New Peanut Allergy Prevention Research: Early Peanut Introduction Benefits All Infants

Latest research confirms that all babies – not just those considered “high-risk” for allergies – can benefit from early peanut introduction

You can always count on us to break down the latest research in the food allergy field. Before we get into the nitty gritty, let’s start with some basic refresher facts about peanut allergies…

What We Already Knew

• Peanut allergies currently affect quality of life for more than 6 million people in the U.S. 
• In the last couple of decades, nut allergies in children have tripled.
• Babies aren’t born with food allergies. They develop over time.
• Research has shown that more than 80% of peanut allergies are preventable with early peanut introduction and consistent consumption until age 5.

Ever since the groundbreaking 2015 Learning Early About Peanut Allergy Study (LEAP) found that sustained peanut consumption in high-risk infants – starting between 4-11 months and until age 5 – reduced the rate of peanut allergy by more than 80 percent, it’s become a widely accepted fact that early peanut introduction is beneficial for high-risk infants (those with severe eczema and/or egg allergy).

As a result of the LEAP Study, health organizations around the globe, including the AAP and USDA, fully pivoted away from previous avoidance guidance, updating their recommendations to advise introducing baby-friendly peanut foods around 6 months for most babies, and even earlier (4-6 months) for high-risk infants, after evaluation by a doctor and possible allergy testing. 

While the research focused on high-risk infants, according to NIH guidelines, early peanut introduction in children without risk factors was “generally anticipated to be safe and to contribute modestly to an overall reduction in the prevalence of peanut allergy.”

However, new studies published in the Journal of Allergy and Clinical Immunology and the European Journal of Allergy and Clinical Immunology have shown that early peanut introduction in a mainstream population is not only highly effective at preventing peanut allergies, but also crucial to bringing down the overall rate of peanut allergies in the general population.

Here’s what you need to know.   

The New Information - This is Big News! 

The new research, which modeled data from 1,943 children in a meta-analysis from the Enquiring About Tolerance (EAT Study), which focused on a low-risk population, and LEAP Study, which focused on a high-risk population, found several important takeaways. 

1. Early Peanut Introduction is Beneficial for All Babies Regardless of Risk Factors:

• Early introduction of peanuts resulted in a significant reduction in peanut allergy across all risk subgroups, including eczema severity and ethnicities. 
• To maximize the prevention of peanut allergy in the population, all infants should start eating peanut products by 6 months of life; infants with eczema, especially severe eczema, should start from 4 months of age. 
• Early introduction for just high-risk infants only reduced the overall burden of peanut allergy by 4.6 percent, whereas early introduction for ALL infants reduced the burden by 77 percent. 
• Even though peanut allergy occurs more frequently in high-risk infants, the low-risk infants make up the majority of the population and therefore the majority of peanut allergies. Therefore only targeting high-risk infants does not significantly bring down the population burden of peanut allergies.

2. The Earlier, The Better (once a baby is ready for solids):

• Early peanut introduction is most effective when it is started before 6 months of age. 
• The estimated reduction in peanut allergy diminished with every month of delayed introduction. If introduction was delayed to 12 months, peanut allergy was only reduced by 33%.
• In both low and high-risk populations the majority of peanut allergies have already developed by age one.
• The preventive benefit of early introduction of peanut decreases as age at introduction increases. In countries where peanut allergy is a public health concern, health care professionals should help parents introduce peanut products into their infants’ diet at 4-6 months of age. 

3. Early Peanut Introduction is Protective for All Ethnicities: 

• Non-Caucasian children have 3x the rate of peanut allergy as Caucasian children (yes, you read that right). There are a number of potential reasons, however, the good news is that early introduction of peanut foods helps prevent peanut allergy in all babies, regardless of ethnicity.

The most important takeaway?

The great news from these studies is that early peanut introduction is protective for all babies, which means if peanut allergy prevention guidelines are successfully implemented across the entire population, we have the potential to nearly eliminate peanut allergies in the future. We think that’s good news worth spreading. Share this article with a friend who needs to know! 

“To maximize the prevention of peanut allergy in the population, all infants should start eating peanut products by 6 months of life; infants with eczema, especially severe eczema, should start from 4 months of age.” - Roberts G., Bahnson H., Du Toit G., O’Rourke C. Sever M., Brittain E., Plaut M., Lack G., Defining the window of opportunity and target populations to prevent peanut allergy, J Allergy Clin Immunol. 2022