Sam Dean | The Roanoke Times

Justin Barnard's ability to eat small amounts of peanut products has "taken a huge bit of stress off us," said his mother, Melissa Barnard. "It's really given him a lot more freedom."

Justin Barnard eats his daily snack — a peanut butter egg — as part of a peanut allergy treatment program.

Right at 2:30 p.m., 6-year-old Justin Barnard got his daily dose of medicine -- a Reese's Peanut Butter Egg.

Blond and blue-eyed, with temporary "Star Wars" tattoos stamped on his arms, Justin munched the chocolatey treat slowly at a counter in the kitchen of his family's Botetourt County home. He wasn't savoring the candy, however. He nibbled almost grudgingly because he doesn't care that much for peanut butter. He's allergic to peanuts.

At least, he was allergic to peanuts.

Now, thanks to an immunology therapy program at Duke University, Justin can eat a few peanuts or a little peanut butter without the fear of his throat closing up. That's a big relief for his mother, Melissa Barnard.

"It's taken a huge bit of stress off us," she said. "For Justin, it took a huge bit of stress off him. It's really given him a lot more freedom."

For families who have children with food allergies, parents are often living in fear of the worst. Common allergic reactions to peanuts include hives and coughing, but some children experience anaphylaxis, a swelling of the throat and tongue that restricts breathing.

Even as Justin showed progress during the program, eventually eating as many as 15 peanuts in a controlled environment without experiencing a reaction, his mother still could not watch one pivotal test when Justin ate a peanut butter and jelly sandwich. She left the room as Justin ate the sandwich with his dad, Randy.

"It's like watching your child eat poison," she said.

Better than alternative

Kimberly Carter, another Botetourt County mom, had no qualms about enrolling her 5-year-old daughter Hanna in the program, especially after watching her little girl experience a serious peanut allergy reaction that landed her in the emergency room at age 2.

"After I saw my daughter have an anaphylactic reaction," Carter said, "and after I saw how cautious they were at Duke, the alternative to feeding her part of a peanut in a controlled environment [in the study] was far worse."

Indeed, Dr. Wesley Burks, one the study's lead physicians, said nervous parents soon got used to the idea of exposing their children to peanut products.

"After the treatment gets started the families and children adjust fairly rapidly to the daily ingestion," Burks wrote in an e-mailed response to questions about the study.

Both Justin and Hanna have shown considerably increased tolerance to peanut products and some other participants have been able to incorporate peanuts into their diet.

The program's success made national news in March when its doctors released a study at a meeting of the American Academy of Allergy, Asthma & Immunology. Justin is one of the first children to complete the program and his story was reported in USA Today and in a West Coast broadcast of "The Early Show" on CBS.

Now, as part of his continued treatment, Justin eats a few peanuts or a peanut butter snack daily to keep his tolerance levels up. The program seems to be working. He has not had an allergic reaction to peanuts in almost four years.

"I tell people he's not allergic to peanuts anymore," Melissa Barnard said. "I wouldn't say he's cured necessarily. It's almost like it's medicine and he has to take it every day."

Buildup is gradual

Justin, who is finishing up kindergarten at Breckinridge Elementary School in Fincastle, participated in the Duke program for nearly three years, from March 2005 to January 2008.

Justin's therapy started with tiny amounts of peanut flour, consisting of as little as 1/100th of a peanut in some cases, in an effort to increase his body's tolerance of peanuts.

He experienced a severe reaction during his first day from ingesting a trace amount of peanut flour, but doctors treated him immediately with the hormone epinephrine, better known as adrenaline, which stops anaphylaxis.

Melissa Barnard learned about the Duke study through Internet research. After Justin was accepted into the program, the Barnards made the 3-hour trek to Durham, N.C., every two weeks as Justin continued his therapy.

Gradually, doctors increased his dose until blood tests showed his reactions were lessening in severity. After one year, he could eat the equivalent of four to six peanuts.

"There were times where we thought, 'This is never going to work,' " said Melissa Barnard. "It weighed on us. 'We've been in this forever.' But we realized we hadn't done it for nothing."

A sense of relief

The Barnards are at least cured of their fear of peanuts.

Justin is no longer frightened at the mere sight of a peanut butter sandwich in a classmate's lunch box or concerned that he might accidentally eat something containing peanuts, which he knew could cause him to break out in hives, experience breathing problems or have an even worse allergic reaction.

Melissa Barnard is also back at work part time. She was so concerned about her son's allergy, she resigned from her teaching position at Greenfield Elementary to stay home with him so she could make sure Justin wasn't exposed to peanuts. He never enrolled in a day care program.

But when it came time for school, the Barnards were confident Justin would be looked after well because his Breckinridge teacher, Stephanie Williamson, has a daughter with a peanut allergy.

"That gave us a lot of comfort, having her for a teacher," Melissa Barnard said.

Barnard now works for the Fincastle Chamber of Commerce, but she still keeps EpiPens, which inject epinephrine, at home, just in case Justin ever has an anaphylactic reaction.

Now he eats peanuts every day, although he still doesn't care for their taste.

"Not too much," he said as he slowly finished his peanut butter egg. It's a bit ironic that Justin can eat a peanut butter egg, because he is allergic to real eggs. He is enrolled in another Duke study to deal with that allergy.

The Duke peanut allergy study is not being hailed as a cure, but it presents a possible breakthrough for nearly 2 million Americans who have peanut allergies.

Hanna recently completed the Duke study and now enjoys Reese's Pieces as part of her continuing therapy.

"Our goal at the beginning was to send her to kindergarten and not worry about the risk of peanut reaction," Kimberly Carter said. "And we are definitely there."