Early-life exposure to peanuts helps thousands avoid deadly allergy later in life

Over 50,000 children in the US avoided being diagnosed with deadly peanut allergies after they were exposed to the allergen early in life, a groundbreaking study suggests.

For decades, the rate of children being diagnosed with allergies to foods like peanuts and eggs climbed, causing doctors to recommend parents avoid giving them to their infants. 

But 10 years ago, a landmark trial found giving peanuts to babies slashed their risk of becoming allergic by 80 percent, causing the National Institute of Allergy and Infectious Diseases (NIAID) to formally recommend early-introduction instead. 

Eight years after federal recommendations shifted, researchers at Children’s Hospital of Philadelphia (CHOP) put the guidelines to the test by analyzing health records from over 120,000 children in the US. 

They found that after NIAID began recommending early exposure, food allergies in infants decreased by 36 percent, and peanut allergies specifically dropped 43 percent.

Researchers speaking to the Daily Mail estimated this may have saved more than 50,000 children from developing food allergies, which affect one in 13 US children, or 4million, and 33million adults. 

And about two percent of children have been plagued with peanut allergies, which can trigger a potentially deadly reaction called anaphylaxis.

Without immediately medical attention, the sudden blood pressure drop and respiratory distress from anaphylaxis kills about 200 Americans each year.

Dr David Hill, senior study author and attending allergist at CHOP, told the Daily Mail: ‘It was exciting to see real-world confirmation that early introduction is working on a national scale. For the first time, we’re seeing fewer kids developing peanut allergies.

‘The decline wasn’t surprising, but the magnitude of decline was very encouraging; it shows that this public health effort is making a real difference.’

The study, published Monday in the journal Pediatrics, looked at electronic health records from about 120,000 children seen across almost 50 doctor offices across the US between September 2012 and January 2020. 

Children were divided into two groups based on initial early-exposure guidelines issued in 2015: ‘preguidelines,’ or seen between September 1, 2012, and October 31, 2014, and ‘postguidelines,’ seen between September 1, 2015 and August 31, 2017. 

Researchers observed participants for two years to look for atopic dermatitis, better known as eczema, an inflammatory condition that causes itchy, dry skin. 

They also looked for immunoglobulin E-mediated food allergy (IgE-FA), the most common type of food allergy caused by an immune system overreaction to certain food proteins. 

A second analysis with a one-year observation timeframe introduced a third group called the ‘postaddendum guidelines’ cohort, or those evaluated between February 1, 2017, and January 31, 2019, after NIAID started recommending early exposure. 

Over 90 percent of children in all groups were between zero and four months old when they were first enrolled in the study.

Children were deemed newly allergic if they were formally diagnosed by a physician and were prescribed an EpiPen, an intramuscular injection that releases the hormone epinephrine to stop severe allergic reactions. 

The researchers found food allergy rates in children under age three decreased from 1.5 percent between 2012 and 2015 to 0.9 percent between 2017 and 2020, after early exposure recommendations were expanded. This is a drop of 36 percent.

They also found peanut allergies specifically dropped 43 percent during that same timeframe. 

Jordyn Koveleski Gorman, a licensed feeding specoalist and founder of Eat Play Say who was not involved in the study, told the Daily Mail: ‘So many parents are terrified of introducing top allergens to their babies for fear of a reaction, so this study’s results are extremely encouraging.’

The experts estimate this led to 57,000 children not being diagnosed with a peanut allergy, as about two-thirds of children are diagnosed with food allergies before age three. The study states that 15 months is the peak onset age of a peanut allergy. 

Dr Hill said: ‘We found that peanut and overall food allergy rates in young children dropped significantly after those guidelines were put in place.’

However, about 80 percent of people with a peanut allergy never outgrow it, and it’s unclear, and the study did not look at allergy rates in older children. 

Researchers believe introducing peanuts early in a child’s life helps train the immune system to recognize and not overreact to them while it is still developing, which prevents an allergic reaction. 

‘Introducing peanuts early helps the immune system learn that these foods are safe rather than dangerous,’ Dr Hill told the Daily Mail. 

‘Peanut allergy was the first to be studied in large, controlled trials, which is why the guidelines started there. The same principle likely applies to other allergenic foods like egg and milk, but peanuts led the way.’ 

He noted the team plans to continue researching how parents introduce allergens like peanuts to their infants, including the age they start, how often, and specific foods.

Koveleski Gorman said: ‘I hope that this study also encourages researchers to look at other top allergens like eggs, wheat, soy, so we can continue to provide parents with the best, most accurate information for their child.’

She noted because whole peanuts are a choking risk for infants, parents can introduce them by taking peanut butter and thinning it with water. She suggests mixing it into the baby’s puree or a soft solid food like a banana, as well as on a spoon. 

Dr Hill said: ‘The message is that early introduction works and we should double down on making sure every parent hears it. 

‘Consistent, accessible guidance from pediatricians and public health agencies can help ensure all families benefit from this prevention strategy.’