By Duke Medicine News and Communications

DURHAM, N.C. -- Children are being exposed to peanuts and exhibiting signs of life-threatening peanut allergies at much earlier ages, according to a new study from researchers at Duke University Medical Center, who caution parents and care-givers to be alert to the trend.

The study, which appears in the current issue of the journal Pediatrics, looked at a group of children born during or after 2000 and compared them to a group of children born between 1995 and 1997. The younger group reported exposure to peanuts at 12 months, and reported their first adverse reaction at 14 months. That's in contrast to a decade ago, when first exposure was documented at 22 months, and first adverse reactions occurred at 24 months.

"This should be a wake-up call to all parents of young children," says Wesley Burks, MD, chief of pediatric allergy and immunology at Duke University Medical Center, and the study's senior author. "Kids are being exposed to peanuts and having allergic reactions much earlier than they did five or 10 years ago."

"There's a valid reason to delay introduction to products containing peanuts," adds Todd D. Green, MD, the study's lead author and assistant professor of pediatrics at Children's Hospital of Pittsburgh. Green was a postdoctoral fellow at Duke where the research was conducted before joining Children's Hospital. "When kids are older, it can be easier to manage bad reactions. They can tell you right away if their mouths feel funny. For that reason alone, it's worth delaying exposing your child to a peanut product, especially if a child is at high risk."

As many as 12 million Americans suffer from food allergies, including milk, soy, eggs, wheat, tree nuts, fish and shellfish, according to the American Academy of Allergy Asthma and Immunology. About 1.8 million Americans are allergic to peanuts, and studies show the incidence of peanut allergy in children has doubled in the past decade, Burks says.

"More research needs to be done to determine why peanut allergy in children is increasing and, most importantly, how to stop this increase," says Anne Munoz-Furlong, director of the Food Allergy and Anaphylaxis Network in Fairfax, VA. "Peanut allergy is life-long and causes the majority of severe or fatal allergic reactions from foods, particularly in teens."

As many as one-third of patients allergic to peanuts have severe reactions that can be near-fatal and sometimes fatal. More specifically, about 200 deaths occur each year due to food-induced anaphylaxis, usually involving peanuts or tree nuts, Burks says.

Current medical studies suggest that strict avoidance of peanuts and peanut products in allergy-prone families is the only way to avoid an allergic reaction. The American Academy of Pediatrics recommends that children avoid peanuts for the first three years of life if immediate family members have food allergies.

In the study, patients with a family history or exhibited evidence of sensitivities to foods other than peanuts showed signs of peanut allergies at earlier ages.

Furlong says this is because "most parents are not aware of the AAP recommendations until after their child is diagnosed with peanut allergy."

Burks and colleagues question whether the earlier signs of exposure are a result of the increased prevalence of peanut allergies, and their next steps are aimed at pinpointing why the exposure levels are rising.

At the same time, they are looking at whether early introduction of peanut products actually promotes tolerance, or could potentially prevent peanut allergies in some patients. A study currently under way at Duke is investigating whether ingesting small amounts of offending foods including peanuts, eggs and milk might desensitize children prone to food allergies, helping their immune system mount an appropriate response.