Dr. David Erstein

Dr. David Erstein

 

Letter from the Doctor 

While seeing infants and their parents at my allergy practice, discussions always cover newborns and first foods. Some parents are more anxious than others, but a universal theme is always "How best can I introduce peanuts to my baby?”

Why the fuss about peanuts?  Peanut allergy has increased over 21% since 2010!*

In 2008 allergists were beginning to realize that we were wrong with the WHEN regarding first time peanut introduction for children. As the years and research progressed, we were confident that the increasing amount of peanut allergy was due to prior recommendations to delay peanut introduction. 

The initial concept for Hello, Peanut! occurred to me while sitting at a food allergy symposium in New York City, held at Mount Sinai’s Jaffe Center, in late 2014.  During a riveting food allergy lecture emphasizing that medical professionals needed to start amending our recommendations asap and promote early peanut introduction– I had a light bulb moment you hear people talk about.

With early infant peanut introduction, we now know the WHY and the WHEN… but we need to provide parents with the best HOW.

The WHY and the WHEN:

The American Academy of Pediatrics recommend that when it comes to peanuts, the earlier an infant is introduced, the less likely they are to develop a peanut allergy (LINK).  This works for high risk infants (those with severe eczema and egg allergy) although to ensure safety they must first be evaluated by their pediatrician and/or allergist to be cleared for peanut introduction (LEAP Study). Importantly, there are other studies that say early introduction can also help with the general population of infants (EAT Study)

The Best HOW:

Hello, Peanut! makes sense to allergists, pediatricians and parents. 

Safe, Convenient, Guided and Gradual

Our gradual system for peanut introduction was developed for a reason and is based on first-hand experience as an allergist. The introduction takes place over 7 consecutive days and with every day, the amount of peanut in each packet increases (see FAQs for more information). 

 

Questions many parents ask:

Can early introduction work for other foods?

Research has only shown a modest improvement with egg introduction.  Research regarding early introduction of the other common food allergens (wheat, soy, seafood, sesame) are not showing conclusive improvements in reducing food allergy (EAT study).  Can you do it? Yes.  Will it help? We don’t know. 

Can I introduce other foods when I introduce peanuts? 

Health professionals typically recommend that when introducing new foods - one single food at a time over the course of a few days is best.  

As an allergist, when consulting with someone who may have had a food allergy reaction, it’s much easier to pinpoint a triggering food when the meal is less of a mix of things.

Do we know how much will help my infant?

Medical professionals are confident only when it comes to peanut protein.  As little as 2 grams per week to as much as 6 grams of peanut protein per week can help prevent a peanut allergy from developing.

Background:

I received my medical degree in 2006 from SUNY Downstate, New York and continued medical training for residency, research fellowship and clinical fellowship in Allergy & Immunology.  I went into the field of allergy because I am an allergy sufferer as well and relating to my patients makes my work that much easier and rewarding.  Through my experience, I developed not only a love of treating allergies but a passion for prevention.

 

Truly,

Dr. David Erstein