An arrangement of peanuts is seen Feb. 20, 2015, in New York. (AP Photo)
A decade after research revealed that introducing peanuts to infants could prevent allergies. The new data shows the approach is making a real-world impact.
A guideline first issued in 2015 recommended that babies, including those at high risk, should start eating peanut products around four months. The results have been significant. Peanut allergies in children aged 0 to 3 dropped by over 27% following the initial guidance. More than 40% after the recommendations were expanded in 2017.
Dr. David Hill, an allergist at Children’s Hospital of Philadelphia and lead author of a study published in Pediatrics, said the findings are “remarkable.” He and his team examined electronic health records from pediatric practices nationwide to track allergy diagnoses before and after the guidance.
“I can say that, today, fewer children have food allergies than there would have been without this public health effort,” Hill noted.
Since 2015, approximately 60,000 children have avoided food allergies, including 40,000 who might have otherwise developed peanut allergies. Yet, food allergies still affect around 8% of children, with peanut allergies impacting more than 2%.
Peanut allergy occurs when the immune system mistakenly treats peanut proteins as harmful. It triggers reactions such as hives, respiratory distress, and, in severe cases, anaphylaxis.
For decades, pediatric advice encouraged delaying peanuts and other allergenic foods until age three. That changed in 2015 with the landmark LEAP trial led by Gideon Lack at King’s College London. The study revealed that introducing peanuts during infancy reduced the risk of developing peanut allergies by more than 80%, with protection lasting into adolescence for about 70% of participants.
The LEAP trial prompted new early-introduction guidelines, but adoption was initially slow. Surveys found only 29% of pediatricians and 65% of allergists followed the expanded 2017 guidance. Early uncertainty about how to safely introduce peanuts outside clinical trials contributed to the hesitation.
Dr. Ruchi Gupta of Northwestern University noted that the study’s data came from select practice sites. This may not fully represent the entire U.S. pediatric population. Still, the findings provide promising evidence that early allergen introduction is gaining traction and delivering measurable results.
Food allergy advocates welcomed the news. Sung Poblete, CEO of Food Allergy Research & Education (FARE), said the study “reinforces what we already know and highlights a real opportunity to reduce peanut allergies nationwide.”
Current guidance, updated in 2021, recommends introducing peanuts and other major allergens between four and six months. Dr. Hill emphasized that small amounts are sufficient. “Little tastes of peanut butter, yogurt, or nut butters help the immune system build tolerance safely,” he said.
Parents are encouraged to consult pediatricians before introducing allergens. Tiffany Leon, a Maryland dietician and FARE director, followed the guidelines with her two young sons. Though her own mother was initially surprised, Leon embraced the updated advice.
“As a dietician, I practice evidence-based recommendations,” she said. “When the guidelines changed, I followed them — it’s how we protect our children’s health.”
The new research underscores a decade of progress, showing that early allergen introduction is transforming pediatric care and helping thousands of children avoid potentially serious food allergies.
