A peanut allergy occurs when the body responds abnormally to proteins found in peanuts. Symptoms of an allergic reaction can range from itchy hives to life-threatening anaphylaxis. As a result, peanut allergy sufferers must be constantly vigilant about the ingredients in the products they consume and the foods consumed around them. Parents of young children with peanut allergy must work with schools and care providers to ensure that their children are not accidentally exposed to peanuts. Many also avoid exposing babies to peanuts and other common food allergens for fear that early exposure may increase the chance of developing allergies.
Researchers from the United Kingdom wanted to evaluate whether peanut consumption or peanut avoidance was a more effective form of treatment to prevent the development of peanut allergy. The trial, published in The New England Journal of Medicine, found that the early introduction of peanuts significantly decreased the frequency of the development of peanut allergy among high-risk children.
The randomized trial included 640 infants aged 4-11 months of age with increased risk of developing peanut allergy because of severe eczema, egg allergy, or both. A skin-prick test was done prior to randomization and infants who had a reaction were advised to avoid peanuts and later included in the analysis. All infants were randomized to having 2 grams of peanut protein 3 times a week for 5 years or to a group that avoided peanut proteins for 5 years. Infants randomized to the peanut group had were given a peanut food and observed for any reaction, called an oral food challenge. Seven infants had reactions during the observation and were instructed to avoid peanuts, but were included in the final analysis. At age 5, a second oral food challenge was given to participants in both groups to look for potential reactions.
Peanut allergy was present in:
Mild sensitization to peanut protein was found in:
There was no difference in the number of severe reactions or events between the two groups.
A randomized trial is considered the most reliable form of research, but how the research is done will affect its reliability. The trial was not blinded which can sometimes affect the outcome but because the outcomes were based on physical reactions from the child it is unlikely it could be influenced by the parent. The trial also only focused on high risk children so these results may be more or less significant in general population.
Researchers from this trial did conclude that consuming peanuts early in life may desensitize children and prevent peanut allergy. Previous studies of other food allergens in people at high risk have also concluded that avoiding these foods in early years did not prevent the development of a food allergy. However, current guidelines state that there is insufficient evidence regarding when to introduce potentially allergenic foods. It remains to be seen whether guidelines will be updated as a result of this study.
Talk to your doctor about your infants nutrition. It is always important to be aware of negative reactions when introducing any new foods to your baby. If your infant is at risk for peanut allergy, talk to the doctor. A skin-prick test may help to determine whether your infant is allergic to peanuts. This information can help guide treatment and help you and the doctor discuss the best nutrition plan for your child.
Family Doctor—American Academy of Family Physicians
Kids Health—Nemours Foundation
Du Toit G, Roberts G, et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. N Engl J Med. 2015 Feb 26;372(9):803-13.
Facts and statistics. Food Allergy Research and Education website. Available at: http://www.foodallergy.org/facts-and-stats. Accessed March 12, 2015.
Gruchalla RS, Sampson HA. Preventing peanut allergy through early consumption—ready for prime time? N Engl Med. 2015 Feb 26;372(9):875-877.
Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert Panel Journal of Allergy and Clinical Immunology. Dec 2010;126(6):S1-S58.
Last reviewed March 2015 by Michael Woods, MD