A significant public health effort initiated nearly a decade ago has led to about 60,000 children in the United States avoiding peanut allergies. This finding emerges from a study published on October 2, 2023, in the medical journal *Pediatrics*, which highlights the impact of guidelines introduced in 2015 recommending the introduction of peanut products to infants as early as four months.
Dr. David Hill, an allergist and researcher at the Children’s Hospital of Philadelphia, led the study analyzing electronic health records from numerous pediatric practices. His team tracked food allergy diagnoses in children before, during, and after the new guidelines were established. According to Hill, “I can actually come to you today and say there are less kids with food allergy today than there would have been if we hadn’t implemented this public health effort.”
The research indicates that peanut allergies among children aged 0 to 3 declined by more than 27% following the initial recommendations, and by over 40% after expanded guidelines were released in 2017. Despite this progress in peanut allergies, the overall incidence of food allergies in the U.S. remains concerning, affecting approximately 8% of children, with more than 2% specifically diagnosed with peanut allergies.
Peanut allergy arises when the immune system mistakenly identifies peanut proteins as harmful, leading to allergic reactions ranging from hives and respiratory issues to potentially life-threatening anaphylaxis. Traditionally, medical advice suggested delaying the introduction of allergenic foods, including peanuts, until children reached three years of age.
The landscape shifted in 2015 when Dr. Gideon Lack from King’s College London published the groundbreaking *Learning Early About Peanut Allergy* (LEAP) trial. The trial demonstrated that early introduction of peanut products significantly reduced the risk of developing food allergies by over 80%. Subsequent studies revealed that the protective effects persisted in approximately 70% of children into their teenage years.
The initial excitement surrounding these findings led to new guidelines encouraging the early introduction of peanuts. However, the practical implementation of these recommendations has been slow. Surveys revealed that just 29% of pediatricians and 65% of allergists adhered to the expanded guidance by 2017. Confusion regarding the best methods for early introduction contributed to this lag, as noted in a commentary accompanying the study by Dr. Ruchi Gupta, a child allergy expert at Northwestern University.
Despite the caution, the new research provides “promising evidence that early allergen introduction is not only being adopted but may be making a measurable impact,” according to the authors.
Advocates for the estimated 33 million individuals in the U.S. living with food allergies expressed optimism about the findings. Sung Poblete, chief executive of the nonprofit group Food Allergy Research & Education (FARE), remarked, “This research reinforces what we already know and underscores a meaningful opportunity to reduce the incidence and prevalence of peanut allergy nationwide.”
The updated guidance, revised in 2021, recommends introducing peanuts and other major food allergens between four and six months of age, without prior screening or testing. Dr. Hill advises parents to consult with their pediatricians regarding the introduction of allergenic foods. He emphasizes that small amounts of peanut butter, milk-based yogurt, soy-based yogurts, and other tree nut alternatives can safely expose infants to these allergens.
Tiffany Leon, a registered dietician from Maryland, implemented early allergen introduction for her sons, James, 4, and Cameron, 2. Initially, her mother was surprised by the new recommendations but Leon explained the evolution of the science. “As a dietician, I practice evidence-based recommendations,” she stated. “So when someone told me, ‘This is how it’s done now, these are the new guidelines,’ I just thought, OK, well, this is what we’re going to do.”
The research confirms the importance of adapting feeding practices based on current evidence, highlighting a vital shift in how pediatricians and parents can work together to potentially mitigate the risk of food allergies in children.
