Peanut Allergy Guideline Update

Peanut allergy affects thousands of children nationwide and it is growing in prevalence. In 1999, it was estimated that 0.4% of children were affected by peanut allergy. By 2010, that number had increased to approximately 2%.

The National Institute of Allergy and Infectious Diseases (NIAID), with the help of 25 other organizations, has recently added an addendum to its clinical guidelines on when peanut-containing foods should be introduced to children.

This change was instituted as a result of a groundbreaking study published in the New England Journal of Medicine in hopes that early introduction of peanut may slow the growth of peanut allergy. The Learning Early about Peanut Allergy (LEAP) trial followed 640 children between 4 and 11 months of age suffering from severe eczema, egg allergy, or both. The children in the study were asked to either consume or avoid peanut-containing products until they reached 60 months of age, at which point, they were tested for the prevalence of peanut allergy using an oral food challenge (OFC). This trial showed a marked decrease in the prevalence of peanut allergy among the group of children chosen to consume peanut-containing foods early in life when compared to those children who were avoiding those foods.

Consuming peanut-containing foods early in life proved to reduce the relative prevalence of peanut allergy by approximately 86% in those without an initial sensitivity to peanut and by approximately 70% in those with an initial sensitivity to peanuts.

After the completion of this study, the NIAID and the 25 other organizations came together and collaboratively set an addendum guideline for the prevention of peanut allergy. The addendum stipulates that those children suffering from severe eczema, egg allergy, or both should be introduced to peanut-containing foods at 4-6 months at the earliest, if cleared by a physician. Those children with mild to moderate eczema should be introduced no earlier than around 6 months and those with no eczema or food allergy should be introduced when age-appropriate. In the latter two groups, the NIAID recommends that peanut-containing foods be introduced at the recommended time.

Please note that this guideline is always meant to be followed under the supervision of a trained physician as introduction of peanuts into the diet could possibly result in a severe allergic reaction.

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