May 27, 2025 • 17 mins
A few years ago, Australia earned the unenviable title of allergy capital of the world.
This could well have been true, with a World Allergy Organisation review finding Australia had the highest rate of food allergies for children under five.
But since then, something happened to turn allergy advice on its head, and parents have been introducing allergens to children at a far younger age than they used to.
So, where are we at now?
Explainer reporter Jackson Graham is here with us today to discuss whether the new strategy has worked.
To read Jackson's piece in The Age and Sydney Morning Herald, follow this link to our websites.
Subscribe to The Age & SMH: https://subscribe.smh.com.au/
See omnystudio.com/listener for privacy information.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
S1 (00:02):
From the newsrooms of the Sydney Morning Herald and The Age.
This is the morning edition. I'm Tammy Mills, filling in
for Samantha Selinger. Morris. It's Wednesday, May 28th. A few
years ago, Australia earned the unenviable title of Allergy Capital
of the world. This could well have been true with
a World Allergy Organization review finding Australia had the highest
(00:25):
rate of food allergies for children under five. But since then,
something happened to turn allergy advice on its head, and
parents have been introducing allergens to children at a far
younger age than they used to. So where are we
at now? Explainer reporter Jackson Graham is here with us
today to discuss whether the new strategy has worked. Welcome, Jackson.
S2 (00:49):
Thanks, Tammy. Really great to be here.
S1 (00:50):
Jackson. First up, can you explain what allergies are and
how you know if you actually have one?
S2 (00:55):
So if you talk to teachers, chefs and allergy specialists today,
they'll basically tell you that there's been a big rise
in allergies and intolerances in their jobs. Um, there's around
5 million people living with allergies in Australia, and up
to a third of the population is expected to experience
an allergy sometime in their lifetime. I'm one of those.
I have a tree nut allergy. I found this out
when I was four years old. I was at home
(01:18):
and I was annoying my grandmother, who was living with
us and recovering from a hip replacement. Uh, my mum
was making a nut loaf in the kitchen, and so
to distract me, she gave me a Brazil nut to
try to crack open with my hands. Um, and then
almost immediately, my fingers started swelling. Uh, there was this
really great pressure. Uh, so it was so bad, it
caused me to actually bite my fingernails, which meant that
(01:40):
I ingested a tiny fragment of the nut. Oh, right.
And from there, I started to have anaphylaxis. So coughing, wheezing,
hives breaking out all over my body. Uh, fortunately, my
parents got me to a doctor pretty quickly. Uh, and
ever since, I've basically had to avoid anything with nuts,
so I've never had an almond croissant, a Waldorf salad,
a duck, a chicken, or even something like Nutella. But
(02:03):
after all these years, I only really delved into what
makes this any different from an intolerance recently. In fact,
I actually used to work at a as a waiter,
and I remember the endless allergies that used to come
in and intolerances. Um, and I'd have to understand, ensure
people didn't eat the wrong thing.
S1 (02:18):
So what's the difference between an allergy and an intolerance?
S2 (02:21):
So remarkably, around 65% of the world's population has some
degree of intolerance to lactose. For example, there's a bit
of a crossover between allergies and intolerances. Intolerances cause allergy
like symptoms, bloating and cramps after drinking milk or a
rash from soap that irritates your skin. Uh, but in general,
the key difference between an allergy and intolerance is the
(02:41):
allergy affects the immune system. It's basically because the immune
system has learned that certain proteins in things like eggs,
cows milk, peanuts, tree nuts, shellfish, bee venom, pollen, or
even animal dander Is a threat to the immune system.
It's learned that. So antibodies called IgG become attached to
(03:03):
a person's immune cells. Uh, and basically those cells detonate almost.
It's a when when the body comes into contact with
the protein again. Um, so it sets off this sort
of chain reaction. Um, so then, yeah, the next time
the body encounters these things, it sends the immune system
into meltdown. Some people will become congested. They have itchy eyes,
(03:25):
they sneeze, they vomit, or it can be life threatening.
Setting off this kind of this reaction, which is known
as anaphylaxis, where someone's throat closes over or their cardiovascular
system shuts down. Uh, that's of course, unless they're administered
quickly with adrenaline. The difference is that the allergies have
this potential to make people extremely sick through through anaphylaxis.
