Feeding peanut butter to infants may prevent peanut allergies later in life, new study finds

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Reassuring new evidence suggests that feeding children smooth peanut butter during infancy and childhood may reduce their risk of developing peanut allergies, even years later.

Compared to avoiding peanuts, Started eating peanuts as a toddler – From 4 months of ageA British study published on Tuesday found that regular consumption of soft, pureed peanut paste until around age 5 reduced the incidence of peanut allergies in British adolescents by 71 percent. NEJM Evidence.

“I wasn't surprised at all because Israeli infants are exposed to peanuts from an early age and allergies don't seem to emerge into adolescence or adulthood, suggesting a long-lasting protective effect,” said Gideon Lack, a professor of pediatric allergy in Israel. King's College London One of the study authors said in an email:

“Peanut allergies develop very early in most children, between the ages of 6 and 12 months, so if you want to prevent the disease, you need to do it before the disease develops,” Lack said of feeding children peanuts. “This biological phenomenon is based on an immunological principle known as oral tolerance induction. We've known for decades that young mice and other laboratory animals that are fed foods such as eggs, milk and peanuts do not develop these allergies later in life.”

Since 2000, the American Academy of Pediatrics Recommendation The government postponed the introduction of peanuts for three years, but ended the recommendation in 2008.

About 10 years later, In 2019, The AAP has updated its guidance. While delaying exposure to allergenic foods will not prevent the disease, “there is now evidence that early introduction of peanuts may prevent peanut allergy,” they said.

Food allergies are a growing public health concern in the United States, and peanut allergies About 2% of U.S. childrenApproximately 1.5 million people under the age of 18 have a peanut allergy. Peanuts are one of the foods that can cause the most severe allergic reactions, including the risk of life-threatening anaphylactic reactions.

“Today's findings should give parents and caregivers greater confidence that feeding peanut products beginning in early childhood, in accordance with established guidelines, can provide durable protection from peanut allergy,” said Dr. Jeanne Marrazzo, director of the National Institute of Allergy and Infectious Diseases. stated in a news release Tuesday. “If widely implemented, this safe and simple strategy could prevent tens of thousands of cases of peanut allergy among the 3.6 million children born in the United States each year.”

The new study, called the LEAP-Trio trial, included data from children who had participated in a peanut allergy study as infants in the UK. LEAP Exam.

A previous study followed infants with eczema and egg allergies up to the age of five and found that at that age the prevalence of peanut allergy was about 17% in the group of children who avoided peanuts, compared with about 3% in the group who ate peanut products – a relative reduction of 81% in peanut allergy.

The LEAP-Trio trial was conducted to determine whether the reduced risk of peanut allergy persists into adolescence.

Approximately 500 children were re-evaluated for the LEAP-Trio study to look at the incidence of peanut allergy around age 12.

At that age, peanut allergies were “significantly more prevalent” among children who had originally avoided peanuts, with about 15% having a peanut allergy. The researchers found that about 4% of children who originally consumed peanuts had a peanut allergy. The researchers wrote that this represents “a 71% reduction in the prevalence of peanut allergy at the time of LEAP-Trio.”

But overall, researchers based in the UK and the US say that if children start eating peanuts in early childhood and continue to do so until around age five, they appear to develop a “durable tolerance” to peanuts into adolescence.

This new finding not only suggests that early exposure to peanuts reduces the onset of peanut allergies, This protective effect continued into adolescence, even after children stopped eating peanuts after age 5, says Dr. Purvi Parikh, an allergist and immunologist at NYU Langone in New York and a spokesperson for the Peanut Allergy Foundation. Allergy and Asthma NetworkHe was not involved in the new study but said in an email Tuesday.

“So ideally, in the absence of other risk factors, you should introduce these allergens early on, between 4 and 6 months of age, and continue consistently until age 5, but then it doesn't have to be as consistent after that,” Parikh said.

She added that introducing peanuts to children at low risk of allergies can be done from around four to six months of age under the supervision of a pediatrician, but children with severe eczema or egg allergies should see an allergist before introducing them too early.

“As babies are not yet able to eat solid food, a thin consistency similar to breast milk or formula is recommended, which can be mixed to prevent choking and can be started with small amounts every three-four days and gradually increased as per tolerance,” Parikh said.

When introducing peanuts into your child's diet: Use smooth peanut butter mixed into a puree Avoid peanut chunks, which can be a choking hazard.

“In general, the answer for parents is 'the earlier the better,' especially for infants with eczema,” Lack said, adding that infants with eczema are at much higher risk of developing food allergies, and they develop these allergies quite early in their first year of life.

“However, children must be developmentally and neurologically ready for solid foods and be able to coordinate chewing and swallowing well without the risk of choking. Most babies can start solid foods at four to six months of age, but every baby is different and needs to be assessed individually,” he said. “Also, food should be given as a soft puree to make it easier to swallow and reduce the risk of choking. We do not recommend introducing solid foods before the age of three months.”

Previous research supports the finding that early exposure to peanuts induces tolerance, but the decision to feed peanuts to children should be made in consultation with a pediatrician, says Dr. Daniel DiGiacomo, a pediatric immunologist at K. Hovnanian Children's Hospital at Jersey Shore University Medical Center in Neptune, N.J., who was not involved in the new study.

“Current expert opinion is to use a shared decision-making approach to food introduction once the infant is developmentally ready and can comfortably consume several other complementary foods,” DiGiacomo said in an email Tuesday.

“I usually start slowly with a pea-sized amount and double the amount each day until they are at an age-appropriate intake (or at least 2 teaspoons), then incorporate it into their diet a few times a week,” he said. “I usually have my family blend the nut butter into a tolerable puree to get the right consistency. You can also dissolve peanut puffs (if peanuts) in water or make a peanut sauce from powdered peanut butter or peanut flour. Again, start slowly, checking for the right consistency and instructing them to stop and contact their allergist if there are any concerns.”