Peanut Allergy Clinic


Please Find below our most frequently answered questions! If you do have a question for which you cannot find an answer, please do reach out, as we’re more than happy to help with any questions or queries!

General FAQ's

Yes we recommend you have access to a full first-aid kit whilst you are taking peanut immunotherapy.  Apart from the treatment your child will otherwise need to continue to avoid peanut and to carry adrenaline as normal.

The immunotherapy starts working as soon as you take it. There is a gradual desensitisation that allows the person to take increased doses of peanut every few weeks until they reach a maintenance of 300 mg which is the equivalent of 1 peanut.

You will see that it is working as your child will be able to tolerate increasing doses of treatment until they are on maintenance. At the end of a year of treatment we will switch your child over to taking peanut protein instead. We do not do food challenges at the end of treatment. Switching over to dietary peanut gives us enough information for your child and you will be able to see that they can manage peanut M&M’s without reaction.

Peanut immunotherapy can be used in children aged 4-17. As long as we start treatment before your child’s 18th birthday we can continue with the treatment when they are 18 and older.

You will be seen by a doctor or nurse from our clinic who will see how you have been getting on with the treatment over the last couple of weeks. If all is well you will have an observed dose of your next treatment dose in clinic and then wait for an hour afterwards. Many people bring something to do during that time such as homework, reading or perhaps a gaming tablet.

About half of children will have some mild symptoms when taking immunotherapy. Common side effects include tummy ache, which often settles once they get used to the new dose. Allergic reactions to treatment can occur. These are normally mild. Anaphylaxis is possible but occurs rarely. Even more rare is inflammation of the food pipe which if persistent we may lead to someone stopping treatment.

Anaphylaxis is possible but occurs rarely. Even more rare is inflammation of the food pipe (eosinophilic oesophagitis) which if persistent may lead to someone stopping treatment.

Most other medications are compatible with the peanut immunotherapy. Your clinic doctor will keep an eye on other treatments to ensure that it is safe to continue.

Peanut immunotherapy is a treatment for peanut allergy. It does not have any effect on other food allergies such as tree nut allergies like cashew. It also does not impact on airborne allergies like grass pollen hay fever. This does not mean that just because there are other food allergies that peanut immunotherapy is not helpful. We have treated many children who have multiple food allergies where peanut allergy has been of most concern to the family. It continues to have a really important impact on quality of life in children with multiple food allergies.

Children taking peanut immunotherapy should continue to avoid peanut in their diet. Children who avoid foods labelled “may contain traces of peanut” (this is known as precautionary advice labelling or PAL) will be able to relax their avoidance of these foods once maintenance treatment dosing has been achieved but other forms of peanut should still be avoided.

At the end of a year’s treatment we will switch over to taking dietary peanut instead. This is a fixed dose of peanut protein to replace your prescribed treatment. This in itself is what we would call a real world challenge as it shows you that real peanut containing foods can be tolerated in small amounts. We do not undertake a formal food challenge. Allergy tests do not predict the severity or probability of reaction in this situation and are not good markers for response to therapy.

Immunotherapy FAQ's

Immunotherapy can be considered for all children with an IgE mediated food allergy and there are very few children who cannot undertake treatment. If a child has asthma which is not controlled then we will need to improve this before treatment can commence. Additionally, if a child has Eosinophilic Oesophagitis, then immunotherapy is not likely to be suitable. Dr Helen and Dr Mich will make a careful assessment in clinic and confirm that your child is likely to benefit and be safe with treatment.

The treatment comes as a capsule which contains peanut protein. The capsules are carefully opened and mixed with a cold pudding like a yoghurt or custard. Children are initially started on a very small amount of peanut protein which is given in a supervised clinic environment. Our clinics are always well staffed, and we have highly qualified staff available to monitor your child at all times. Once your child has tolerated their first ‘dose’ in clinic, they go home and continue to have this dose daily for 2 weeks. We then see you all in clinic again after 2 weeks to give the next dose up.

Our treatment programme is for 2 years. Children will visit us at Southampton Children’s Hospital every 2 weeks for the first 6 months. After this, children will visit every 3 months for the next 6 months. After the first year, children are swapped from the licenced medication to peanut M&Ms and follow ups are done virtually for another year. It is important to understand that we recommend peanuts are kept in the diet daily even at the end of our two-year programme to ensure that tolerance is maintained.

By the end of the treatment programme individuals are able to tolerate 300mg peanuts -this equate to one to two peanuts. After the first year on the licensed medication we will transfer your child to peanut M&Ms to keep costs down. They will safely be able to eat two peanuts a day but many individuals in the study were able to have much higher amounts of peanut than this without a reaction.

Undertaking immunotherapy is a commitment which the whole family needs to be on board with as there are frequent appointments for the first six months. However, we all recognise that life needs to continue despite active treatment and therefore, many of our families will still go on holiday during the treatment programme and we can make arrangements with you for treatment to continue.

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