sistent enough to require prescription- strength topical medication to treat it. If your baby falls into the high risk cat- egory: 1) See the pediatrician. You’ll need to confirm that your baby is, in- deed, at high risk for peanut allergy. The pediatrician will need to test for peanut sensitization, which means that your baby’s immune system has already been exposed to peanuts and mistaken- ly recognizes peanuts as bad guys. “We know that children can become allergic to peanuts without ever eating them,” Dr. Nowak-Wegrzyn says. Protect Your Baby from Peanut Allergy A — by Sandra Gordon s one of the most common food allergies, peanut al- lergy affects 1 to 2 per- cent of children, which doesn’t sound like much. But if your baby or toddler is among them, it is one child too many. The inside story? During a peanut aller- gy attack, the immune system misfires, regarding peanut proteins as harmful. Peanut allergy can bring on itchy skin or hives, which look like large or small welts, lip swelling, vomiting, and runny nose or congestion. Airways can narrow too, making it hard to breathe. If your child is diag- nosed with peanut allergy, you’ll have to do everything you can to help him/ her avoid peanuts. Peanut allergy has no cure; it’s typically lifelong once it de- velops and it can be fatal. Avoiding peanuts is a lot of work because peanut protein is everywhere, even in the air, and the constant vigi- lance it takes to keep peanuts and pea- nut containing foods away from your child is scary and stressful. From day- care, play dates, and birthday parties to school, summer camp, and sleepovers, life is a lot more complicated when your child has a peanut allergy. That’s why the new guidelines for peanut allergy prevention published by 26 WNY Family July 2018 the National Institute of Allergy and Infectious Diseases (NIAID) are so important for your baby’s health. For the first time, “we have an intervention that could potentially prevent peanut allergy,” says Anna Nowak-Wegrzyn, MD, professor of pediatrics at the Icahn School of Medicine at Mount Sinai and researcher at the Elliot and Roslyn Jaffe Food Allergy Institute in New York City, who helped create the guidelines. The guidelines are based on a land- mark 2015 New England Journal of Medicine study, which suggested that giving infants peanut-containing foods could help prevent peanut allergy by 81 percent. “It’s a massive, dramatic ef- fect,” Dr. Nowak-Wegrzyn says. How can you help prevent your child from developing a peanut allergy? Dr. Nowak-Wegrzyn provides these basic steps, depending on your baby’s level of risk. Babies at High Risk for Developing Peanut Allergy Your baby is at high risk for devel- oping peanut allergy if by 4 to 6 months of age, your baby has severe eczema (a red, itchy, scaly rash) or egg allergy or both. Severe eczema is frequent or per- If your child has severe eczema, for example, a peanut allergy can gain a foothold; peanut protein in the en- vironment or on your hands can enter your baby’s body through microscopic breaks in the skin. The pediatrician will need to do a peanut skin prick test or a blood test, known as Peanut sIgE. These tests measure peanut specific im- munoglobin E, which are antibodies to peanuts. In the case of the blood test, your baby’s blood work will be sent to a lab for actual testing. If your doctor isn’t comfortable doing these tests, you may be referred to a specialist. Next Steps: 2) Go on peanut patrol. If your baby’s skin test or blood test is highly or significantly positive, your baby may already be allergic to peanuts. Unfortu- nately, it’s too late for prevention. Ex- pect your doctor to talk with you about how to manage your child’s peanut al- lergy, which means peanut avoidance. Or, the doctor may schedule a su- pervised feeding. If your baby’s skin or blood test is negative or somewhat posi- tive (there are lots of false positives on skin tests), your baby’s doctor should do a supervised feeding test in the doctor’s office. A feeding test involves giving your baby a small dose of peanut butter (2 teaspoons) mixed with two to three teaspoons hot water, after it has cooled or 21 pieces of softened Bamba, which is corn pop cereal that contains peanut butter powder.