New peanut allergy treatment at Children’s Mercy aims to improve kids’ quality of life

OVERLAND PARK, Kan. -- Peanut allergies in children can cause a lot of anxiety for kids -- and for their parents.

But there's a new treatment at Children's Mercy that's easing concerns.

About a dozen children are in various stages of oral immunotherapy for their peanut allergies at Children's Mercy. Eleven-year-old Norah McMains is one of those kids.

The therapy involves eating a small amount of peanut flour, and eventually peanuts, every day. It desensitizes kids, like Norah, who have peanut allergies.

"When she was nine months old, I fed her a nibble of peanut putter and her lips started to swell up. And she was batting at her mouth and she started to cry, and I was like, 'Oh my gosh, I think she's allergic to peanut butter,'" said Elizabeth McMains, Norah's mom.

Jodi Shroba, a pediatric nurse practicioner at Children's Mercy, administers Norah's therapy.

Jodi Shroba checks on Norah during a treatment

"So essentially what we're doing, we're giving small amounts of the food that the child is allergic to and we're taking and telling the body that, in small amounts, this is not harmful," Shroba said. "And over time, larger amounts are not going to cause a serious reaction."

Shroba helped bring the oral peanut desensitization to Children's Mercy in September.

The old standard treatment for peanut allergies was to avoid the food entirely, and carry Epi-Pens.

Now, kids like Norah can come to Children's Mercy every two weeks for six months for the oral immunotherapy.

Treatment starts with a super low dose of peanut flour at the same time every day, and move up to quarter portions of peanuts. They eventually eat entire peanuts with food. The amounts increase every two weeks for six months.

"Once they reach maintenance dose, they stay on that maintenance dose indefinitely," Shroba said. "Right now this is not a cure. It's a treatment to allow for safety of accidental exposures, cross contamination, experiences where there may be peanuts that they're unaware of, and if they ingest it, their reaction should not be as bad, or maybe not at all."

Norah will have to eat peanuts daily for the rest of her life to make her treatment work, but the treatment eases her mother's concerns.

"There's always that little worry in the back of your mind. Even though she's 11 and we've come this far without any big emergencies, it's still a lot of worry," McMains said. "That's why we came here."

But there are some risks involved with this type of treatment.

According to medical professionals at Children's Mercy, kids who do immunotherapy are more likely to have a reaction to their allergens than kids who avoid foods they're allergic to.

Norah and her mom

"This really is a commitment, but it's a commitment families are very happy to make," Shroba said. "The fear of anaphylaxis is great, and there's high anxiety in our food allergic kids."

"And this gives them an opportunity to be more free and to eat with their friends at the restaurant and not have to sit at the peanut free table at school. And they can go to Royals games. They can go to Chiefs games, and they don't have to worry that the person next to them is eating peanuts," Shroba said. "It's a life changer. Their quality of life improves."

Dr. Jay Portnoy, an allergist at Children's Mercy, said children who have severe peanut allergies benefit the most from the oral immunotherapy.

"Parents often ask me, 'Is my child too allergic to get the oral desensitization?" Portnoy said. "And I would say that the more allergic you are, the more this might potentially benefit you. Otherwise there's a risk of having an accidental exposure to peanut, and you'll have a severe reaction. People who have very mild reactions to peanuts may not need it as much because there's not as much risk if there is an accidental exposure."

Norah and her family weighed all the risks and benefits, and for them, it's worth it.

"The first time she ate the peanut, I was like weeping and really grateful that someone thought this is a big deal, that someone figured this out," McMains said. "So I think it's exciting."

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