My daughter has a peanut allergy, and I feed her peanuts daily. Yes, you read that correctly. At just three years old, she has this allergy, yet in our household, peanuts are not a forbidden food. We don’t scrutinize ingredient labels, nor do we confirm with restaurant staff whether her meals are safe. While traveling, we don’t seek out allergen-free dining options or grocery stores. We don’t notify airlines about her allergy, nor do we ask them to avoid serving peanuts on flights. If another child at the park enjoys peanut butter, it doesn’t faze us. On Halloween, if someone fills her bucket with Reese’s, we don’t bat an eye — she’ll likely indulge in one after we get home. The reason for this seemingly reckless behavior? Oral immunotherapy, or OIT.
My journey began when my daughter was just ten months old. The first time I introduced her to peanut butter, it was a mere smear on a slice of bread. Within minutes, hives erupted across her face and chest, her skin turning red and puffy, and one eye swelling shut. Both skin tests and blood work confirmed her peanut allergy. I still recall the nurse’s sympathetic expression as she conveyed the diagnosis, as if my daughter had been dealt a life-altering blow. It was then that I understood the gravity of food allergies and the anxiety they cause.
Peanut allergies are complex; even a trace amount can trigger severe reactions. Once, after handling peanut butter and washing my hands thoroughly, my daughter still broke out in hives from a minuscule amount of peanut protein I hadn’t completely removed.
Peanuts contain various allergenic proteins, and my daughter is specifically allergic to ARAH2, a protein linked to severe reactions and one that is rarely outgrown. However, this made her an excellent candidate for oral immunotherapy. OIT involves gradually increasing the amount of peanuts consumed, starting with a tiny dose and slowly progressing to a full serving. This treatment demands daily dosing, along with regular visits to the allergist for dose adjustments and monitoring, typically spanning six to twelve months to achieve desensitization.
Once a patient reaches maintenance, they must continue regular doses to retain their desensitization. It’s a lifelong commitment, similar to recommendations for those who outgrow allergies, as not continuing to consume the allergen can lead to a return of the allergy.
It’s crucial to understand that OIT is not a cure. There’s no definitive solution for food allergies; OIT merely helps patients become desensitized. Post-OIT, patients can generally consume their allergen freely, but if my daughter stops her doses, her desensitization will fade, and she may react again. Epi-pens remain a necessary precaution.
While the FDA has recently approved Palforzia, a peanut powder-based treatment, OIT remains relatively new, with studies suggesting that its protective benefits may diminish once treatment ceases. Therefore, it’s essential to discuss OIT in detail with your medical team.
Despite OIT not being a physical cure, it offers significant emotional relief. Managing a food allergy is more than just avoiding peanuts; cross-contamination can occur from shared manufacturing lines, and even a meal prepared on a surface that previously held peanuts can be dangerous. For children like my daughter, exposure to even the slightest trace of peanut protein could lead to anaphylaxis before starting OIT.
Oral immunotherapy alleviates the stress of grocery shopping and label scrutiny. It makes dining out, attending family gatherings, and celebrating birthdays worry-free. I look forward to her starting school in a couple of years, dating, and eventually going off to college without the constant fear of her allergy looming over us. Although she still medically qualifies as allergic, OIT allows us to live life as if she is allergy-free.
My daughter has a peanut allergy, and I feed her peanuts every day — without worry.
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In summary, my daughter’s peanut allergy may seem daunting, but with oral immunotherapy, we’ve transformed our daily lives. This treatment allows us the freedom to enjoy life without the constant dread of food allergies.
Keyphrase: peanut allergy treatment
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