a photo of peanuts in their shells.

Doctors are now suggesting parents expose children to peanuts earlier.

A new statement released by the National Institutes of Health (NIH) suggests children should be fed peanuts in their first year of life  – a significant deviation from previous guidelines set in 2000 by the American Academy of Pediatrics, which told parents to wait until after their child’s 3rd birthday to give them peanuts. The new guidelines are based on a 2015 clinical trial, which found that children with a high risk of developing a peanut allergy who ate peanuts regularly starting in infancy up until age 5, were 81 percent less likely to develop an allergy.

The new recommendations, which are also supported by the American Academy of Pediatrics, set three different guidelines for introducing peanuts into your child’s diet. The first guideline addresses children considered high-risk for peanut allergies – those with severe eczema, egg allergy, or both. Those with a high-risk of developing a peanut allergy, according to the new guidelines, should have foods containing peanuts, introduced into their diets between 4 to 6 months of age. Those in the high-risk bracket should also be evaluated be a physician for skin and blood allergy tests before being fed peanuts.

Children in the second category, those with mild or moderate eczema, should be introduced to peanuts around 6 months. Children in the third category, those with a low risk of developing a peanut allergy, can have foods containing peanuts introduced into their diets as their parents see fit, once they are able to eat solid food.

Doctors are encouraging parents to follow the new guidelines, hoping the new recommendations will decrease the rising rates of peanut allergies. “There is this magic window of opportunity, where you can introduce peanut-containing foods,” Dr. David Stukus, a pediatric allergist in Ohio and coauthor of the new guidelines, told Stat News. “Our immune system undergoes dramatic development and maturation during the first years of life. We introduce peanut-containing foods early, the immune system can get used to it.”

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“He looks perfectly normal to me.”

The woman inspected my son, evaluating him for signs of his food allergies. She stared into his blue eyes. He stared back, trading his glance between his mother and this stranger. He was 3 or 4 at the time, tow-headed and already familiar with his well-learned phrase if anyone offered him food: “No, thank you. I have food allergies.”

“That’s because he is.” I cringe a little inside at the thought that some people are looking for outward evidence of my son’s life-threatening food allergies. If he’s displaying evidence, something has gone wrong. It’s hard to appreciate what we can’t see, but as an allergy parent, I work overtime and do my best to make certain there is nothing to see.

I don’t ever want to see my child turn blue as his blood pressure drops and his throat tissue swells. I don’t want to see the hives bubble unchecked over his entire body, scalp to toes. I don’t want to see my child go limp as I inject epinephrine and call 911 for a ride to the emergency room in case he experiences a rebound and we need to do a second injection. Many of us have been there and done that at least once. My son was diagnosed at 9 months old when he reacted to infant cereal. I can still remember standing in the ER as the nurse whisked him past everyone else into the back. And so began our education. As a parent, it’s your job to learn quickly and learn well.

As parents, we are successful and triumphant if you don’t see a thing. Seeing nothing is a victory.

One year at our annual allergist visit, my son’s doctor told me we handle allergies very well, that being proactive has had a positive impact on his quality of life.

I believe we all want to do the right thing; we just need the knowledge to make good decisions. So, my son would attend parties. I’d talk with the host beforehand to make certain his food “matched” the others’ as closely as possible. We’d bring allergy-friendly snacks for the entire group. We’d answer questions, demonstrate how to use epinephrine and talk about cross-contamination. While we wouldn’t hide his allergies, we did our best to approach the subject in a positive way, explaining we needed help to keep my son safe and healthy.

And people responded tenfold. If anyone found something free of my son’s numerous allergies, we’d find a package on the porch. Friends were triumphant, bringing treasures they’d found to share.

My son and I tuned into a program on the local radio station that was talking about food allergies. We listened intently, hoping perhaps there was something new to learn. My son was fairly quiet throughout, listening to other people’s experiences. When it finished, we talked. He said, “Mom, I’m glad you never treated me like I was in a bubble. I know what to do, and how to share what I need.”

Years ago, we began a neighborhood tradition at our home, “Gingerbread Night.” In the beginning, when we were few, I’d make allergy-friendly gingerbread houses from scratch for every child. As we grew larger and the entire table filled up and then some, we switched to gingerbread people. We’ve also added a modern twist with a few gingerbread zombies as well.

We provide the gingerbread people and frosting bags full of white icing. Guests provide gingerbread toppings that are allergy-friendly. Each year, there’s a hunt and a challenge to provide something new. Ingredient lists are carefully read. Processing is double-checked to make certain there is no cross-contamination. And happy chaos reigns with bowls of ingredients, ridiculous amounts of frosting, and group-judged and photographed cookies. And lots of milk to wash them all down. Everyone leaves with a basket of cookies and a wonderful memory of our holiday tradition. Neighbors stop me in the street in October to see if we’ve set a date for our can’t-be-missed event. Good friends have moved to Germany, and although they have no allergies, a box of our special gingerbread men will find their way across the ocean to be part of our special day.

