Editorial - Otolaryngology Online Journal (2018) Volume 8, Issue 4
Peanut-healthy but Risky for a Young Child
- *Corresponding Author:
- Dr. Vadisha S Bhat
Professor of Otorhinolaryngology, KS Hegde Medical Academy
Deralakatte, Mangalore-575018, Karnataka, India
Received date: December 3, 2018; Accepted date: December 4, 2018; Published date: December 10, 2018
Peanut or groundnut is considered as nutritious food, as it is rich in many essential nutrients which include calories, protein, vitamins, and dietary minerals . Peanuts also contain polyphenols, polyunsaturated and monounsaturated fats, phytosterols and dietary fibers . They are indeed a good source of nutrition, especially for children.
On the other hand, peanut is also a common cause of food allergy, which sometimes can be fatal. The incidence of peanut allergy was on the increase, in spite of avoiding peanuts for children with high risk of peanut allergy. National Institute of Allergy and Infectious Diseases while issuing the guidelines for diagnosis and management of food allergies, recommend feed peanuts as early as four to six months for an infant with a high risk of peanut allergy . They observed that early exposure to peanut would lead to desensitization, and reducing the severity of peanut allergy in such infants, citing dual allergen exposure hypothesis which states that early oral exposure to food allergen induces tolerance.
However, it is not safe to feed peanuts for a child before the age of four years, as these kids will not be able to chew the nut to be able to swallow safely. Consumption of whole peanuts proves fatal for some kids when it is aspirated into the airway. Most of the studies have reported peanuts as the most common foreign body in children undergoing bronchoscopy for suspected foreign body aspiration . Mortality or hypoxic brain injury occurs in 4% of patients with foreign body aspiration. The incidence of foreign body aspiration is more common in children less than three years, which can be attributed to poorly coordinate swallowing and lack of posterior dentition . A high index of clinical suspicion is most important for the diagnosis of foreign body aspiration, as also eliciting the history of choking and a clinical assessment of the respiratory system which is followed by a radiograph of the chest. Missed or delayed diagnosis of an aspirated peanut can result in respiratory complications like recurrent pneumonia and chronic cough . The best method to diagnose and treat a case of foreign body bronchus is rigid bronchoscopy, which carries its own associated risk .
The American Academy of Pediatrics suggests the parents use peanut butter instead of the whole nut. The guidelines emphasize using “infant safe” forms of peanut, like peanut butter thinned with warm water or mixed into pureed fruit or vegetables . Crushed peanuts mixed with jaggery, which is a common sweet dish, is an equally good alternative. Prevention is always a better option especially in the case of foreign body aspiration, which can be done by educating the public about the proper feeding methods and the risk associated with improper feeding habits. While we observe Children’s day on 20th of November, Otolaryngologists should take the responsibility of educating the public in this regard; hence at least a few lives can be saved .
- Nutrition facts for peanuts, all types, raw, USDA Nutrient Data?. Conde Nast, USDA National Nutrient Database, version SR-21. 2014.
- "Nuts (including peanuts)". Micronutrient Information Center. Corvallis, OR: Linus Pauling Institute, Oregon State University. 2009.
- Togias A, Cooper SF, Plaut M, et al. Addendum guidelines for the prevention of peanut allergy in the United States: Report of the National Institute of allergy and infectious diseases?sponsored expert panel. Ann Allergy Asthma Immunol. 2017;118:166-73.
- Sandhofer MJ, Salzer H, Kulnig J. Foreign body aspiration-Sometimes a tough nut to crack. Respir Med Case Rep. 2015;15:18-9.
- Tan HKK, Brown K, McGill T, et al. Airway foreign bodies: A 10-year review. Int J Pediatr Otorhinolaryngol. 2000;56:91-9.
- Sicherer SH, Sampson HA, Eichenfield LF, et al. The benefits of new guidelines to prevent peanut allergy. Pediatrics. 2017;139:e20164293.