Peanut allergies reduced by 77% by introducing peanuts at 4-6 months old

Peanut allergies can be reduced by 77% if babies are fed peanut products at four to six months of age, a new study found.

The peer-reviewed study was published in the Journal of Allergy and Clinical Immunology in December.

The study was led by Prof. Graham Roberts of the National Institute for Health and Care Research (NIHR) Southampton Biomedical Research Center, which is hosted by University Hospital Southampton (UHS) and the University of Southampton, and Prof. Gideon Lack of Kings College London, with the cooperation of the Immune Tolerance Network (ITN) and the US National Institute of Allergy and Infectious Diseases (NIAID).

The study used data from Enquiring About Tolerance (EAT) and Learning Early About Peanut Allergy (LEAP), two random trials previously conducted by Lack that included both children at high risk for developing a peanut allergy and children at low risk for developing a peanut allergy.

Most children develop allergies by the time they turn one year old.

The modeled approach found that it is best to introduce peanut products - preferably creamy peanut butter or other peanut products without choking hazards, not whole or broken peanuts - at four to six months of age, and four months for babies with eczema.

The researchers advised that mothers should breastfeed for at least the first six months of their baby's life and introduce peanut products within the aforementioned time window.

They found that introducing peanut products into all babies' diets by six months could reduce peanut allergies by up to 77% of the population.

In comparison, waiting to introduce peanut products until 12 months of age would lead to only a 33% reduction.

“Over several decades, the deliberate avoidance of peanut has understandably led to parental fear of early introduction,” said Roberts. “This latest evidence shows that applying simple, low-cost, safe interventions to the whole population could be an effective preventive public health strategy that would deliver vast benefits for future generations.”

Israel's allergen culture

Prof. Lack noted that Israel exemplifies the fact that the benefits of introducing peanut products decrease as infants get older.

“The benefits of introducing peanut products into babies’ diets decrease as they get older. This reflects the experience in Israel, a culture in which peanut products are commonly introduced early into the infant diet and peanut allergy is rare,” said Lack. “There is a narrow window of opportunity to prevent an allergy from developing. Introducing peanut products at four to six months of age could substantially reduce the number of children developing peanut allergy.”

The study also found that targeting the entire population can yield the greatest benefits as most allergies occur without any known risk factors.

“Targeting only the highest-risk infants with severe eczema reduced the population disease burden by only 4.6%,” the study read. “Greatest reductions in peanut allergy were seen when the intervention was targeted only to the larger but lower-risk groups.”

“In countries where peanut allergy is a public health concern, health care professionals should help parents introduce peanut products into their infants’ diet at 4 to 6 months of life,” the researchers concluded.