New Ground Breaking Study Suggests Early Consumption May Help Prevent Peanut Allergy
Dr. Engler has just returned from the 2015 annual meeting of The American Academy of Allergy, Asthma & Immunology (AAAAI) and was present in the audience for the announcement of the results of a ground breaking study published in the New England Journal of Medicine. The Learning Early About Peanut Allergy (LEAP) study found that among children at high risk for getting peanut allergies, eating peanut snacks by 11 months of age and continuing to eat them at least three times a week until age 5 cut their chances of becoming allergic by more than 80% compared to kids who avoided peanuts.
The study involved more than 600 infants in the United Kingdom ages 4 to 11 months who were at high risk for a peanut allergy. That risk was present because the children were already diagnosed with egg allergies or severe eczema which are both known to be linked to peanut allergies. The children were randomly assigned to either consume 6 grams (0.2 ounces) of a snack made from peanut butter per week or to avoid peanuts altogether, until they were 5 years old. Overall, about 17 percent of children who avoided peanuts ended up developing a peanut allergy by the end of the study, compared with just 3 percent of those who consumed the peanut butter snack. This translates to an 81 percent reduction in the rate of peanut allergies.
"Food allergies are a growing concern, not just in the United States but around the world," said National Institute of Allergy and Infectious Diseases Director Anthony S. Fauci, M.D. "For a study to show a benefit of this magnitude in the prevention of peanut allergy is without precedent. The results have the potential to transform how we approach food allergy prevention."
In the meantime researchers suggest that any infant between 4 months and 8 months of age believed to be at risk for peanut allergy should undergo skin-prick testing for peanut. If the test results are negative, the child should be started on a diet that includes 2 g of peanut protein three times a week for at least 3 years, and if the results are positive but show mild sensitivity (i.e., the skin test reaction measures 4 mm or less), the child should undergo a food challenge in which peanut is administered and the child's response observed by an allergist who has experience performing a food challenge. Children who pass the food challenge should then be started on the peanut-containing diet. Although other studies are urgently needed to address the many questions that remain, especially with respect to other foods, the LEAP study makes it clear that we can do something now to reverse the increasing prevalence of peanut allergy.
It is very important to understand that this is not something you should just do on your own, without appropriate medical evaluation. To do so in children susceptible to peanut allergy puts your child at risk of having a severe, potentially life threatening reaction to peanut. Keep in mind, every child in this study underwent allergy skin testing and, if necessary, physician-supervised oral challenge for peanut before eating it at home for the first time. About 10% of potential study participants were deemed too risky to enroll due to the large size of their skin test. Formal evaluation and consultation by an allergist is paramount in making sure this is the proper and safe choice to make before giving peanut to high-risk infants.
If your child is at risk of developing peanut allergy due to family history, eczema and/or egg allergy, please set up an appointment for allergy skin testing and to discuss the results of this study to determine if peanut product introduction is the right decision for your child.