Peanut allergy risk cut if babies are given allergen early, study suggests
Peanut allergy incidences could plummet by 77% if products containing the nutrient were part of babies’ diets at four to six months of age, scientists have said.
Researchers in the UK have said they have identified a “clear window of opportunity” where introducing an allergen into a baby’s diet when they are between four and six months old significantly reduces the risk of developing the condition.
They added that waiting to introduce the peanut products until the children are a year old would lead to only a 33% reduction in cases.
The NHS currently recommends introducing solid foods to babies from around six months of age, when they are seen as being developmentally ready.
Based on their findings, recently published in The Journal Of Allergy And Clinical Immunology, scientists are calling for the Government to review the latest evidence.
Professor Graham Roberts, from the National Institute for Health and Care Research (NIHR) Southampton Biomedical Research Centre and University of Southampton, said that the last Government review was in 2018 and since then there have been numerous studies that show that introducing foods from three to four months of age “very successfully reduce the chances of developing peanut allergy and other food allergies as well”.
Introducing peanut products at four to six months of age could substantially reduce the number of children developing peanut allergy
Professor Gideon Lack
He added: “So we would suggest though, this is the time for the Government to relook at this evidence, and I suspect they will change the recommendations around introducing peanuts.”
Professor Roberts said there are challenges to overcome as over many decades, “the deliberate avoidance of peanut has understandably led to parental fear of early introduction”.
He said: “This latest evidence shows that applying simple, low-cost, safe interventions to the whole population could be an effective preventive public health strategy that would deliver vast benefits for future generations.”
Peanut allergy affects around 2% (1 in 50) of children in the UK and has been increasing in recent decades, according to Allergy UK.
Most peanut allergies have already developed by the time a child turns one year of age.
It is more common in children with severe eczema and egg allergy, the researchers said, and children of non-white ethnicity are also more likely to be affected.
As part of the study, the researchers looked at data from the Enquiring About Tolerance (EAT) and Learning Early About Peanut Allergy (LEAP) studies.
The Leap study involved 640 babies considered at high risk of developing peanut allergy and examined the early introduction of peanut products.
The Eat project saw more than 1,300 three-month-old babies recruited in England and Wales and tracked over several years and investigated the early introduction of six allergenic foods: milk, peanut, sesame, fish, egg and wheat.
They also looked at data from the Peanut Allergy Sensitisation study.
The researchers said their findings showed it was best to introduce peanut products to babies at four to six months of age.
For babies with eczema, the researchers recommend introducing the products, smooth peanut butter or other suitable peanut snacks, from four months of age.
Whole or broken peanuts should not be given to babies, the team said.
Education is going to be important here both for health professionals and parents so that any change in the advice is effective and safe
Prof Mary Fewtrell
They said the baby should also be developmentally ready to start solids.
The team also advises mothers to breastfeed for at least the first six months of their child’s life alongside introducing peanuts to their diet from four to six months.
Babies developing serious allergic reactions, such as difficulty in breathing, should seek immediate medical attention, the scientists said.
Professor Gideon Lack, from King’s College London and Guy’s and St Thomas’ NHS Foundation Trust said: “The benefits of introducing peanut products into babies’ diets decreases as they get older.
“This reflects the experience in Israel, a culture in which peanut products are commonly introduced early into the infant diet and peanut allergy is rare.
“There is a narrow window of opportunity to prevent an allergy from developing.
“Introducing peanut products at four to six months of age could substantially reduce the number of children developing peanut allergy.”
Commenting on the study, Mary Fewtrell, professor of paediatric nutrition at the UCL GOS Institute of Child Health, said: “This may well be a sensible approach, but infant feeding recommendations are not made considering only one outcome such as food allergy.
“The risks and benefits of any proposal for a range of outcomes has to be considered, and that’s what the expert groups will do when deciding whether to modify the existing advice.”
She added: “As the authors point out, education is going to be important here both for health professionals and parents so that any change in the advice is effective and safe.”
Margaret Kelman, acting head of clinical services for Allergy UK, added: “For expectant parents and parents of young infants there will hopefully be a change in advice around weaning, especially for infants who are considered at high risk of allergy.
“For those considering introduction of peanut products at around four months, we believe it is important to do so under the guidance of a healthcare professional.
“Notwithstanding this latest research supports previous studies which show that adopting this practice could potentially lead to the reduction in the incidence of peanut allergy among the food allergic population.”