New SeaFAC Guidelines On Early Peanut Introduction For Infants to Prevent Peanut Allergy
Certain infants carefully fed peanut protein show reduced peanut allergy
After years of parents being told to delay giving their young children peanuts to prevent a peanut allergy, a new LEAP (Learn Early About Peanut Allergy) study is presenting evidence for a different approach.
The study found certain high-risk infants “carefully” fed peanut protein in the first year of life experienced an 86 percent reduction in peanut allergy by age 5. The results of LEAP were so remarkable that the Seattle Food Allergy Consortium (SeaFAC) executive committee felt it should offer parents a set of guidelines they can use to start the discussion with their pediatrician or allergist on how to safely introduce peanut protein to their infants.
Kids at risk for developing peanut allergy include infants ages 4–11 months old with:
- Moderate to severe eczema (persistent rash affecting grater than 75 percent of skin),
- A food allergy (such as egg or milk) and/or
- A family history of significant food allergy
SeaFAC recommends that high-risk infants should see an allergy specialist for peanut skin testing and a possible oral challenge. After allergy testing, infants with a negative peanut skin test should begin eating peanut protein regularly in order to help prevent peanut allergy. Infants with a strongly positive peanut skin test should continue avoiding peanut until additional guidelines are available. Infants with a borderline or low positive skin test may be eligible for careful graded challenge to peanut in an allergy clinic.
Although the LEAP study did not include low-risk infants, there is enough available evidence that the SeaFAC executive committee recommends parents should consider regularly feeding peanut protein early to infants at low risk of developing an allergy, under the advisement of their pediatrician. Peanut protein is inexpensive and generally safe if introduced to infants in a form other than whole peanuts (e.g. 2 teaspoons of smooth peanut butter mixed with mashed banana).
It’s unknown whether early introduction of tree nuts, seeds or other allergenic foods is beneficial.