S1 (03:45):
Okay. And so where does Australia sit in comparison to
the rest of the world in terms of allergy rates,
like has that actually been going up and are allergies
more common now.
S2 (03:55):
That's a great question, Tammy. So if you ask any pediatricians,
there's definitely a consensus that allergy rates have gone up
in recent decades. Um, but unfortunately, cases weren't really measured
that well before the 1990s. Um, so there certainly are
stories out there of people who suffered allergies well before then. Um, actually,
in fact, my mom was one of those she, you know,
would get hives from certain pollen as a child and maybe,
(04:17):
you know, there's some genetic basis for it. Um, which
is interesting. But yeah, we've had great studies in Australia.
In 2011, the Murdoch Children's Research Institute found that food
allergies affect about 10% of all children in Melbourne. Um,
and this particular study gave rise to the catchphrase, uh,
that you mentioned in the introduction that Australia is the
allergy capital of the world for this young age group.
(04:39):
That could well be true. You know, two years later,
the World Allergy Organization found that there was the highest
rates of food allergy, were, in fact, uh, in children
under five in Australia, followed by Finland and Canada. Yeah.
But for food allergies among anyone under the age of 18.
Britain actually topped that list and Australia ranked 11th. Um,
so I think the the data globally is is a
(05:01):
bit patchy. Um, but there certainly is a picture emerging
that that allergies are affecting a large part of the population. Uh,
and hay fever is another example. It affects something like
1 in 5 people in Australia. So look, you know,
there's a consensus among among allergists that that basically they
are seeing more and more of these cases. And I
think although the data is difficult to prove, uh, it
(05:23):
seems to be the case.
S1 (05:25):
That's kind of surprising, because I guess the image or
perception of Australia is that we're like outdoorsy people that
are hardy and wouldn't have such things such as allergies.
But what's happening in Australia, like, why do we seem
to have more children with allergies?
S2 (05:38):
Yeah, that's that's a great point, Tammy. And uh, indeed,
we're sort of seen as, you know, not being too,
you know, overly cautious about, um, you know, exposing ourselves to,
to allergens and germs and things like that. So probably
the biggest difficulty with allergies is that we don't know
exactly what causes them. Um, this this actually has a
big effect on on the whole thinking around allergies. They're
(06:01):
a bit of a challenge to know. There's certainly a
challenge to know how to prevent. So there are several
theories about what causes them. And you sort of touch
on one there. The biggest is that, um, there's something
called the hygiene hypothesis. Um, it's important to really note here, though, that,
that these are just theories, like there's probably not one, uh,
cause for allergies. Okay. And, well, to put it in
(06:23):
the language of scientists, it's what they call multifactorial. So
there's probably a range of things going on that are
causing allergies. Okay. Um, the hygiene hypothesis basically says that
that as a society, as society has industrialized more, it's
become cleaner and meaning that we're less exposed to germs
and dirt than in the past. There are even studies
showing a relationship between living on a farm or having
(06:45):
a dog at home. That suggests that these children are
less prone to allergies. Um, there's other theories that are
linked to this idea that actually zoom right into our
gut and, and suggest that within something called the microbiome,
we don't have the right mix of viruses and bacteria
that are supporting the immune system, and that might be
making us more susceptible to allergies. Other theories suggest that
(07:05):
we don't get enough vitamin D exposure. Um, maybe the
weather or our genes play a role too. Um, so
as you can see, there's there's there's all of these factors.
What I found really fascinating when I was working on
this piece is that one researcher named Professor Sheryl van
Nunen in Sydney's Northern Beaches found a tick bite was,
in fact causing, uh, cases of meat anaphylaxis among, uh,
(07:28):
sort of older, older age groups and not children. They
had all never previously had an issue when eating meat.
And basically the tick, uh, picked up a sugar molecule
called Alpha Gal, uh, which they passed on to humans
when they, when they, uh, bit the human, too. So
meat anaphylaxis cases, uh, seem to have increased when fox
(07:49):
baiting was introduced and the animals, the ticks fed off proliferated.
So this is a bit of a niche allergy. It's
a it's anaphylaxis from uh, to meat later in life.
