Sometimes nature surprises us by favoring health measures that earlier seemed counter-intuitive.
Such was the case last year when a study published in the New England Journal of Medicine indicated that babies at high-risk* for peanut allergy were better off being exposed to peanut than avoiding it. This study turned the assumed wisdom - protecting young allergy susceptible children from peanuts - on its head.
As you might recall, the research showed when at risk babies were fed a peanut-butter “mush” - starting at ages 4 to 11 months - they were about 80 percent less likely to have a peanut allergy at age 5. This was in comparison with infants not exposed to peanut protein.
Follow-up Study Reveals More
Now, results from a year long follow-up study with the same children supports the benefit of early peanut exposure. The young participants, between ages 5 and 6 during the follow-up, maintained their tolerance for peanuts even after 12 months of peanut abstinence.
“Among children at high risk for allergy...a 12-month period of peanut avoidance was not associated with an increase in the prevalence of peanut allergy,” reported the researchers. This suggests that the benefit of early peanut exposure is permanent.
Though preliminary guidelines for the application of this research have already been created, this does not give parents a green light to feed their infants peanut butter. The guidelines state:
- ”...that health care providers should recommend introducing peanut-containing products into the diets of ‘‘high-risk’’ infants early on in life (between 4 and 11 months of age) in countries where peanut allergy is prevalent...”
- ”Infants with early-onset atopic disease, such as severe eczema, or egg allergy...might benefit from evaluation by an allergist or physician trained in management of allergic diseases...”
There is still more that doctors need to understand about early exposure, such as exactly how much peanut babies need to consume, and for which other foods early exposure will work. The current application guidelines will be tweaked as more research data are collected.
Tips for Parents
Though parents may naturally be eager to benefit from the early exposure research, pediatrician Dr. Claire McCarthy adds her own cautionary advice to the guideline recommendations:
- Do not give problem foods to babies if there are known or suspected food allergies. If the child has eczema, bloody stools, experiences vomiting, rashes, is fussy after eating anything, or has a parent or sibling with food allergies, consult with a doctor before putting the child on solid foods.
- Never give infants or toddlers actual peanuts, or any type of solid food they might choke on. There are a variety of safe ways to expose babies to solid food proteins; a doctor or allergist can recommend how.
While it’s unfortunate medical science had peanut allergy prevention backwards when recommending delayed exposure, we can be grateful going forward knowing the recent discoveries may soon reduce peanut allergy incidence. However, early exposure does not eliminate peanut allergy, so parental caution, and working with doctors or allergists, is essential.
*Children at high risk for food allergy have a family history of allergy and/or have conditions such as eczema or asthma.