New peanut allergy guidelines issued

peanutNew guidelines recommend feeding peanut-related products to infants early to avoid peanut allergies from developing.

A new study, “Learning Early about Peanut,” or LEAP, found that infants at a high risk of developing peanut-related allergies should be introduced to peanut products at an early age to prevent the allergy from forming.

“Consumption of a peanut-containing snack by infants who are at high-risk for developing peanut allergy prevents the subsequent development of allergy,” according to the LEAP study.

The study was conducted by the Immune Tolerance Network, a collaborative network for clinical research funded by the National Institute of Allergy and Infectious Diseases, part of the National Institute of Health.

According to the Center for Disease Control and Prevention, more than 50 million people suffer from allergies.

Peanut allergies are the leading cause of anaphylaxis and death due to food allergy, according to the study. Additionally, peanut allergies have doubled in Western countries in the last 10 years.

Two percent of children suffer from peanut-related allergies. For those allergic children, eating peanut products can cause anaphylaxis or even death.

As a result, allergists recommended parents avoid feeding young at-risk infants allergenic foods such as peanuts and peanut products to prevent food allergies. Pregnant and lactating mothers were also advised to avoid peanut products.

However, findings from the study recommends otherwise.

“Our findings suggest that this advice was incorrect and may have contributed to the rise in the peanut and other food allergiesm,” said Dr. Gideon Lack, the lead investigator for the LEAP study.

The study began with the hypothesis that introduction of peanut products during infancy would lead to acceptance of the peanut proteins rather than an allergic reaction.

The study found that early introduction of peanuts could prevent allergy in high-risk, sensitized infants and in those infants with no tendency toward the allergy.

New recommendations on when to introduce peanut products are outlined by the study and fall into three categories.

  1. Children most likely to develop a peanut allergy include infants allergic to egg, have severe asthma or both. New guidelines recommend introducing peanut products at 4-to-6 months, or have an allergist administer a skin test for peanut allergy.  If the child is not allergic, parents can continue with introducing peanut products at 4-to-6 months. If the child is allergic, do not.
  2. Children with mild-to-moderate eczema who are less likely to have an allergy can be introduced to peanut products around the 6-month timeframe.
  3. Children with no allergies or eczema and no family history of either can be introduced to peanut products at any age.

Parents not sure of whether to begin introducing peanut products to their children should consult with their child’s pediatrician.

The study was published in the New England Journal of Medicine in March 2015 and can be found at http://www.nejm.org/doi/full/10.1056/NEJMoa1414850#t=articleBackground.

The guidelines can be found on the Journal of Allergy and Clinical Immunology website at http://www.jacionline.org/article/S0091-6749(16)31222-2/abstract.

Stephanie Holcombe

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