New study finds smooth peanut butter reduces allergy risk in infants

Peanut allergies affect approximately 2% of children in the United States, translating to nearly 1.5 million individuals younger than 18

The study's findings are a significant reassurance that early peanut introduction reduces the initial development of peanut allergies and provides lasting tolerance into adolescence, even if peanut consumption decreases after age five.

Senior Writer

JUNE 24, 2024 5:59 PM EDTJUN 24, 2024, 5:59 PM EDT

New evidence suggests that feeding children smooth peanut butter during infancy and early childhood can significantly reduce their risk of developing a peanut allergy, even years later. This discovery provides a promising strategy for preventing one of the most common and potentially severe food allergies.

A study published in the journal "NEJM Evidence" highlights that introducing peanut consumption as early as four months of age and continuing regularly until around five years old is associated with a 71% reduced rate of peanut allergy among adolescents in the United Kingdom. This finding was based on a long-term follow-up study, the LEAP-Trio trial, which tracked children who participated in the earlier LEAP (Learning Early About Peanut Allergy) trial.

It's recommended to introduce peanuts as a smooth puree mixed into a soft food to avoid choking hazards

"I was not entirely surprised because infants in Israel are exposed to peanuts very early, and allergy does not appear to emerge in adolescents or adults. This suggests the protection is long-term," said Gideon Lack, professor of pediatric allergy at King's College London and an author of the study. Lack emphasized the importance of early exposure to peanuts, noting that peanut allergy develops early in children between six and 12 months. He explained that this preventative approach is based on the immunological principle of oral tolerance induction, a concept supported by decades of animal research.

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Historically, the American Academy of Pediatrics (AAP) recommended delaying the introduction of peanuts until three years of age starting in 2000. However, this recommendation was ended in 2008. By 2019, the AAP updated its guidance to reflect that delaying the introduction of allergenic foods doesn't prevent disease and that early introduction of peanuts may help prevent peanut allergy.

New evidence suggests that feeding children smooth peanut butter during infancy and early childhood can significantly reduce their risk of developing a peanut allergy, even years later.

Food and peanut allergies have become a growing public health concern. Peanut allergies affect approximately 2% of children in the United States, translating to nearly 1.5 million individuals younger than 18. Peanuts are among the food types that can cause the most severe allergic reactions, including anaphylaxis, a life-threatening condition.

Historically, the American Academy of Pediatrics (AAP) recommended delaying the introduction of peanuts until three years of age starting in 2000. However, this recommendation was ended in 2008.

As CNN informed, Dr. Jeanne Marrazzo, director of the US National Institute of Allergy and Infectious Diseases, highlighted the significance of these findings. "Today's findings should reinforce parents' and caregivers' confidence that feeding their young children peanut products beginning in infancy according to established guidelines can provide lasting protection from peanut allergy." She noted that widespread implementation of this strategy could prevent tens of thousands of cases of peanut allergy each year.

The LEAP-Trio trial included data on children in the United Kingdom who had participated in the LEAP trial as infants. The original study followed infants with eczema and egg allergy through age five, revealing that the prevalence of peanut allergy was about 17% in children who avoided peanuts, compared to about 3% in those who consumed peanut products—a dramatic 81% reduction.

For the LEAP-Trio follow-up, around 500 children were reassessed at age 12. The results showed that peanut allergy remained significantly more prevalent among children who avoided peanuts, with about 15% having a peanut allergy. In contrast, only about 4% of those who consumed peanuts early on had a peanut allergy, representing a 71% reduction in prevalence.

The study's findings are a significant reassurance that early peanut introduction reduces the initial development of peanut allergies and provides lasting tolerance into adolescence, even if peanut consumption decreases after age five. Dr. Purvi Parikh, an allergist and immunologist at NYU Langone, stated, "So ideally if there's no other risk factors, we should continue to introduce these allergens early at 4-6 months and continue them consistently until age 5, but after that, we don't need to be as consistent."

For parents considering this approach, it's recommended to introduce peanuts as a smooth puree mixed into a soft food to avoid choking hazards. Children at low risk can start around four to six months old, but those with severe eczema or egg allergy should consult an allergist first. Dr. Lack advised that each baby should be individually assessed for readiness to start solid foods, typically between four and six months of age. This ensures that the foods are given as a soft puree to facilitate safe swallowing.