How To Desensitize Your Child To A Food Allergy

“Oral immunotherapy” can help you reintroduce foods after an allergy has begun.

A new therapy for food allergies is being developed at Northwestern University. The news is suddenly full of new recommendations on how to keep your baby allergy free. But what if it is too late to prevent allergies in your household? What if you’ve already seen your little one break out in hives, swell into a bawling bruised tomato or some other scary reaction? Have the great advances in allergy understanding just come too late for you and your kid? No. Especially if your child is still relatively young. The newest treatment, under study by experts at Northwestern University in Chicago, involves educating the immune system on the safety of, say, peanuts, by attaching peanut proteins to white blood cells. This interaction safely helps the immune system learn to accept peanuts in the same way we might cordially befriend the friend of our best friend. So far, the research has only been done in mice, but the researchers are hopeful the technique will soon transfer to humans. Various versions of oral immunotherapy are already being used, with the immune system becoming “re-educated” when the patient eats and digests the offending substance in tiny amounts that are gradually increased. I did this for my daughter to desensitize her to a severe egg allergy. On doctor’s orders (don’t go it alone), I made a cake for 5-month old Clara with just one egg and gave her 1/20 of it every day. After several months of this, I put two eggs in a cake and then three. By the time she was 2, she no longer had painful facial swelling after eating eggs, and she even cozied up to a plate of scrambled eggs with delight. To keep her allergies away, I now feed her eggs twice a week. All this feeding and eating is considered a form of oral immunotherapy. For the minority of allergy sufferers who have extreme intolerance to certain foods ― those who react severely to the tiniest amounts, such as contaminants from factory machinery or from simply from touching an allergen ― Dr. Kari Nadeau of Stanford University, director of the Sean N. Parker Center of Allergy and Asthma Research, has successfully developed an oral immunotherapy treatment that is basically a slower, even more cautious version of what we did for Clara and later for our two sons, who had reactions to eggs and sesame. Nadeau had medical-grade flours made of common allergens so that they can be eaten in extremely tiny amounts on a daily basis. The amount is upped slowly, sometimes backtracking a bit if the kid has a reaction, but then barreling ahead no matter, until the formerly allergic child can safely tolerate a full dose of the allergen, say a small handful of nuts or an entire egg. The child must continue eating this “maintenance dose” every day, possibly for the rest of their life.

In many situations, the child, especially if young and allergic to dairy or egg, does not need commercial-grade powders but can, with a doctor’s approval, start with the actual allergen in its food form in minute amounts. Greater and greater quantities can be slowly introduced until it is no longer an issue. They then need to eat a maintenance dose of the formerly offending food two to three times a week for at least five years. My kids fall into this camp. At this time, allergy desensitization, to be done safely, requires intense hands-on help from a doctor. Approach an allergist as soon as possible about desensitization through oral immunotherapy, especially if the child is allergic to dairy or egg. The younger your child, the more likely the treatment will work. Unfortunately, desensitization protocols for nuts, seeds, fish and shellfish are still in their infancy, are considered more risky and are likely unavailable in most medical practices. It may be helpful, however, to stop avoiding all nuts if your child is allergic only to, say, almonds. This approach likely helped resolve my daughter’s life-threatening allergies to cashews, hazelnuts, almonds, Brazil nuts, pistachios and macadamia nuts. We fed Clara her four safe nuts (pecans, walnuts, pine nuts and peanuts), pureed into a smooth, baby-friendly butter, every day in infancy, and by the time she started nursery school, she was allergy free. If you want to try this approach, have a new round of testing done before introducing different nuts, seeds, fish or shellfish to find out if any new allergies have developed. Any allergenic foods deemed safe for your child should be given regularly. You might also want to ride the current wave of research in allergy desensitization. Epicutaneous immunotherapy, or the gradual introduction of allergens through a skin patch, is a new experimental treatment that is seeing particular success in young children who have a peanut allergy. The trials are in progress and are unfortunately not recruiting new patients at the moment, but keep an eye out for future studies. The forthcoming research could dramatically improve treatment options for allergic children. To learn more about upcoming clinical trials, please see the resources below: Food Allergy Research and Education (FARE): One of the best places to receive helpful and up-to-date information, this organization provides a range of resources, from handbooks for the newly diagnosed to information on how to participate in a clinical trial. World Health Organization’s International Clinical Trials Registry: Type “food allergy” and the name of your country into the search engine to find a selection of clinical trials recruiting participants. Consortium of Food Allergy Research (CoFAR): Funded by the National Institutes of Health, CoFAR is conducting multi-center clinical and observational studies to advance our understanding of food allergies. The website includes tools that help predict whether a baby is likely to “grow out” of an egg or milk allergy.