NIAID recommendations lower risk of peanut allergy development

Taken by Lianne Mandelbaum
Dr. George Du Toit
LEAP Study Pro Con Debate at FAAM Rome Italy

Infants who already have severe eczema or other allergies are considered to be high-risk.

Peanut allergies in kids can be life threatening.

Australian children have among the world's highest prevalence of peanut allergy, with 3 per cent of children affected. It is recommended by this panel that peanut containing foods be introduced into the diets of these kids as early as 4 to 6 months of age to lower the risk of developing peanut allergy.

New peanut allergy guidelines announced today by the National Institute of Allergy and Infectious Diseases (NIAID) offer the promise that early introduction of peanut-containing foods to infants can prevent the development of peanut allergy.

In all cases, infants should start other solid foods before they are introduced to peanut-containing foods.

"Allergy is a hard thing to pin down, but observational studies show that the rate of peanut allergy is at least three times higher now than it was a couple of decades ago", said Chan, who is also head of the Division of Allergy and Immunology in UBC's Department of Pediatrics.

That's a reversal of a previous guideline that recommended waiting to introduce young children to peanut-based foods until they were toddlers.

Whether the dietary change really will cut US peanut allergies depends on how many parents heed the new advice, and the guidelines urge doctors to follow up, even offer lower-risk tots an in-office taste, to reassure them. The new baby needs a chance at prevention so talk to your doctor about how to do so while keeping the allergic family member safe, with extra care in washing hands and keeping food separate, said Greenhawt, an allergy specialist at Children's Hospital Colorado. Poole said babies shouldn't get whole peanuts or a big gobs of peanut butter; both are choking hazards.

"We need to communicate with (parents) directly and put them at ease, otherwise the only place they will feel comfortable giving their baby peanut is in the parking lot outside the emergency room", said Chan. They are the ones safest to feed with peanut-containing foods, based exclusively on family preference.

"If you try to get a peanut or peanut butter and they won't take it, that's okay".

"We understand now that consuming peanut by around six months of age educates specialized cells - regulatory gatekeepers - in the gut", Chan said.

The Australasian Society of Clinical Immunology and Allergy will meet again in Melbourne in March to thrash out how the U.S. approach could be made practical in Australia, where the distances between allergists and their patients can be vast and the clinics have long waiting periods.

Building tolerance means that a peanut-containing food should be consumed about three times a week, the report said.

Researchers in the meantime had noticed a tenfold higher rate of peanut allergy among Jewish children in Britain, who aren't fed peanut products during infancy, compared to those in Israel, where peanut-based foods are common starting around age 7 months.

Introduce peanut-containing foods at an appropriate age and in accordance with family preferences and cultural practices.