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Preventing Peanut Allergies: Is it Possible?

 Originally posted on June 29, 2015.

Over the past 10 years the prevalence of peanut allergies in American children has nearly doubled, and about 2 percent of children have a peanut allergy. While there are many theories and speculations, it’s unclear exactly why allergies have increased.

Now, the American College of Allergy, Asthma and Immunology is suggesting new guidelines about introducing peanuts into an infant’s diet. New research shows that introducing peanuts around 4 to 6 months of age can reduce the risk of the child developing a peanut allergy.

The Learning Early About Peanut study (LEAP) concluded that the early introduction of peanuts dramatically decreased the risk of developing peanut allergy. Of the children that were given peanuts as an infant, only 1.9 percent were allergic at the age of 5 compared to 13.7 percent of the children in the group that avoided peanuts.

Dr. Stephen Taylor, Best Food Facts expert and Professor and Co-Director of the University of Nebraska Food Allergy Research & Resource Program, states, “It seems like a good idea to avoid allergens in food, but that may not be the best course. Some evidence suggests that early introduction of certain kinds of solid foods into the baby’s’ diet may actually promote tolerance of those foods, rather than the development of food allergies. The recently completed research in England does indicate that early ingestion of peanuts may help to prevent the development of peanut allergy, but parents should seek advice from their pediatrician or allergist because there are some important caveats to that advice.”

The LEAP results have prompted the AAAAI to give guidance to assist healthcare providers across the globe in their clinical decisions. The new guidelines reflect collaboration between a dozen medical organizations from countries including the U.S., Canada, Japan, and Australia, as well as the European Academy of Allergy and Clinical Immunology and the World Allergy Organization. These recommendations include:

  • Given the LEAP findings, high-risk infants should be introduced to peanuts or peanut-containing products between the ages of 4-to-11 months of age. High-risk is defined as those having severe eczema and/or an existing food allergy.
  • Infants who show signs of eczema or egg allergy within the first 4-to-6 months of life should be tested for peanut allergy with a skin prick test and possibly a medically-supervised peanut challenge. Families with such a child should work with a physician to facilitate safe, early introduction of peanuts if possible.
  • Parents of children who have fewer risk factors for peanut allergy are not advised to delay giving their children peanuts. This has been the case for several years.
  • Though LEAP details many aspects of how peanuts can be introduced, physicians should note that it does not discuss alternative doses of peanuts, the minimal length of treatment necessary to induce tolerance, the potential risks if peanut consumption is stopped early, or what happens if the infant does not consume peanuts on a regular basis.
  • These guidelines do not apply to older children or those with existing peanut allergy. These only apply to infants who have never eaten peanuts. People with existing allergies must continue to carry epinephrine.
  • These guidelines also stress the importance of intervention by healthcare providers rather than potentially dangerous parent-conducted interventions.