But what's interesting is that it perhaps sums up the
challenge with with pinpointing the causes of allergies. As you
can see with this case, there's this complicated interaction between
the environment and our biology at play.
S1 (08:11):
It's surprising. Right? Because you would have thought, well, at
least like I would like to think that with all
that we know and how far ahead we are with science,
that we would be able to find a cause for allergies.
So that's super interesting. What about the age that children
are exposed to allergens? Does that have anything to do
with it?
S2 (08:27):
So around the time I was diagnosed, parents were told
not to introduce children to common allergens before three years
of age. And now ask any new parent and they're
told basically to introduce things like nut butters, cooked egg,
cow's milk to their babies from between four months and
and at least before 12 months of age. What Allergists
(08:50):
have found out in recent years is many children avoid
getting food allergies if they're introduced to the food early enough.
S1 (08:57):
Okay.
S2 (08:57):
The thought here is that it seems to prime the
immune system being introduced to the food.
S1 (09:02):
Okay.
S2 (09:02):
So the old advice wasn't helping, and maybe even it
was contributing to people getting food allergies. It's a remarkable
change to have the advice shift so dramatically, and has
been a task for health professionals to teach the public about.
S1 (09:17):
We'll be back in a minute. This is bringing up
very vivid memories for me as a new parent myself,
and having gone through the list of allergens and testing
your child, you know, at around six months or before
they're 12 months of age. So I can definitely relate.
One of the really things I found fascinating about your
piece is that you spoke to the professor who was
(09:39):
actually responsible for turning this advice. So when to introduce
children to allergies on its head? Ted. So can you
tell us a bit about what led him to this discovery?
S2 (09:49):
Yes. So his name is Gideon Lack, an allergist in London. Uh,
changing advice like this, it must be the most amazing
moment in any researcher's career. Um, it's. And it's fascinating
to learn the backstory. Um, of course, he was soaking
in the world of allergies for years. Uh, which is
worth noting, uh, which obviously helped him know what the
(10:09):
right questions were to ask. Um, but what really spurred
him along was asking pediatricians at a conference in Tel
Aviv in the early 2000 how many children they saw
with peanut allergy. Their answer was hardly any, uh, whereas
in London it would have been nearly every doctor. What
he found was many parents in Israel gave their children
a snack called Bamba, basically a corn puff dusted in
(10:32):
peanut butter. He went and tested the rates between Israel
and the UK, and then set up groups of British
children exposed to or not exposed to peanuts from an
early age, and found that exposing the children to peanuts
showed a 90% reduction in peanut allergy.
S1 (10:46):
Huge. And did this flow on to what happened in Australia.
S2 (10:50):
So in 2016 we changed the guidelines to introduce allergens
to children between four months and 12 months of age.
And the result of that is that it appears to
have slowed the rate of peanut allergies, uh, in Australia.
It hasn't stopped them or reversed them, but it has
certainly slowed their increase. The rates of hospital presentations have
(11:12):
dropped for nearly every age group are following that advice.
But they, interestingly, slightly rose for babies younger than one.
The group who the advice applies to the most.
S1 (11:23):
Okay.
S2 (11:24):
Yet even then, when she zooms in on this age group,
this group of babies who are having the allergens earlier
than they otherwise would have. The rise in presentations don't
actually equate to more admissions into those hospitals, and crucially,
it doesn't actually result in more cases of anaphylaxis.
S1 (11:40):
Okay. So it's possible that there's a reaction of some kind.
And because parents are giving babies these allergens earlier, so
then they're rushing to the hospital to make sure it's
not anaphylactic reaction.
S2 (11:52):
It's possible. You know, there could be, uh, you know,
a skin rash as a result of, uh, the food,
you know, being applied around the mouth rather than in
the mouth or little triggers that, you know, make parents
think perhaps, you know, this is, uh, a reaction, uh, but,
you know, it's not actually leading to more admissions.
S1 (12:08):
Oh, interesting. Another thing that I found fascinating in your
piece is this possible link between asthma and allergies. What's
this about?
S2 (12:15):
Okay, this is fascinating. So, Gideon Lack in London has
found children with dry or broken skin. So basically, eczema
of varying severity are more likely to develop an allergy.
