Peanuts and Choking

Dr. Tamara Willoughby

Recently, the lay press reported a promising breakthrough in decreasing the frequency of peanut allergies in children at high risk for peanut allergy by early introduction of peanuts. (1)  In the study “peanuts” were introduced to infants between the ages of 4 and 11 months. (1)  The research shows promise to combat the increasing prevalence of peanut allergy in Western countries. (1) Although, not discussed in news reports, the peanut product given to infants in the study was not whole peanuts.  Infants were given “Bamba,” a peanut butter flavored puffed maize product. (1) Some news reports, although not all, discussed that early introduction of peanuts should be done under a physician’s care. The general public should also be reminded about the choking risk of peanuts especially in children 3 and under and that babies in this study were not given whole peanuts.   Choking is a leading cause of mortality and morbidity in children 3 and under with food, toys and coins most often the culprits. (2) Small children are vulnerable to choking in many ways.  A child’s airway occludes easily with small objects because of the small diameter of the airway and young children often can’t cough with enough force to dislodge a foreign body. (2) Additionally until molars erupt, children are unable to sufficiently chew food into smaller portions adequate for swallowing. (2) Finally, even though children at age 3 to 4 have molars, they are still learning to chew and are easily distracted which can lead to choking. (2) Approximately 1 child every 5 days in the United States dies from choking on food. (2) High risk foods for choking include hot dogs, hard candy, peanuts, nuts and seeds, whole grapes, raw carrots, apples,  popcorn, marshmallows, chewing gum and globs of peanut butter. (2)  In conclusion,  lets take this opportunity to educate the public regarding choking risks in children along with enthusiasm for promising  research on peanut allergy prevention. read more

Kids are smoking again…and a social media battle boils over whether e-cigarettes are a solution or a new path to an old problem.

Chair Michael H. Greenwald, MD

After years of steady decline in smoking among young people, we are now seeing a significant rise in the use of e-cigarettes or “vaping.” In December the AAP, AAFP, ACP, and ACOG joined the AMA in issuing a public statement of support for a Surgeon General report highlighting the increased use and dangers of e-cigarettes in young people.  At the same time there is a widespread counter message seen in advertisements and social media claiming the benefits of e-cigarettes and attacking the efforts of the CDC, Surgeon General and FDA.  All physicians should become educated about the issues and be prepared to discuss them with their patients.  What are the facts? read more