An In-Depth Look at the 'Feeding Peanut Butter to Infants' Study

No matter how well-controlled a research program is, none of us should change our behavior based on the results of one study.

For instance, the results of the research at King’s College London on introducing peanut protein to infants are encouraging. The findings show that early introduction of peanuts to children with a high risk for peanut allergy alters their immune response to peanuts, cutting their allergy risk by up to 86 percent.

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What the Media Blurbs Leave Out

However, the study protocols were carefully controlled and not just any infant 4 to 11 months old could enroll. Infants who became participants were at risk for developing a peanut allergy because each already had severe eczema, an egg allergy or both.

Potential participants also had their sensitivity to peanut extract assessed using a skin-prick test.

  • One group of final research participants consisted of infants with no measurable reaction to the skin-prick test.
  • A second final group of participants had skin test reactions (wheals) that measured 1 to 4 mm in diameter.

Infants with larger than 4 mm wheal reactions did not participate in the research.

Participants in each final group were then given a baseline peanut challenge:

  • Those who had no reaction to the skin-prick test were given 2 grams of peanut protein in one dose.
  • Those who had a reaction to the skin test were given 3.9 grams of peanut protein in incremental doses.

Infants who had an allergic reaction to the baseline challenge remained part of the study but were instructed to avoid peanuts.

Controlled Consumption and Monitoring

Participants in each group who passed the baseline challenge were randomly assigned to avoid peanuts or were told to consume 6 grams of peanut protein each week.

The peanut protein was distributed in three or more meals throughout the week. It came from a selected source called Bamba, a snack food made from peanut butter and puffed maize. Children who did not like Bamba were given one of two selected brands of smooth peanut butter.

The study participants were periodically tested for their immune response to peanuts, including a final test at 60 months.

The research study’s weaknesses include not having a placebo regimen and not testing low-risk infants or those whose skin-prick test produced a greater than 4 mm wheal reaction.

Significant Results

The final research analysis showed early peanut consumption was associated with an 86 percent reduction of peanut allergy at 60 months of age in participants who started with a negative skin-prick test result. The reduction was 70 percent among participants with a positive skin test at the study’s inception.

No deaths occurred within the study. Hospitalization rates and serious adverse events between the peanut avoidance and peanut consumption groups were similar.

Although the research results are significant and may influence the way peanut and other food allergies are prevented, giving peanut protein to infants is definitely not something to try without the supervision of allergy professionals. The research intervention was safe and well-tolerated but also specific, highly controlled and well-monitored.

Source: NEJM
Photo credit: Arlane Hunter / flickr creative commons


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