I should flag here that the evidence for this is
still circumstantial rather than proven through a rigorous study. But
the thinking is that perhaps proteins from, say, peanut butter
(12:37):
get passed into the baby's skin when people touch them
or they're around the food.
S1 (12:41):
Okay.
S2 (12:42):
Maybe this leads to the immune system learning those proteins
are a threat rather than getting to know them through
the digestion process. It's an interesting theory and could be
one explanation for how food allergies come about. So of course,
the early introduction of food through small portions put into
babies mouths, as health authorities now advise, could be one
way of blocking off eczema as a possible cause or
(13:04):
pathway for allergies.
S1 (13:06):
Okay, so you're kind of saying there that it's if
a baby or a child has eczema and if a parent, say,
touches them with peanut butter or some such on their hands,
even without meaning to or like just within the throes
of daily life, which you would that possibly that could
be causing an allergic reaction. Yeah, potentially.
S2 (13:26):
Basically it's the body would be encountering that allergen for
the first time through the skin rather than through the mouth.
S1 (13:34):
That's so interesting. But the long or the short of
it is, there seems to be no solid answer for
what causes allergies, which is highly annoying, but I guess
that's humans for you. But what about cures for allergies?
Is there a cure for one?
S2 (13:48):
So there have been treatments such as antihistamine, which we've
many of us will have heard of. Uh, and that's
been around since at least the middle of last century.
And that for allergies such as hay fever and of course,
there's adrenaline for anaphylaxis. Um, but for food allergy, there
have been few actual cures in Australia at least. Uh,
so the one that has shown the most promise is
(14:11):
offered in the United States. And it's a form of immunotherapy,
oral immunotherapy, where someone is given small doses of the
food under controlled conditions over potentially months until they build
up their tolerance to it. Yeah, not everyone responds to it,
but it does seem to desensitize many people. Allergies can
(14:31):
be very sensitive to the ups and downs of the
immune system on any given day, so something like a
cold or even exercise can actually influence how severe someone's
reaction is. So that's one reason the dosages have to
be tightly controlled rather than simply administered at home. Um,
there have been families in Australia who have actually travelled
to the US to get this treatment. Uh, but fortunately
(14:52):
it is becoming increasingly available here, too. Uh, there's a
program in ten hospitals across Australia at the moment for
babies with peanut allergy. Um, it will be interesting to
see if this gets expanded to more allergens and older
ages and further hospitals. Um, I guess in the meantime,
living with analogy makes people like me at least a
little more cautious. Um, at the worst, it's it's living
(15:14):
with a lot of worry, uh, such as navigating a
trip overseas or a dinner party invitation that can feel
like walking on eggshells.
S1 (15:22):
Given the allergy that you have. What was the most
surprising thing about this piece that you've written? What did
you discover that was new and interesting to you?
S2 (15:32):
Probably that, you know, early introduction advice, um, was really
surprising to me because, yeah, obviously when I was a
baby that was never around, I would have never eaten
a nut before that day where I was handed, you know,
a Brazil nut and basically had it in my hands.
And I was four then. So the idea that, um,
babies should be sort of given these to kind of
prime their immune systems, you know, long before they even
(15:55):
reach one year of age, is a big change in advice.
S1 (15:59):
And in such a short space of time. Really?
S2 (16:01):
Yeah, exactly. And I suppose the other thing that surprised
me was just how alert you have to be to
all of the different, you know, kind of possibilities of
what could cause allergies. And it's probably as, as we
talked about doesn't have one cause. So, um, it's hard
for us to think about that. You know what? There
could be, like, multiple things working together that are that
(16:22):
are kind of causing us to become more prone to allergies.
S1 (16:28):
Well, thank you so much, Jackson, for your time. It's
been a really interesting conversation.
S2 (16:33):
Thanks, Tammy. Thanks so much for having me on.
S1 (16:34):
And for anyone wanting more information, please do check out
Jackson's explainer on our website so you can find a
link for it in our show notes. Jackson. Thanks again.
S2 (16:43):
Thanks, Tammy.
S1 (16:52):
Today's episode of The Morning Edition was produced by Josh towers.
