Peanut Allergy Prevention Recommendations Are Working!
The American Academy of Pediatrics (AAP) recently published a study that demonstrates that peanut allergies have decreased since the recommendations were published for babies to eat peanut-containing foods early and often.
What this study showed…
In the article "Guidelines for Early Food Introduction and Patterns of Food Allergy," researchers demonstrated that peanut allergies have DECREASED since the LEAP Study, specifically after the LEAP Study prompted the consensus statement for multiple professional allergist societies to recommend early allergen introduction in 2015.
Furthermore, the study demonstrated that peanut allergies have also DECREASED since the NIAID updated its guidelines in 2017 to recommend early peanut introduction.
Background on Peanut Allergy
The uptick in peanut allergy was noted in the 1990s, after which the AAP recommended babies avoid peanut until 3 years of age. This guidance was rescinded in 2008 (Pediatrics 2008): “Although solid foods should not be introduced before 4 to 6 months of age, there is no current convincing evidence that delaying their introduction beyond this period has a significant protective effect on the development of atopic disease regardless of whether infants are fed cow milk protein formula or human milk. This includes delaying the introduction of foods that are considered to be highly allergic, such as fish, eggs, and foods containing peanut protein.”
But that wasn’t super convincing.
Then came the LEAP study.
In 2015, the LEAP Study led by Dr. Gideon Lack and a team at Kings College, very clearly demonstrated that early incorporation of peanut can help prevent peanut allergies in at-risk babies, and that there was no harm to these babies in being fed baby-friendly peanut foods prior to 6 months of age.
What really is “early introduction”?
So you’re probably wondering, “What is early introduction?” And “How can I help my baby avoid a peanut allergy?”
The term “early introduction” really isn’t a great description of what happened in LEAP and what we really mean by early intro.
In LEAP, a baby-appropriate peanut food - like Bamba peanut puffs or diluted peanut butter - was fed:
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earlier than was the norm in most developed countries (so as early as 4 months of age whereas many developed countries still carried antiquated concepts of delaying introduction of commonly allergenic foods in hopes of preventing problems) and,
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was fed often (multiple times per week), not just introduced once.
All this suggests that a better name for “early introduction” would be “earlier incorporation” of peanut into the baby’s diet.
Soooooo “early introduction” really means feeding babies allergens (like peanut) starting around 4 months of age (or sooner if the baby is ready!) and feeding the food often, both of which help teach the immune system to tolerate the food.
It’s great to have data that tell the story that feeding babies developmentally-appropriate peanut early and often has saved many families from living with peanut allergies!
But how do you feed babies peanut SAFELY? Peanuts are choking hazards!
Yes, peanuts absolutely are choking hazards and should not be fed to babies. Even peanut butter is too thick and tacky to be safe for babies.
Babies can, however, be fed peanut-containing foods, such as Mission MightyMe Puffs (which was actually developed with the doctor behind the LEAP Study, Dr. Gideon Lack), or you can thin smooth peanut butter with breast milk or mix it into your baby’s favorite puree or water.
Breastfeeding? That’s great! Early introduction has been shown to complement breastfeeding and does not interfere with your journey.
And maybe you are concerned about your baby reacting? In the event that your baby does react (risk is less than 1% in most babies), then the reaction is often limited to skin symptoms. And be comforted in knowing that the earlier you start feeding your baby peanut-containing foods, the less likely your baby is to react.
Questions about food allergies?
Talk with your pediatrician!
Written by Alice Hoyt, MD
Dr. Alice Hoyt is a board-certified allergist and pediatrician. She leads the Hoyt Institute of Food Allergy and hosts the Food Allergy and Your Kiddo podcast. She is a scientific advisor for Mission MightyMe. Find her on social @hoytfoodallerg
