Chelmsford, MA  North Andover, MA Nashua, NH
978-256-4531 978-689-8890 603-881-7433



The offices will be closed on Monday May 30


for Memorial Day.




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Introduction of Peanuts to Infants

Interim Guidance from expert panel regarding early peanut introduction- (LEAP) study

There is now scientific evidence (Level 1 evidence from a randomized controlled trial) that health care providers should recommend introducing peanut-containing products into the diets of “high-risk” infants early on in life (between 4 and 11 months of age) in countries where peanut allergy is prevalent because delaying the introduction of peanut can be associated with an increased risk of peanut allergy.




Infants with early-onset atopic disease, such as severe eczema, or egg allergy in the first 4 to 6 months of life might benefit from evaluation by an allergist or physician trained in management of allergic diseases in this age group to diagnose any food allergy and assist in implementing these suggestions regarding the appropriateness of early peanut introduction. Evaluation of such patients might consist of performing peanut skin testing, in-office observed peanut ingestion, or both, as deemed appropriate after discussion with the family. The clinician can perform an observed peanut challenge for those with evidence of a positive peanut skin test response to determine whether they are clinically reactive before initiating at-home peanut introduction. Both strategies were used in the LEAP study protocol.






Meet Our Doctors

Julian Melamed, MD, ABIM, ABAI

Angela Ahuja Malik MD, ABPD, ABAI

Li Liang, MD, PhD, ABAI

Ami Mehra, MD, ABIM, ABAI


Our allergists are board certified in pediatric and adult Allergy and Immunology, and have trained at some of the top training programs in the country, including Harvard Medical School, National Jewish Respiratory Center and Albert Einstein Medical College.  We participate in the Maintenance of Certification Program. Click here to read more about this program. Dr. Melamed and Liang have both been awarded the prestigious Top Doctor Awards for 2011.





The Dangerous Season for Patients with Food Allergy



For parents of kids with food allergic kids holiday treats-from candy to cookies are frightening.  Common allergens such as peanuts, tree nuts, milk and egg are often ingredients in many treats. Some kids may experience a rash or red, itchy skin, vomiting, a stuffy, itchy nose, or diarrhea or stomach cramps if they eat a food to which they are allergic. For children who are severely allergic, a single bite of these foods may cause a life-threatening reaction termed anaphylaxis.


The danger however continues through the holiday season while visiting family over Thanksgiving, Christmas, Hanukah and New Year where many allergenic foods are ingested from tree nuts to foods that may not have been introduced into the child's diet.


Even scarier is a recent study from Mt. Sinai where milk, egg and peanut content from major and minor manufacturers were examined in foods that were labeled as "may contain" or no allergen declared.  There were a number of products that tested positive for these allergens especially milk and egg even though no allergen was declared. Peanut content was less of an issue in this situation.   To read the full article click here.