Tom McKendrick is our head of audio. To listen to
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(17:14):
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your inbox every day. Links are in the show. Notes.
I'm Tammy Mills, this is the morning edition. Thanks for listening.
From the newsrooms of the Sydney Morning Herald and The Age.
This is the morning edition. I'm Tammy Mills, filling in
for Samantha Selinger. Morris. It's Wednesday, May 28th. A few
years ago, Australia earned the unenviable title of Allergy Capital
of the world. This could well have been true with
a World Allergy Organization review finding Australia had the highest
(00:25):
rate of food allergies for children under five. But since then,
something happened to turn allergy advice on its head, and
parents have been introducing allergens to children at a far
younger age than they used to. So where are we
at now? Explainer reporter Jackson Graham is here with us
today to discuss whether the new strategy has worked. Welcome, Jackson.
S2 (00:49):
Thanks, Tammy. Really great to be here.
S1 (00:50):
Jackson. First up, can you explain what allergies are and
how you know if you actually have one?
S2 (00:55):
So if you talk to teachers, chefs and allergy specialists today,
they'll basically tell you that there's been a big rise
in allergies and intolerances in their jobs. Um, there's around
5 million people living with allergies in Australia, and up
to a third of the population is expected to experience
an allergy sometime in their lifetime. I'm one of those.
I have a tree nut allergy. I found this out
when I was four years old. I was at home
(01:18):
and I was annoying my grandmother, who was living with
us and recovering from a hip replacement. Uh, my mum
was making a nut loaf in the kitchen, and so
to distract me, she gave me a Brazil nut to
try to crack open with my hands. Um, and then
almost immediately, my fingers started swelling. Uh, there was this
really great pressure. Uh, so it was so bad, it
caused me to actually bite my fingernails, which meant that
(01:40):
I ingested a tiny fragment of the nut. Oh, right.
And from there, I started to have anaphylaxis. So coughing, wheezing,
hives breaking out all over my body. Uh, fortunately, my
parents got me to a doctor pretty quickly. Uh, and
ever since, I've basically had to avoid anything with nuts,
so I've never had an almond croissant, a Waldorf salad,
a duck, a chicken, or even something like Nutella. But
(02:03):
after all these years, I only really delved into what
makes this any different from an intolerance recently. In fact,
I actually used to work at a as a waiter,
and I remember the endless allergies that used to come
in and intolerances. Um, and I'd have to understand, ensure
people didn't eat the wrong thing.
S1 (02:18):
So what's the difference between an allergy and an intolerance?
S2 (02:21):
So remarkably, around 65% of the world's population has some
degree of intolerance to lactose. For example, there's a bit
of a crossover between allergies and intolerances. Intolerances cause allergy
like symptoms, bloating and cramps after drinking milk or a
rash from soap that irritates your skin. Uh, but in general,
the key difference between an allergy and intolerance is the
(02:41):
allergy affects the immune system. It's basically because the immune
system has learned that certain proteins in things like eggs,
cows milk, peanuts, tree nuts, shellfish, bee venom, pollen, or
even animal dander Is a threat to the immune system.
It's learned that. So antibodies called IgG become attached to
(03:03):
a person's immune cells. Uh, and basically those cells detonate almost.
It's a when when the body comes into contact with
the protein again. Um, so it sets off this sort
of chain reaction. Um, so then, yeah, the next time
the body encounters these things, it sends the immune system
into meltdown. Some people will become congested. They have itchy eyes,
(03:25):
they sneeze, they vomit, or it can be life threatening.
Setting off this kind of this reaction, which is known
as anaphylaxis, where someone's throat closes over or their cardiovascular
system shuts down. Uh, that's of course, unless they're administered
quickly with adrenaline. The difference is that the allergies have
this potential to make people extremely sick through through anaphylaxis.
S1 (03:45):
Okay. And so where does Australia sit in comparison to
the rest of the world in terms of allergy rates,
like has that actually been going up and are allergies
more common now.
