Peanut allergies fall, but Michigan schools are sticking with restrictions

New research shows early peanut introduction lowers allergy risk
Peanut allergies rose through the early 2000s but have since declined after guideline changes
Schools continue to use nut restrictions to protect allergic students

Peanut allergies are on the decline nationwide, and some experts now recommend kids be exposed to the legumes early in life. But don’t pack that PB&J in the lunch bag yet.

Many Michigan schools are still operating under strict nut bans, while others are considering updating their current policies amid new research.

A study published by the American Academy of Pediatrics in October shows that the number of children with a peanut allergy has declined as much as 43% since 2017, when the group endorsed guidelines calling for kids as young as four months to be introduced to age-appropriate peanut foods.

But while there has been an overall decline in children with nut allergies, many schools discourage or even prevent students from bringing peanut products.

The Michigan Department of Education confirmed that there will be “no changes to school nutrition policies or practices currently (in place) if schools are following recommendations to prevent allergen exposure at schools.”

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“There is nothing more important than the safety of each and every FPS student, and so we do monitor and manage the risk nut allergies may cause to students who have adverse reactions,” said Kelly Coffin, superintendent of Farmington Public Schools.

At the district’s Forest Elementary School, students are prevented from bringing “any foods that contain peanut butter, peanut flour, peanut oil or other nuts. This includes no food with almonds, coconuts, filberts, Brazil nuts, cashews, hazelnuts, macadamia nuts, pecans, pine nuts, pistachios and walnuts,” according to the school’s policy.

“Our other buildings follow a nut-restricted policy, which allows for more flexibility and targeting, such as nut-free areas or tables at lunch, to manage and minimize risk where it’s highest, rather than banning nuts across the entire school,” Coffin said.

She confirmed that, in light of new research, Forest Elementary School is looking to adopt a less restrictive policy moving forward and that shift may happen across the district as well.

Several other school districts have policies that designate specific areas as “nut-free” or even discourage children from bringing products containing peanuts and other highly allergenic foods, including Romeo Community School, which discourages bringing foods that contain peanuts and tree nuts or have been processed in the same facility as those products to buildings designated as “nut-aware.”

Donley Elementary School in East Lansing has a similar policy banning tree-nut products from lunchrooms and classrooms, as well as Mill Creek Elementary School in Dexter.

“As research continues to evolve, schools may make adjustments within their existing nutrition frameworks to appropriately include peanut-based foods, recognizing peanuts as a valuable, affordable source of protein in meals and snacks,” said John Galacz, president of the School Nutrition Association of Michigan in a statement to Bridge Michigan.

“Looking forward, as fewer children develop peanut allergies due to earlier introduction at home, school menus may become more inclusive and nutritionally diverse,” he said.

Allergies on the decline

Even in the last five years, Dr. Amy Eapen, pediatric allergist for Henry Ford Health, said she’s seen fewer patients with a severe peanut allergy.

“There’s a lot of anxiety around food allergies, understandably so. It’s one of the biggest reasons kids can go to the ER,” she said. “People are embracing the guidelines, and it’s actually having a big change, meaning that we’re seeing way less peanut allergies.”

Early introduction to peanuts can also help children overcome a developing peanut allergy, especially for children with eczema, who are more likely to develop a food allergy.

“The gut is more tolerant than the skin. If you’re eating something, then that food is being told that it’s tolerant by the body,” Eapen said. “But if you’re not eating it … even in small forms, you’re paving this path towards allergies.”

A baby’s body is trying to figure out what it likes and doesn’t like. Early introduction to peanuts can train a baby’s body not to react to them before a full-on allergy develops, Eapen explained.

However, the same cannot be said for older children.

“As you get older, it is harder to outgrow a food allergy. Peanuts are one of those ones that can stick for life,” she said.

Changing guidelines

About 33 million Americans have at least one food allergy, including the 6.2 million people with a peanut allergy, according to Food Allergy Research and Education. For decades, parents were told to avoid giving peanuts to young children, only to learn later that early introduction may actually help prevent life-threatening reactions.

In 2001, the American Academy of Pediatrics recommended that parents avoid introducing peanuts and other allergenic foods to their children before the age of 3, especially those with eczema who were considered “high risk.”

Research at the time suggested early exposure may increase the risk of them developing a severe food allergy that could result in anaphylaxis, an allergic reaction that can be life-threatening.

The recommendation came in the midst of a sharp rise in US children who developed a peanut allergy from 0.04% in 1997 to 1.4% in 2008, according to the Journal of the American Medical Association.
The academy updated its guidelines in 2017 after a trial led by Learning Early About Peanut Allergy (LEAP) found that among 640 high-risk infants aged 4 to 11 months, early and consistent peanut introduction was linked to an 86% reduction in relative risk. Only about 2% of infants who consumed peanuts developed an allergy, compared to 14% of those who avoided them.