A decade after a pivotal study demonstrated that introducing peanut products to infants could prevent serious allergies, new research reveals that this approach has had a significant impact in practice. Approximately 60,000 children have avoided developing peanut allergies since guidelines were first released in 2015, recommending that the allergen be introduced to infants as early as four months of age.
Dr. David Hill, an allergist and researcher at Children”s Hospital of Philadelphia, expressed the importance of this finding, stating, “That”s a remarkable thing, right?” His team conducted an analysis of electronic health records from numerous pediatric practices to monitor food allergy diagnoses in children before, during, and after the guidelines were established. “I can actually come to you today and say there are less kids with food allergy today than there would have been if we hadn”t implemented this public health effort,” he added.
The study indicated that the incidence of peanut allergies among children aged 0 to 3 years decreased by over 27% following the initial guidelines in 2015, and by more than 40% after the recommendations were broadened in 2017. However, this initiative has not yet reversed the overall rise in food allergies observed in the United States in recent years, where about 8% of children are affected, including over 2% with peanut allergies.
Peanut allergies occur when the immune system incorrectly identifies proteins in peanuts as harmful substances, leading to allergic reactions such as hives, respiratory issues, and potentially severe anaphylaxis. For many years, medical professionals advised delaying the introduction of peanuts and other common allergens until children reached the age of three.
The breakthrough came in 2015 when Gideon Lack from King”s College London published the influential Learning Early About Peanut Allergy (LEAP) trial, which demonstrated that early introduction of peanut products in infancy could reduce the risk of developing food allergies by over 80%. Subsequent analyses revealed that this protective effect persisted in about 70% of children into their teenage years.
Despite the compelling evidence, the adoption of these new guidelines has been gradual. Surveys indicated that only around 29% of pediatricians and 65% of allergists adhered to the expanded recommendations issued in 2017. A commentary accompanying the study noted that confusion surrounding the optimal timing and method for introducing peanuts contributed to this delay.
The data analyzed in this study came from a specific subset of participating pediatric practices, which may not fully represent the entire pediatric population in the United States, according to Dr. Ruchi Gupta, a child allergy specialist at Northwestern University. Nevertheless, the research offers “promising evidence that early allergen introduction is not only being adopted but may be making a measurable impact,” the authors concluded.
Advocates for the approximately 33 million individuals in the U.S. with food allergies welcomed the findings, emphasizing the potential to reduce the incidence and prevalence of peanut allergies nationwide. Sung Poblete, CEO of the nonprofit organization Food Allergy Research & Education (FARE), remarked, “This research reinforces what we already know and underscores a meaningful opportunity to reduce the incidence and prevalence of peanut allergy nationwide.”
The study highlights the current guidelines, which were updated in 2021, recommending the introduction of peanuts and other major allergens between four and six months of age without the necessity for prior screening or testing. Parents are encouraged to consult their pediatricians with any questions regarding the introduction of these foods.
Dr. Hill suggested that introducing small amounts of peanut butter, milk-based yogurt, soy-based yogurts, and tree nut butters can be effective ways to safely expose a child”s immune system to these allergenic foods.
Tiffany Leon, a registered dietician from Maryland and director at FARE, shared her experience of introducing peanuts and other allergens early to her sons, James and Cameron. Initially, her mother was taken aback by the advice to feed such foods to children under the age of three, but Leon explained the evolution of scientific understanding in this area. “As a dietician, I practice evidence-based recommendations,” she stated. “So when someone told me, “This is how it”s done now, these are the new guidelines,” I just thought, OK, well, this is what we”re going to do.”