S2 (03:55):
That's a great question, Tammy. So if you ask any pediatricians,
there's definitely a consensus that allergy rates have gone up
in recent decades. Um, but unfortunately, cases weren't really measured
that well before the 1990s. Um, so there certainly are
stories out there of people who suffered allergies well before then. Um, actually,
in fact, my mom was one of those she, you know,
would get hives from certain pollen as a child and maybe,
(04:17):
you know, there's some genetic basis for it. Um, which
is interesting. But yeah, we've had great studies in Australia.
In 2011, the Murdoch Children's Research Institute found that food
allergies affect about 10% of all children in Melbourne. Um,
and this particular study gave rise to the catchphrase, uh,
that you mentioned in the introduction that Australia is the
allergy capital of the world for this young age group.
(04:39):
That could well be true. You know, two years later,
the World Allergy Organization found that there was the highest
rates of food allergy, were, in fact, uh, in children
under five in Australia, followed by Finland and Canada. Yeah.
But for food allergies among anyone under the age of 18.
Britain actually topped that list and Australia ranked 11th. Um,
so I think the the data globally is is a
(05:01):
bit patchy. Um, but there certainly is a picture emerging
that that allergies are affecting a large part of the population. Uh,
and hay fever is another example. It affects something like
1 in 5 people in Australia. So look, you know,
there's a consensus among among allergists that that basically they
are seeing more and more of these cases. And I
think although the data is difficult to prove, uh, it
(05:23):
seems to be the case.
S1 (05:25):
That's kind of surprising, because I guess the image or
perception of Australia is that we're like outdoorsy people that
are hardy and wouldn't have such things such as allergies.
But what's happening in Australia, like, why do we seem
to have more children with allergies?
S2 (05:38):
Yeah, that's that's a great point, Tammy. And uh, indeed,
we're sort of seen as, you know, not being too,
you know, overly cautious about, um, you know, exposing ourselves to,
to allergens and germs and things like that. So probably
the biggest difficulty with allergies is that we don't know
exactly what causes them. Um, this this actually has a
big effect on on the whole thinking around allergies. They're
(06:01):
a bit of a challenge to know. There's certainly a
challenge to know how to prevent. So there are several
theories about what causes them. And you sort of touch
on one there. The biggest is that, um, there's something
called the hygiene hypothesis. Um, it's important to really note here, though, that,
that these are just theories, like there's probably not one, uh,
cause for allergies. Okay. And, well, to put it in
(06:23):
the language of scientists, it's what they call multifactorial. So
there's probably a range of things going on that are
causing allergies. Okay. Um, the hygiene hypothesis basically says that
that as a society, as society has industrialized more, it's
become cleaner and meaning that we're less exposed to germs
and dirt than in the past. There are even studies
showing a relationship between living on a farm or having
(06:45):
a dog at home. That suggests that these children are
less prone to allergies. Um, there's other theories that are
linked to this idea that actually zoom right into our
gut and, and suggest that within something called the microbiome,
we don't have the right mix of viruses and bacteria
that are supporting the immune system, and that might be
making us more susceptible to allergies. Other theories suggest that
(07:05):
we don't get enough vitamin D exposure. Um, maybe the
weather or our genes play a role too. Um, so
as you can see, there's there's there's all of these factors.
What I found really fascinating when I was working on
this piece is that one researcher named Professor Sheryl van
Nunen in Sydney's Northern Beaches found a tick bite was,
in fact causing, uh, cases of meat anaphylaxis among, uh,
(07:28):
sort of older, older age groups and not children. They
had all never previously had an issue when eating meat.
And basically the tick, uh, picked up a sugar molecule
called Alpha Gal, uh, which they passed on to humans
when they, when they, uh, bit the human, too. So
meat anaphylaxis cases, uh, seem to have increased when fox
(07:49):
baiting was introduced and the animals, the ticks fed off proliferated.
So this is a bit of a niche allergy. It's
a it's anaphylaxis from uh, to meat later in life.
But what's interesting is that it perhaps sums up the
challenge with with pinpointing the causes of allergies. As you
can see with this case, there's this complicated interaction between
the environment and our biology at play.
S1 (08:11):
It's surprising. Right? Because you would have thought, well, at
least like I would like to think that with all
that we know and how far ahead we are with science,
that we would be able to find a cause for allergies.
So that's super interesting. What about the age that children
are exposed to allergens? Does that have anything to do
with it?
