Exposing Babies to Peanuts May Help Curb Allergy Risk

Many high-risk infants should be given peanut products starting at four months, researchers say

Monday, February 23, 2015

Related MedlinePlus Pages

MONDAY, Feb. 23, 2015 (HealthDay News) -- Giving peanut products to infants at high risk for peanut allergy may reduce the risk of developing the allergy by 80 percent, a startlingly new study suggests.

For years, the conventional wisdom was to avoid giving peanuts to infants who were at risk for developing an allergy to them. And although that recommendation was retracted in 2008, many parents continued to avoid giving peanut products to their infants, said lead researcher Dr. Gideon Lack, from the department of pediatric allergy at King's College London in England.

"However, eating peanut [products] in the first year of life protects against the development of peanut allergy in a high-risk group of children," he said. "This is the exact opposite of what was recommended."

Babies who have a high risk of developing a peanut allergy are those who have severe eczema and/or have an allergic reaction to eggs, Lack said.

The new study was published online Feb. 23 in the New England Journal of Medicine, to coincide with a planned presentation of the findings at the American Academy of Allergy, Asthma & Immunology annual meeting in Houston.

Dr. Rebecca Gruchalla, from the departments of internal medicine and pediatrics at the University of Texas Southwestern Medical Center at Dallas and co-author of an accompanying journal editorial, said, "This study clearly shows that early introduction of peanut [products] leads to a decrease in peanut allergy."

Gruchalla cautioned, however, that giving peanut products to high-risk infants needs to be done in consultation with a pediatrician and an allergy specialist.

Peanut allergy and other allergies have been increasing around the world, she said. Why this is so, however, isn't clear. "That's the million dollar question. Is it lifestyle changes? Is it food changes? Is it genetic? We don't know," she added.

In the study, Lack's team selected 640 infants, aged 4 months to 11 months, who were at high risk of developing peanut allergy.

The babies were randomly selected either to eat at least 6 grams of peanuts in food served three or more times a week, or to avoid peanut products until they were 5.

Lack said that even some children who could not tolerate peanuts developed some immunity. Overall, at age 5, the prevalence of peanut allergy in all children who ate peanut products was just over 3 percent, compared with slightly more than 17 percent among those who avoided foods or snacks with peanuts in them, the researchers found.

"This is a greater than 80 percent reduction in the prevalence of peanut allergy," Lack said.

Moreover, introducing peanut products early was safe and well tolerated, the researchers added. Infants were not given whole peanuts because of the risk of choking, they noted.

Lack recommended that infants at risk for peanut allergy have a skin test for peanut at 4 months of age. If the test is clear, they should be given peanut products regularly until the age of 5.

If the skin test shows a reaction to peanut, then they should have a challenge to peanut under a doctor's supervision. If they tolerate it, then they should continue eating peanut products. If they cannot tolerate the challenge, then they will need treatment to manage the allergy, Lack said.

SOURCES: Gideon Lack, M.D., department of pediatric allergy, King's College London, England; Rebecca Gruchalla, M.D., Ph.D., departments of internal medicine and pediatrics, University of Texas Southwestern Medical Center, Dallas; Feb. 23, 2015, New England Journal of Medicine, online; Feb. 23, 2015, presentation, American Academy of Allergy, Asthma & Immunology annual meeting, Houston

HealthDay