Babies exposed early to peanuts less apt to develop the allergy later

SALT LAKE CITY — Parents who start feeding peanut products to their children very early, from infancy to age 5, help drastically reduce the risk the child will become allergic to peanuts later.

That’s according to a study sponsored by the National Institutes of Health’s National Institute of Allergy and Infectious Diseases and led by King’s College London, which reverses years of thinking on how to introduce — or avoid — potential allergens. The findings are published in the journal NEJM Evidence.

The findings held true even when children did not subsequently eat peanut products for a long time. The study said that regular, early consumption “provided lasting tolerance to peanuts into adolescence irrespective of subsequent peanut consumption, demonstrating that long-term prevention and tolerance can be achieved in food allergy.”

“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,” the institute’s director, Dr. Jeanne Marrazzo, said in a written statement. “If widely implemented, this safe, simple strategy could prevent tens of thousands of cases of peanut allergy among the 3.6 million children born in the United States each year.”

The findings are part of a trio of studies on the topic.

The first, called the Learning Early About Peanut Allergy clinical trial, and the subsequent study both tackled the issue of peanut allergy, which can be deadly. In the study, half of the participants regularly ate peanut butter until age 5, while the other half avoided any peanuts in that period. The early peanut exposure resulted in an 81% reduction in the risk of a peanut allergy at age 5. The second study included children from the first, who were told to avoid peanuts from age 5 to 6. Most in the peanut-exposure first study group had no peanut allergy at age 6.

The third study enrolled 508 of the original 640 study kids. They were an average of age 13 at that time. Of those, 255 had been in the eat-peanuts group, while the other 253 had avoided peanuts early. The children were then gradually introduced to more and more peanuts “in a carefully controlled setting” to see if it was safe for them to eat what amounted to 20 or more peanuts. They were also surveyed about recent peanut consumption habits.

‘The sooner the better’

In the third study, 14.5% of those in the group who avoided peanuts early and 4.4% of those from the peanut-consuming group had a peanut allergy at age 12 or older. That provided the finding that the risk of developing the allergy in adolescence was reduced 71% if peanut consumption began early and was regular until age 5.

Per the study, detailed advice on introducing infants to peanuts early and safely is available in the “Addendum Guidelines for the Prevention of Peanut Allergy in the United States,” a document designed specifically for parents and caregivers.

“It can generally be said ‘the sooner the better’ for parents, especially in babies with eczema,” Gideon Lack, professor of pediatric allergy at King’s College London and a study author, told CNN. He said babies with eczema are at much higher risk of developing food allergies. They also tend to develop the allergies well before their first birthday.

“However, the child needs to be developmentally and neurologically ready to eat solid foods and be able to coordinate chewing and swallowing without a risk of choking. Most babies will be able to start weaning between four and six months of age but each baby is an individual and needs to be assessed individually,” he said. “Also, the foods should be given as a soft puree to facilitate swallowing and reduce the risk of choking. We do not recommend introducing solids before three months of age.”