S2 (08:27):
So around the time I was diagnosed, parents were told
not to introduce children to common allergens before three years
of age. And now ask any new parent and they're
told basically to introduce things like nut butters, cooked egg,
cow's milk to their babies from between four months and
and at least before 12 months of age. What Allergists
(08:50):
have found out in recent years is many children avoid
getting food allergies if they're introduced to the food early enough.
S1 (08:57):
Okay.
S2 (08:57):
The thought here is that it seems to prime the
immune system being introduced to the food.
S1 (09:02):
Okay.
S2 (09:02):
So the old advice wasn't helping, and maybe even it
was contributing to people getting food allergies. It's a remarkable
change to have the advice shift so dramatically, and has
been a task for health professionals to teach the public about.
S1 (09:17):
We'll be back in a minute. This is bringing up
very vivid memories for me as a new parent myself,
and having gone through the list of allergens and testing
your child, you know, at around six months or before
they're 12 months of age. So I can definitely relate.
One of the really things I found fascinating about your
piece is that you spoke to the professor who was
(09:39):
actually responsible for turning this advice. So when to introduce
children to allergies on its head? Ted. So can you
tell us a bit about what led him to this discovery?
S2 (09:49):
Yes. So his name is Gideon Lack, an allergist in London. Uh,
changing advice like this, it must be the most amazing
moment in any researcher's career. Um, it's. And it's fascinating
to learn the backstory. Um, of course, he was soaking
in the world of allergies for years. Uh, which is
worth noting, uh, which obviously helped him know what the
(10:09):
right questions were to ask. Um, but what really spurred
him along was asking pediatricians at a conference in Tel
Aviv in the early 2000 how many children they saw
with peanut allergy. Their answer was hardly any, uh, whereas
in London it would have been nearly every doctor. What
he found was many parents in Israel gave their children
a snack called Bamba, basically a corn puff dusted in
(10:32):
peanut butter. He went and tested the rates between Israel
and the UK, and then set up groups of British
children exposed to or not exposed to peanuts from an
early age, and found that exposing the children to peanuts
showed a 90% reduction in peanut allergy.
S1 (10:46):
Huge. And did this flow on to what happened in Australia.
S2 (10:50):
So in 2016 we changed the guidelines to introduce allergens
to children between four months and 12 months of age.
And the result of that is that it appears to
have slowed the rate of peanut allergies, uh, in Australia.
It hasn't stopped them or reversed them, but it has
certainly slowed their increase. The rates of hospital presentations have
(11:12):
dropped for nearly every age group are following that advice.
But they, interestingly, slightly rose for babies younger than one.
The group who the advice applies to the most.
S1 (11:23):
Okay.
S2 (11:24):
Yet even then, when she zooms in on this age group,
this group of babies who are having the allergens earlier
than they otherwise would have. The rise in presentations don't
actually equate to more admissions into those hospitals, and crucially,
it doesn't actually result in more cases of anaphylaxis.
S1 (11:40):
Okay. So it's possible that there's a reaction of some kind.
And because parents are giving babies these allergens earlier, so
then they're rushing to the hospital to make sure it's
not anaphylactic reaction.
S2 (11:52):
It's possible. You know, there could be, uh, you know,
a skin rash as a result of, uh, the food,
you know, being applied around the mouth rather than in
the mouth or little triggers that, you know, make parents
think perhaps, you know, this is, uh, a reaction, uh, but,
you know, it's not actually leading to more admissions.
S1 (12:08):
Oh, interesting. Another thing that I found fascinating in your
piece is this possible link between asthma and allergies. What's
this about?
S2 (12:15):
Okay, this is fascinating. So, Gideon Lack in London has
found children with dry or broken skin. So basically, eczema
of varying severity are more likely to develop an allergy.
I should flag here that the evidence for this is
still circumstantial rather than proven through a rigorous study. But
the thinking is that perhaps proteins from, say, peanut butter
(12:37):
get passed into the baby's skin when people touch them
or they're around the food.
S1 (12:41):
Okay.
S2 (12:42):
Maybe this leads to the immune system learning those proteins
are a threat rather than getting to know them through
the digestion process. It's an interesting theory and could be
one explanation for how food allergies come about. So of course,
the early introduction of food through small portions put into
babies mouths, as health authorities now advise, could be one
way of blocking off eczema as a possible cause or
(13:04):
pathway for allergies.