While it was more difficult 15 years ago (my son’s first birthday cake was a two-pound block of cheddar cheese with a candle in it), time and repetition have made us all comfortable with our approach. We don’t ever let our guard down; we simply follow the plan. And after a while, people learned there was nothing to see, provided we followed those set rules. And after a while, they started to see a blue-eyed, blond-headed boy, and not “that kid with the allergies.”

The rules set in place all those years ago remain, but they are old hat by this time. We know what to do and how to do it. All of us.

And today, at 15 years old, my little boy stands at 6-foot-2 in his bare feet. His skin is clear, his eyes are beautifully blue, and his golden locks are still curly, albeit a bit darker these days. He is joyful, intelligent and already making plans to drive and thinking about how to deal with his allergies in college, how to budget and how to cook for himself. He has a plan.

And, yes, he has food allergies. He is anaphylactic to wheat, eggs, tree nuts, peanuts and barley. He carries epinephrine 24/7. He wears medical ID dog tags. He totes business cards that list his allergies and his emergency contacts. He is very much aware of his allergies and what they mean.

And we are very happy to say there’s nothing to see here, except a teenage boy much like any other young man on his way to becoming an adult.

Image via Thinkstock.

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A few years ago, I was diagnosed with having two food allergies after having mind-blowing migraine headaches for four or more years. After finding out I had an allergy, I, like always, developed some sort of upper-respiratory/sinus infection. My normal staff pharmacist knew I had an allergy and usually picked a manufacturer she was sure did not contain wheat and gluten by-products, but she was on vacation. The conversation I had with a floater pharmacist that day blew my mind.

Dear Floater Pharmacist,

When I saw you checking my script, you looked much younger than me. Quite possibly a baby. But what a sweetheart you were. The tech offered to ring up the prescription, but you declined, saying you wanted to speak with me. Worried, I ambled over to the counter, expecting to find out that the script was not going to be covered by my insurance.

Instead, when you came over, you looked at me with a furrowed brow and asked if I had any food allergies. Surprised, I answered, stating yes, I have two food allergies: gluten and wheat. I was careful about the drugs I was prescribed, knowing that sometimes gluten by-products are used in the production of medication.

She looked at me, looked at the script and said the greatest words I had ever heard: “I thought so.” In your support, you told me how you noticed, when looking at my profile, that most of my medications were in tablet format instead of capsule. However, one of the medications I had been taking recently for an infection was known to contain trace amounts of gluten in the capsule. She proffered me the prescription and said, “I hope you don’t mind, but I exchanged out the drug we would normally dispense with the one I know is free of allergens. It may cost you a little bit more, but it will not cause you to develop any extra symptoms.”

Flustered, I smiled and could only utter out a thank you. I had never met someone, even my own doctor, who thought to look and see if the medication I was being prescribed contained those ingredients. You took initiative and a substantial risk, knowing I may have requested for it to be changed back. But you have no idea how much I truly appreciated it.

So, my baby-faced, rookie floater pharmacist, thank you. You truly show the knowledge of a veteran pharmacist. I wish you the best of luck in your career.

Sincerely,

The woman with all the allergies

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My 2 year old's allergy bracelet. My 2 year old's Superman AFOs.

One of these pictures tends to elicit kindness and compassion from people in my community and on the Internet. The other photo seems to bring out the worst in those same people. The irony is that both show the same child, just two different disabilities.

At just over a year old, my now-2-year-old son was diagnosed with a peanut allergy. Just like that, everyday places like the park became life-threatening. Shortly after his diagnosis, I posted a question on my town’s Facebook page: “Does our town have a peanut free school?” We live in a school choice state, so it was possible that at least one of the three elementary schools in our town was completely nut free.

Despite being a yes or no question, my post accumulated nearly 300 comments from community members. Many were entirely negative. I was told I should home school my son because of his allergy. I was also told “How dare you claim his food allergy is a disability,” after explaining that my son has a right to “free and appropriate education” under the Americans With Disabilities Act. (Food allergies are considered a disability under the ADA.) On a different Facebook post, some Internet stranger implied I should allow my child to die by telling me “You should just allow natural selection to do its job,” so his child could bring a peanut butter sandwich to school. He clearly doesn’t understand what natural selection means.

Another parent recently posted a video explaining the Teal Pumpkin Project to our town’s Facebook page. While many people were supportive of the initiative, some people took offense to it, proclaiming “the world isn’t fair” and “these kids just need to suck it up and deal with [not being able to trick or treat].” One woman took offense to using the holiday to create awareness, stating “This isn’t what holidays are about.”

I also posted a reminder at the beginning of summer, asking people if they chose to bring peanut products to the park, could they please eat them at the picnic tables and not near the equipment. I was told I should not bring my child to the park. The amount of cruelty I see on a daily basis regarding food allergies is astounding. The fact that someone would wish my child dead just so theirs could bring a peanut butter sandwich to school is appalling.

