Consensus communication on early peanut introduction and the prevention of peanut allergy in high-risk infants

Highlights: This clearly written, concise document communicates the essential details about a recent ground breaking study: Randomized trial of peanut consumption in infants at risk for peanut allergy which is the first randomized study investigating the timing of peanut introduction in infants at high risk of food allergy. Previous observational studies suggested that a delayed introduction may increase peanut allergy, and the results of this study strongly support that position. Infants with eczema or egg allergy (because they are a high risk for peanut allergy) were randomized to start peanut consumption around the time of weaning or delay consumption until 5 years. Peanut allergy (assessed at five years) was significantly lower in the groups that started peanut early. Peanut sensitization was measured prior to the study, and infants with a high degree of sensitization were excluded (because of increased likelihood of already being allergic). Note: this publication is the results of the LEAP study (Learning Early about Peanut Allergy).

Application to Dietetic Practice: The 2008 American Academy of Pediatrics recommendation suggests that high risk infants do not need to delay peanut.  However, this new consensus recommends active peanut introduction for infants at high risk of allergy between 4 and 11 months. It also suggested that infants may benefit from evaluation by an allergist or physician trained in allergy prior to introduction.  Unfortunately, many allergist have very long waiting lists. This leaves dietitians in a conundrum. Ideally, they should recommend families seek advice from a knowledgeable physician, but an appointment before the child is 11 months may not be likely.  Therefore, dietitians can provide information on peanut introduction, but not specific recommendations.

Web Link

Another good article on this ground breaking research is Preventing Peanut Allergy through Early Consumption — Ready for Prime Time? Pub Med ID – 25705823  Web Link

Original Study –Randomized trial of peanut consumption in infants at risk for peanut allergy – Pub Med ID 25705822 Web link

Posted in: Summer2015-Research