S1 (13:06):
Okay, so you're kind of saying there that it's if
a baby or a child has eczema and if a parent, say,
touches them with peanut butter or some such on their hands,
even without meaning to or like just within the throes
of daily life, which you would that possibly that could
be causing an allergic reaction. Yeah, potentially.
S2 (13:26):
Basically it's the body would be encountering that allergen for
the first time through the skin rather than through the mouth.
S1 (13:34):
That's so interesting. But the long or the short of
it is, there seems to be no solid answer for
what causes allergies, which is highly annoying, but I guess
that's humans for you. But what about cures for allergies?
Is there a cure for one?
S2 (13:48):
So there have been treatments such as antihistamine, which we've
many of us will have heard of. Uh, and that's
been around since at least the middle of last century.
And that for allergies such as hay fever and of course,
there's adrenaline for anaphylaxis. Um, but for food allergy, there
have been few actual cures in Australia at least. Uh,
so the one that has shown the most promise is
(14:11):
offered in the United States. And it's a form of immunotherapy,
oral immunotherapy, where someone is given small doses of the
food under controlled conditions over potentially months until they build
up their tolerance to it. Yeah, not everyone responds to it,
but it does seem to desensitize many people. Allergies can
(14:31):
be very sensitive to the ups and downs of the
immune system on any given day, so something like a
cold or even exercise can actually influence how severe someone's
reaction is. So that's one reason the dosages have to
be tightly controlled rather than simply administered at home. Um,
there have been families in Australia who have actually travelled
to the US to get this treatment. Uh, but fortunately
(14:52):
it is becoming increasingly available here, too. Uh, there's a
program in ten hospitals across Australia at the moment for
babies with peanut allergy. Um, it will be interesting to
see if this gets expanded to more allergens and older
ages and further hospitals. Um, I guess in the meantime,
living with analogy makes people like me at least a
little more cautious. Um, at the worst, it's it's living
(15:14):
with a lot of worry, uh, such as navigating a
trip overseas or a dinner party invitation that can feel
like walking on eggshells.
S1 (15:22):
Given the allergy that you have. What was the most
surprising thing about this piece that you've written? What did
you discover that was new and interesting to you?
S2 (15:32):
Probably that, you know, early introduction advice, um, was really
surprising to me because, yeah, obviously when I was a
baby that was never around, I would have never eaten
a nut before that day where I was handed, you know,
a Brazil nut and basically had it in my hands.
And I was four then. So the idea that, um,
babies should be sort of given these to kind of
prime their immune systems, you know, long before they even
(15:55):
reach one year of age, is a big change in advice.
S1 (15:59):
And in such a short space of time. Really?
S2 (16:01):
Yeah, exactly. And I suppose the other thing that surprised
me was just how alert you have to be to
all of the different, you know, kind of possibilities of
what could cause allergies. And it's probably as, as we
talked about doesn't have one cause. So, um, it's hard
for us to think about that. You know what? There
could be, like, multiple things working together that are that
(16:22):
are kind of causing us to become more prone to allergies.
S1 (16:28):
Well, thank you so much, Jackson, for your time. It's
been a really interesting conversation.
S2 (16:33):
Thanks, Tammy. Thanks so much for having me on.
S1 (16:34):
And for anyone wanting more information, please do check out
Jackson's explainer on our website so you can find a
link for it in our show notes. Jackson. Thanks again.
S2 (16:43):
Thanks, Tammy.
S1 (16:52):
Today's episode of The Morning Edition was produced by Josh towers.
Tom McKendrick is our head of audio. To listen to
episodes of The Morning Edition as soon as they drop,
follow us on Apple, Spotify, or wherever you listen to
your podcasts and to support our journalism, subscribe to us
by visiting The Age or smh.com.au. Subscribe and sign up
(17:14):
for our Morning Edition newsletter to receive a comprehensive summary
of the day's most important news, analysis and insights in
your inbox every day. Links are in the show. Notes.
I'm Tammy Mills, this is the morning edition. Thanks for listening.
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