Advice to feed babies peanuts early and often helped thousands of kids avoid allergies

Category: (Self-Study) Health

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A decade after a landmark study proved that feeding peanut products to young babies could prevent the development of life-threatening allergies, new research finds the change has made a big difference in the real world.

About 60,000 children have avoided developing peanut allergies after guidance first issued in 2015 upended medical practice by recommending introducing the allergen to infants starting as early as 4 months.

“That’s a remarkable thing, right?” said Dr. David Hill, an allergist and researcher at Children’s Hospital of Philadelphia, and author of a study published in the medical journal Pediatrics. Hill and colleagues analyzed electronic health records from dozens of pediatric practices to track diagnoses of food allergies in young children before, during, and after the guidelines were issued.

The researchers found that peanut allergies in children ages 0 to 3 declined by more than 27% after guidance for high-risk kids was first issued in 2015 and by more than 40% after the recommendations were expanded in 2017.

The effort hasn’t yet reduced the overall increase in food allergies in the U.S. in recent years. About 8% of children are affected, including more than 2% with a peanut allergy.

Peanut allergy is caused when the body’s immune system mistakenly identifies proteins in peanuts as harmful and releases chemicals that trigger allergic symptoms, including hives, respiratory symptoms, and, sometimes, life-threatening anaphylaxis.

For decades, doctors had recommended delaying feeding children peanuts and other foods likely to trigger allergies until age 3. But in 2015, Gideon Lack at King’s College London published the groundbreaking Learning Early About Peanut Allergy (LEAP) trial.

Lack and colleagues showed that introducing peanut products in infancy reduced the future risk of developing food allergies by more than 80%. Later analysis showed that the protection persisted in about 70% of kids into adolescence.

Advocates for the 33 million people in the U.S. with food allergies welcomed signs that early introduction of peanut products is catching on.

This article and video were provided by The Associated Press.

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[Caitlyn Critchlow being fed watered-down peanut butter]

Dr. David Hill (interview): “When an allergen is introduced to the immune system via the skin, a breakdown in the skin barrier, that can be a real risk factor for development of allergy. And so that was actually one of the early observations that led to the seminal work in 2015 known as the LEAP study, which showed that if we actually introduce that allergen to children by mouth, having them eat it, before they’re introduced to it via their skin, we can reduce the risk that that child’s going to go on to develop the food allergy itself.”

[Peanuts and peanut butter]

Dr. David Hill (interview): “So that had been the guidance for decades. And I think it was well-intentioned, right? We didn’t really understand what the risk factors were for development of food allergy. And so intuitively it made sense to say, let’s reduce the risk of exposure to those highly allergenic foods until the child is slightly older, and potentially we can better manage an anaphylactic reaction if the child were to have one.”

[Ross Critchlow preparing watered-down peanut butter in a bottle for his daughter Caitlyn]

Dr. David Hill (interview): “The reason those recommended those change, those recommendations changed in 2015 is because there was this seminal study of several hundred children. They were randomized to either early peanut introduction or normal peanut introduction. And what the authors found is that the rate of peanut allergy was significantly lower. The long-term data suggests up to 70% lower in the children that had the early peanut introduction.”

[Peanuts in their shells]

[Sack of nuts]

Tiffany Leon (interview): “As a dietitian, practice evidence-based recommendations throughout my career. And so when someone told me, Oh, this is this is how it’s done now, these are the new guidelines, I just thought, Oh okay, well this is what we’re gonna do then.”

[Peanuts and peanut products]

Tiffany Leon (interview): “So around four, around five months we like sat him in the chair and fed him a few of the lower risk allergenic foods. I think we did like green beans, infant cereal, you know, did a few things first and then we just jumped in with two feet.”

[Peanut vendor at a market]

[Salted peanuts]

Dr. David Hill (interview): “You know, hindsight’s 20/20. It would have been nice to recognize this earlier and implement it even faster. At the same time, this is probably the biggest public health success in allergy in the modern era. I would say. You know, what our data shows is that because of, or at least associated with those early introduction guidelines, there’s about 60,000 less kids with food allergy today than there would have been. And that’s a remarkable thing, right? That’s the size of some cities. And it’s nice to have that kind of evidence to indicate that a public health intervention actually had the desired effect.”

[Peanuts]

Dr. David Hill (interview): “It’s, it’s amazing for me to be able to sit here with you today and say, you know, for the first time in modern history, not only have we reduced the rate of food allergy diagnoses, but we’re actually lower than we were five years ago.”

[Dessert counter with an allergy alert sign]

This script was provided by The Associated Press.