New Infant Dietary Guidelines To Reduce Risk Of Peanut Allergy

The National Institutes of Health NIH-sponsored expert panel issues infant nutrition guidelines to prevent peanut allergy. The recommendations focus on introducing peanut-containing foods to infants.

An expert panel sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, issued guidelines today to aid health care providers in early introduction of peanut-containing foods to infants to prevent the development of peanut allergy.

Peanut allergy is a growing health problem for which no treatment or cure exists. People living with peanut allergy, and their caregivers, must be vigilant about the foods they eat and the environments they enter to avoid allergic reactions, which can be severe and even life-threatening. The allergy tends to develop in childhood and persist through adulthood. However, recent scientific research has demonstrated that introducing peanut-containing foods into the diet during infancy can prevent the development of peanut allergy.

The new Addendum Guidelines for the Prevention of Peanut Allergy in the United States supplement the 2010 Guidelines for the Diagnosis and Management of Food Allergy in the United States. The addendum provides three separate guidelines for infants at various levels of risk for developing peanut allergy and is targeted to a wide variety of health care providers, including pediatricians and family practice physicians.

  1. Guideline 1 focuses on infants deemed at high risk of developing peanut allergy because they already have severe eczema, egg allergy or both. The expert panel recommends that these infants have peanut-containing foods introduced into their diets as early as 4 to 6 months of age to reduce the risk of developing peanut allergy. Parents and caregivers should check with their infant’s health care provider before feeding the infant peanut-containing foods. The health care provider may choose to perform an allergy blood test or send the infant to a specialist for other tests, such as a skin prick test or an oral food challenge. The results of these tests will help decide if and how peanut should be safely introduced into the infant’s diet.
  2. Guideline 2 suggests that infants with mild or moderate eczema should have peanut-containing foods introduced into their diets around 6 months of age to reduce the risk of peanut allergy.
  3. Guideline 3 suggests that infants without eczema or any food allergy have peanut-containing foods freely introduced into their diets.

In all cases, infants should start other solid foods before they are introduced to peanut-containing foods.

Development of the Addendum Guidelines was prompted by emerging data suggesting that peanut allergy can be prevented by the early introduction of peanut-containing foods. Clinical trial results reported in February 2015 showed that regular peanut consumption begun in infancy and continued until 5 years of age led to an 81 percent reduction in development of peanut allergy in infants deemed at high risk because they already had severe eczema, egg allergy or both. This finding came from the landmark, NIAID-funded Learning Early About Peanut Allergy (link is external) (LEAP) study, a randomized clinical trial involving more than 600 infants.

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov.

Reference: A Togias et al. Addendum guidelines for the prevention of peanut allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases-sponsored expert panel. Journal of Allergy and Clinical Immunology DOI: 10.1016/j.jaci.2016.10.010 (2017).