Dr. Scott Sicherer, professor at Mount Sinai Hospital and co-author of the study said the study may serve as a wake-up call for some who care for food-allergic children.
"The bottom line is that you have to maintain a high level of vigilance," he said. "That applies to the parents, but also to other people taking care of the child: grandparents, siblings, babysitters, teachers. Basically everyone who is around the child needs to know about the allergy and understand what to do to keep the child safe."
There have been changes in recent years that safeguard against the threat of food allergy complications. Food allergy advocacy groups have been at the fore, urging airlines to stop serving peanuts on planes and discouraging mothers from bringing peanut butter and jelly sandwiches to the soccer field. Familiarity among caregivers with the sole medication known to save a person from life-threatening anaphylaxis -- epinephrine, otherwise known as an EpiPen -- has grown. Awareness has grown to the extent that some parents, out of fear their child may have food allergies, will give them peanut butter for the first time in hospital parking lots.
"In the scheme of the things, it's a partnership between parents and health professionals," said Dr. Clifford Bassett of New York University's School of Medicine. "If parents want to reintroduce foods, they should make a plan with a food allergy expert. Some patients will need a food challenge in the office in a supervised environment, and some can trial foods at home. It's all about education, collaboration, and preparedness."
As for Goldenberg's son Jacob, he likely won't be trying pecan pie or walnut brownies anytime soon. His family runs a completely nut-free household, and they have only allowed him to eat in similarly safe environments.
Until now. Jacob is currently away from home at a conference for gifted children.
"It's the first time I've let him out of a secured zone," his mother said. "But I think at age 10, you need to let that happen. Given his age and preparedness, you have to trust that you've done everything you can to prepare your child to function well in the world."