Shortly after turning 2, my son was diagnosed with a Chiari I malformation. A part of his brain called the cerebral tonsils is being pushed out of his skull, causing a variety of symptoms. He will most likely need to have a decompression surgery within the next 1-2 years. Around the same time, my son was fitted for his first set of ankle-foot orthotics, AFOs. The cause of his spasticity, toe walking, and gait issues is unknown at this time. What we do know is that the braces have helped him tremendously.

Like any 2-year-old, my son loves the park. The park closest to us is the community center park. He is also obsessed with swings. The community center park only has big kid swings and baby swings. Once he got his braces, it became extremely difficult to get him into and out of the baby swings. I once again posted a question to my town’s Facebook page asking if anyone knew of any grants for special needs playground equipment. I explained my son recently got leg braces and it was a challenge to use the swings. People in my community were extremely helpful with getting me in contact with someone at the rec center. Other people said they would help with a Kickstarter campaign if needed because the park “should be accessible for all children.”

The kindness was overwhelming and greatly appreciated. Yet the irony of it all had me laughing. Just months prior, I was told by members of the same community that I should keep my child home from the park due to his peanut allergy disability. Now this community is telling me that the park should be accessible for all. I don’t believe anyone made the connection that it was the same child they had vilified in the past.

As a society, we have come a long way with regards to how we treat individuals with disabilities, especially children. It is apparent however, that the kindness and compassion sometimes only seem to extend to children whose disabilities can be seen. The Universe has presented my child with two uniquely challenging disabilities. One brings out the best in our community. The other brings out the worst. When I look at him, though, I don’t see a child with disabilities. I see my child. A child who deserves to be treated with kindness in all aspects of his life. It is my hope that one day my community will see it, too.

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Halloween can be an exciting season of pumpkins, costumes, spooky movies and trick-or-treating. But for parents of children with food allergies, there is a different, much more terrifying reason to be afraid of the holiday. Approximately 15 million Americans are affected by food allergies. That’s 1 in every 13 children, and those statistics continue to increase. Halloween is prime time for a majority of the eight major food allergens to circulate. They present in treats you might not expect: soy, milk, egg and even wheat are used in many fruit chews and chocolates. A greater number of candies and chocolate are made with or processed around peanuts and tree nuts, increasing the risk of cross-contamination.

As someone with mast cell disease, even a minuscule amount or exposure to an allergen can send me into anaphylactic shock. I’m 22, and I can adjust to the idea of not getting candy and understand that many may not be safe for me to eat. But that lesson can be much more difficult for a 4-year-old to understand.

Society is growing increasingly aware of the importance of accessibility and inclusivity for all, and Halloween is no exception. Here are six ways to make sure Halloween can be a safe and enjoyable holiday for all!

1. Be on the lookout for teal pumpkins.

The Teal Pumpkin Project is an initiative on behalf of the non-profit organization Food Allergy Research and Education (FARE) with the intent of “creating a safer, happier Halloween” for all children. The organization advocates to make Halloween inclusive and safe for children with food allergies. When you see a teal pumpkin outside of a house, it means that house is offering non-food treats as an alternative to candy.

2. Buy candy that has an ingredient list on each piece.

Though many of the treats that are handed out on Halloween are from reputable brands, try to make sure that each piece of candy has an ingredient list on the back. This can help parents be sure that the treat is safe for their child, minimizing the risk that comes with assumption.

3. Revamp your Halloween tradition!

Make this the year to look beyond the basket of candy. Instead of filling multiple baskets with different types of candy, include a basket with non-food treats. Items like glow sticks, glow stick necklaces, bouncy balls, spider rings, Halloween-themed pencils, erasers and stationary, fake vampire teeth, stickers, sunglasses, keychains, Silly Putty or hair accessories are great! The best part is that you don’t have to look beyond your local dollar store.

4. Don’t share your candy.

We grow up with the understanding that sharing is a sign of kindness and encourage it throughout childhood, but this is one time to teach your children not to. Even though it may seem harmless and may be extended with good intentions, this can be dangerous for kids with food allergies. Encourage your children to reach out to an adult before sharing their candy with a friend.

5. Don’t snack on-the-go.

When I was old enough to understand trick-or-treating, my parents stressed the importance of making sure they checked my candy before I unwrapped and ate it. Parents, please remind your children not to eat candy before getting home and checking it thoroughly. There have been far too many stories of dangerous foreign objects or substances found in Halloween candy, but the most dangerous item for some children may be in the ingredients.

6. The Switch Witch.

In recent years over the holidays, the Elf on the Shelf trend has taken over homes worldwide. It was only a matter of time before it spread to other holidays, and this is genius! The Switch Witch is a witch figurine accompanied by a book that tells a story and encourages children to give their candy to the witch in exchange for a toy, gift, or reward of some sort. It is a great way for children with food allergies to participate in the joy of trick-or-treating and still be rewarded without the risk.

As the years progress, I can’t help but be amazed and immensely grateful for all of the initiatives and awareness being put forward to make this world a safer place for kids and adults alike. Here’s to a safe and fun Halloween for all!

Follow this journey on #SimplySabrina.

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