Study finds guidance on introducing peanuts to children early in life helped 60,000 children avoid allergies
A decade after a landmark study proved that feeding peanut products to young children could prevent the development of life-threatening allergies, new research shows the change has made a big difference in the real world.
Nearly 60,000 babies have survived peanut allergies, leading to a change in medical practice after guidance first issued in 2015 recommended that caregivers introduce allergens to infants as early as four months of age.
“It’s a remarkable thing, isn’t it?” said Dr. David Hill, an allergist and researcher at the Children’s Hospital of Philadelphia and author of a study published Monday in the medical journal Pediatrics.
“I can actually come to you today and say that if we had not implemented this public health effort there would be fewer children suffering from food allergies today,” he said.
Hill and colleagues analyzed electronic health records from dozens of pediatric practices to track food allergy diagnoses in young children before, during, and after the guidelines were released.
Researchers found that peanut allergies in children ages zero to three dropped by more than 27 percent after guidance for high-risk children was first issued in 2015, and by more than 40 percent after recommendations were expanded in 2017.
Canadian researchers found that banning foods like nuts and peanuts from schools is not the best way to protect children from life-threatening allergic reactions. CBC’s Deanna Sumnac-Johnson explains the change.
This effort has not reduced the overall increase in food allergies in the US in recent years. About eight percent of children are affected, including more than two percent of children with peanut allergies.
An allergic reaction to peanuts occurs when the body’s immune system mistakenly identifies proteins in peanuts as harmful and releases chemicals that trigger allergy symptoms, including hives and respiratory symptoms. Sometimes, it can also cause anaphylaxis, a life-threatening type of reaction that can include a drop in blood pressure, dizziness, trouble breathing, and more.
Groundbreaking 2015 study
For decades, doctors advised delaying feeding peanuts and other allergy-causing foods to children until age three. But in 2015, Gideon Lack at King’s College London published the groundbreaking Learning Early Trial about Peanut Allergy, or LEAP.
Lack and colleagues showed that exposure to peanut products in infancy reduced the risk of developing future food allergies by more than 80 percent. Subsequent analysis showed that protection persists into adolescence in about 70 percent of children.
Study issues new guidelines urging early introduction of peanuts The Canadian Pediatric Society recommends Starting to introduce common allergy-causing foods, including peanuts, to babies four to six months of age.
But putting those guidelines into practice has been slow in some places.
The surveys found that only 29 percent of pediatricians and 65 percent of allergists followed the expanded guidance issued in 2017. According to a note that accompanied the study, this lag was due to confusion and uncertainty about the best way to incorporate peanuts early in life. Initially, medical experts and parents alike questioned whether the practice could be adopted outside strictly controlled clinical settings.
Data for the analysis came from a subset of participating practice sites and may not represent the entire U.S. pediatric population, said the commentary, led by Dr. Ruchi Gupta, a pediatric allergist at Northwestern University.
However, the new research “offers promising evidence that early allergen introduction is not only being adopted, but may also have a measurable impact,” the authors concluded.
Advocates for the 33 million people in the U.S. who suffer from food allergies welcomed the sign that the early introduction of peanut products is taking off.
“This research reinforces what we already know and highlights a meaningful opportunity to reduce the incidence and prevalence of peanut allergies nationwide,” said Sung Poblete, chief executive of the nonprofit group Food Allergy Research and Education (FARE).
Hill said the new study emphasizes current guidance, updated in 2021, that calls for treating peanuts and other major food allergens between four to six months without prior screening or testing. Parents should consult their pediatricians with any questions they may have.
“It doesn’t have to be a lot of food, but peanut butter, milk-based yogurt, soy-based yogurt and a little flavor of tree butter should be there,” he said. “These are really good ways to allow the immune system to be exposed to these allergy-causing foods in a safe way.”
Tiffany Lyons, 36, a registered dietitian in Maryland and director at Fyre, introduced her sons, James, 4, and Cameron, 2, to peanuts and other allergens.
At first, he said, Lyon’s own mother was puzzled by the advice to feed such foods to children before the age of three. But Lyon pointed out how the science has changed.
“As a dietitian, I practice evidence-based recommendations,” she said. “So when someone said to me, ‘This is the way it’s done now, these are the new guidelines,’ I thought, OK, OK, this is what we’re going to do.”