Feeding infants peanuts may prevent food allergies in early childhood

SEATTLE — A new study reported Monday in The New England Journal of Medicine demonstrates that consumption of a peanut-containing snack by infants, who are at high risk for developing peanut allergy, prevents the subsequent development of allergy. 

 

"For decades allergists have been recommending that young infants avoid consuming allergenic foods such as peanut to prevent food allergies," stated lead researcher Gideon Lack of Kings College London. "Our findings suggest that this advice was incorrect and may have contributed to the rise in the peanut and other food allergies."

 

The prevalence of peanut allergy has doubled over the past 10 years in the United States and numerous other countries. Peanut allergy, which now affects approximately 1.5% of young children, can cause adverse reactions ranging from development of hives and abdominal pain to severe anaphylaxis that requires immediate treatment with epinephrine. Because of the risk of anaphylaxis, children with peanut allergy are advised to avoid peanut in their diet and must carry an epinephrine autoinjector kit with them for use in event of a severe reaction.

 

Peanut allergy is an aberrant response by the body's immune system to harmless peanut proteins in the diet. This study was based on a hypothesis that regular eating of peanut-containing products, when started during infancy, will elicit a protective immune response instead of an allergic immune reaction. The "Learning Early About Peanut allergy" randomized controlled study enrolled more than 600 children between four and 11 months of age at high risk for peanut allergy to test whether consumption or avoidance of peanut until the age of 5 years would result in decreased incidence of peanut allergy. Children in the peanut consumption arm of the trial ate a peanut-containing snack food at least three times each week, while children in the peanut avoidance arm did not ingest peanut-containing foods.

 

The infants enrolled in the study had severe eczema and/or egg allergy, which put them at high risk of developing peanut allergy. Of the children who avoided peanut, 17% developed peanut allergy by the age of five years. Remarkably, only 3% of the children who were randomized to eating the peanut snack developed allergy by the age of five years. Therefore, in high-risk infants, sustained consumption of peanut beginning in the first 11 months of life was highly effective in preventing the development of peanut allergy.

 

The LEAP study was designed and conducted by the Immune Tolerance Network, with additional support from FARE and led Lack. The study is the first randomized trial to prevent food allergy in a large cohort of high-risk infants.