November 22, 2024 | Black & Kletz Allergy
Much of the information from the past decade regarding when to introduce peanuts into the diet of infants has been reviewed recently and subsequently revised. Research over the past 9 years shows that early introduction and regular consumption of peanuts decreases the risk of developing a peanut allergy. It is no longer recommended that parents delay the introduction of peanuts in most children, as delay beyond 12 months may actually increase the risk of peanut allergy.
A landmark clinical trial published in 2015, called the Learning Early About Peanut Allergy (LEAP), showed that the introduction of peanut products into the diets of infants at high risk of developing peanut allergy was safe. This led to an 81% reduction in the subsequent development of the peanut allergy. Prior to 2008, clinical practice guidelines recommended avoidance of potentially allergenic foods in the diets of young children who were at heightened risk for the development of food allergies. The LEAP study was the first to show that the early introduction of dietary peanut is actually beneficial.
An extension of the LEAP study published in 2016 called the Learning Early About Peanut Allergy – On (LEAP-On) demonstrated that regular consumption of peanut-containing foods beginning in infancy induces peanut tolerance that persists following a year of avoidance. This suggests that there are lasting benefits of early-life consumption for infants at high risk for developing peanut allergy. Investigators found that most children from the original peanut-consumption group remained protected from peanut allergy at age 6.
A new study called the Learning Early About Peanut Allergy – Trio (LEAP-Trio), sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), and published in the journal NEJM Evidence on May 28, 2024, further revealed that feeding children peanut products regularly from infancy to age 5 years of age reduced the rate of peanut allergy in adolescence by 71%, even when the children ate or avoided peanut products as desired for many years.
The LEAP investigators designed the LEAP-Trio study in order to test whether the protection gained from early consumption of peanut products would last into adolescence if the children could choose to eat peanut products in whatever amount and frequency they desired. The study team enrolled 508 of the original 640 LEAP trial participants—nearly 80%—into the LEAP-Trio study. 255 participants had been in the LEAP peanut-consumption group and 253 had been in the LEAP peanut-avoidance group.
The adolescents were assessed for peanut allergy primarily through an oral food challenge. This oral food challenge involved giving participants gradually increasing amounts of peanut in a carefully controlled setting to determine if they could safely consume at least 5 grams of peanut, the equivalent of more than 20 peanuts.
The study found that 15.4% of the participants from the early childhood peanut-avoidance group and 4.4% of the individuals from the early childhood peanut-consumption group had peanut allergy at age 12 or older. These results showed that regular, early peanut consumption reduced the risk of peanut allergy in adolescence by 71% compared to early peanut avoidance.
The study team also discovered that although participants in the LEAP peanut-consumption group ate more peanut products throughout childhood than the other participants overall, the frequency and amount of peanut consumed varied widely in both groups and included periods of not eating peanut products. This demonstrated that the protective effect of early peanut consumption lasted without the need to eat peanut products consistently throughout childhood and early adolescence.
These results confirm that feeding young children peanut products beginning in infancy can provide lasting protection from peanut allergy and further reinforce the current guidelines about the benefits of the early introduction of peanut products.
Despite the research about the early introduction of peanuts in infants, it is very important that every parent or guardian discuss this with their infant’s pediatrician before introducing peanuts to their child. Parents and guardians should follow their pediatrician’s recommendation and also seek care from a board certified allergist for an allergy consultation.
The board certified allergy specialists at Black & Kletz Allergy have been diagnosing and treating food allergies for more than 50 years. We treat both adult and pediatric patients. Black & Kletz Allergy has offices in Washington, DC, McLean, VA (Tysons Corner, VA), and Manassas, VA. All 3 of our offices have on-site parking. For further convenience, our Washington, DC and McLean, VA offices are Metro accessible. Our McLean office location offers a complementary shuttle that runs between our office and the Spring Hill metro station on the silver line. For an appointment, please call our office or alternatively, you can click Request an Appointment and we will respond within 24 hours by the next business day. If you suffer from food allergies, we are here to help you sort out whether or not you actually have an allergy vs. a food sensitivity. Our allergists will educate you on what to look for and what to do going forward regarding your specific food allergies. Black & Kletz Allergy is dedicated to providing the highest quality allergy care in a relaxed, considerate, and professional environment.
