Looking back on this now I am thankful he didnt take a bite of that cracker most likely he would have been dead. The ped never mentioned the severety of his allergy at his next well check up when I reminded him of the episode. Another doctor in my group I went to see a few weeks after I saw my normal ped my son was sick and he was going to prescribe a prescription and asked if he has any allergies I said just to PB, he said do you have an epipen? I said no, and he explained the severity!!
We went to the CT conference and DR Sampson talked about ped not being taught ANY COURSES on allergies. Also he showed us a study that showed the ped didnt know how to use an epipen, the parents scored higher when they ran a random test. Pretty Bad!!

Posted on: Thu, 06/17/1999 - 12:07am
LouiseLarsen's picture
Joined: 06/07/1999 - 09:00

I wholeheartedly agree that the medical community is frighteningly ill-informed about Peanut-Allergies.
I am shocked at how little they know about the phenomena of anaphylaxis due to peanuts.
The "starting solid foods" guidelines are all over the map in regard to peanuts.
I mean, I was pregnant from March '96 - Dec. '96 and read everything I could get my hands on about babies, etc...(As I'm sure everyone does when they're pregnant for the first time.)
I never read one thing that warned me about peanut allergies from those books. The "What To Expect" books especially appalled me; after my daughter almost died at 15 mos. from severe anaphylaxis from one bite of peanut butter, I reviewed my books. I couldn't believe I could have been so careless to miss the warnings that surely had to be in the books.
Well, there really was no warning. Just a vague reference that a peanut allergy is "extrememly rare"...It was even rather dismissed...AND, in their "Best Odds Diet for Toddlers", they have recipes for "Peanut-Butter Balls."
The "What To Expect"...books are like a bible for most women, they probably purchase one the day they have a positive pregnancy test....How can these writers not feel an obligation to update their books on a yearly basis in order to keep up with all the medical discoveries that are made all the time? I think it is beyond foolish, after all, the authors would get more money each time it was revised! I think somebody somewhere should be held accountable for failing to warn parents about the possibility of a fatal disease as a result of food eatten by mother or child.
This is simply unacceptable and mothers should not have to find out the "hard way"...The information DOES exist. Let's get it out to the public!

Posted on: Thu, 06/17/1999 - 4:29am
kellyh's picture
Joined: 05/27/1999 - 09:00

Hi Louise. I too had those books and considered them my "bible". I just want to say, that I too read everything there was to read on pregnancy. I had heard of peanut allergies and so I know if I had seen a warning, I would have not eaten the amount of peanutbutter that I had. I was reading the other day "What to expect with Toddlers" and came across a section that stated children under 3 should not eat peanuts. Ok, then why do they give receipes like you mentioned. It was only one line and I find it so hard to believe they didn't take it seriously. I have been told by researchers at John Hopkins, that there is no "proof" of giving this allergy to your child while being pregnant. BUT, the doctor did stress that not eating it was a good idea. She says I probably sensitized my daughter while breastfeeding. I believe if alcohol can get to the fetus, then so can everything else. She did say that if anyone in your family has allergies, you can pass it to your child and it can come out as any type of allergy. Unfortunately, my husband has asthma, hayfever and I am lactose intolerant(except while I was pregnant) and allergic to wheat. No one ever told me to alter my diet at all. I ate alot of peanutbutter ( I remember my husband giving me peanutbutter sandwiches while I was literally breastfeeding my daughter- yikes!!), milk, and eggs. I thought I was doing everything right. But as that doctor told me, sometimes it just doesn't matter. I will always be peanut free for my daughter's sake, but I think before I get pregnant again, I will check out Canada's and the UK's guidelines. I always assumed the US was "on top of all research" What a shock. Also, I did look up a site (not sure of the address) but it was about the peanut farmers etc. There was a section on peanut allergies and I was surprised at how informed it was. They actually suggested children under 7 should not eat peanuts. I just wish I had gotten all this info and then I could have made my own decisions. I know my child still could have gotten allergies, but maybe it wouldn't have been this bad. So now we deal with it and pray they come up with a vaccine. I just pray my future children will be alot luckier. Kelly

Posted on: Thu, 06/17/1999 - 11:38am
dhumphries's picture
Joined: 02/02/1999 - 09:00

Hi Kelly,
I just wanted to mention that I read that the reason books warn against children under three not eating peanuts is due to the choking hazard, and not the potential allergic reaction. That is probably why you see that warning, but then see recipes with pb in the same book.
I agree that we need to get these authors more informed about pa. I would be willing to bet that just as many individuals die from the reaction as they do from choking on pnts.
Stay Safe, Debbie


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