In the recent past, doctors, nutritionists and scientists recommended avoiding the introduction of foods that contain peanut ingredients to children until the age of three. Although this was suggested for all children, parents of children who were at increased risk for peanut allergy (especially those who were previously diagnosed with eczema or other food allergies) were strongly cautioned to adhere to these guidelines. However, as time went on, research began to show that the slow introduction of peanut proteins from a very early age may better prevent peanut allergy in all infants, which could reduce the currently increasing rates of peanut allergy development in children.
Impacts of the Old Recommendation
The previous school of thought was that a delayed introduction of peanut into the diet would allow the gut and immune system time to mature, which could help to prevent allergies. This delayed introduction brought about a couple unexpected impacts.
Research was later released linking the delayed introduction of allergenic foods to an increased risk of food allergy. Since 2010, peanut allergy in children has increased by 21 percent, according to new research presented at the American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting. Studies also found that children with eczema had an increased chance of developing allergies if they were exposed to certain foods (including peanut-containing foods) in the air but did not actually consume them.
The New Study That Offers Hope
A recent randomized control trial, known as the LEAP (Learning Early about Peanut Allergy) study, was conducted by the Immune Tolerant Network (IT) in January 2017. During the trial, 640 children from ages four to 11 months were found to be at heightened risk for the development of peanut allergy based on severe eczema and/or an existing egg allergy. Half of these infants were randomized to be introduced to peanut and to continue eating it three times a week until five years of age. The other half were asked to avoid peanut-containing foods for the same duration.
The results were surprising. The children who ate peanuts displayed a lower rate of peanut allergy (3.2 percent) compared to those who avoided it (17.2 percent), which suggested that the introduction of peanut-containing foods before 11 months was greatly effective in preventing peanut allergy development.
The team conducted a follow-up study, LEAP-On, which found that children who ate peanuts until they turned five still did not develop a peanut allergy during their sixth year of life, even if they avoided peanut from the time they turned five and on. The results from these studies are groundbreaking in terms of the potential we now have to prevent the development of peanut allergy.
New Guidelines for the Prevention of Peanut Allergy in Children
Parents may now have a way to prevent peanut allergy by introducing infants to peanut products early on, once their risk has been assessed by their pediatrician and allergist. As a result of the LEAP trials, new guidelines were introduced by the National Institutes of Health and the National Institute of Allergy and Infectious Diseases (NIAID) last January, to encourage parents through the process of introducing foods that contain peanut to infants that are at high, medium and low risk for the development of peanut allergy.
It is advised that you talk with your child’s healthcare provider before feeding peanut-containing foods to your infant. Your doctor may order an allergy blood test to determine whether peanut should be introduced to your baby’s diet and the safest way to do it, if so.
Currently, there are three recommendations regarding when you can introduce peanuts to a child to reduce the risk of peanut allergy:
- For children who have no eczema or food allergy, it is recommended that you introduce foods that contain peanut ingredients at any age. This leaves the decision up to parents, according to their family and cultural preferences as well as general readiness for solid foods (baby can hold her head up with good neck control, can sit with support, etc.).
- If a child has mild to moderate eczema, peanut-containing foods may be introduced around six months of age to reduce the risk of developing peanut allergy.
- If a child has severe eczema, food allergy or both, it is recommended that peanut-containing foods be introduced as early as four to six months of age.
It is also advised that you never feed your infant whole peanuts due to the choking risk.
As parents begin implementing these new guidelines by introducing peanut-containing foods earlier, there is hope that peanut allergy rates will begin to drop.