Feeding children peanut products from infancy to age five reduces their risk of developing a peanut allergy until early adolescence, researchers say.
Children who regularly ate peanut paste or puffed peanut snacks from four to six months were 71% less likely to have a peanut allergy at age 13 than those who avoided peanuts, suggesting a long-lasting effect of early peanut consumption.
The simple dietary intervention could prevent around 10,000 cases of potentially life-threatening peanut allergies each year in the UK alone, doctors said, and reduce global cases by 100,000 annually.
Gideon Lack, professor of pediatric allergy at King’s College London, said decades of advice to avoid peanuts had made parents wary of giving them to their children from such an early age. But he said the evidence is now clear that early exposure to peanuts provides long-term protection against the allergy.
“I strongly recommend that babies be introduced to peanuts by four months if they have eczema and by six months if they don’t have eczema,” Lack told the Guardian. Babies with eczema are at greater risk of developing peanut allergies, probably because traces of the food can more easily penetrate the skin and be targeted by the immune system.
The rate of peanut allergy has risen in recent decades in many Western countries. One in 50 children in the UK now has the allergy, with around 14,000 newly diagnosed each year. Although 20% of children typically outgrow the allergy, for the rest the condition can mean lifelong avoidance of peanuts and the inevitable worry of a severe allergic reaction if they accidentally come into contact with the food.
Despite their name, peanuts are legumes and come from a different family of plants to tree nuts such as almonds, Brazil nuts, cashews, pistachios and walnuts. About a third of children with peanut allergy will have an allergy to at least one type of tree nut.
Previous work by the same researchers found that regular consumption of peanut products from childhood reduced the risk of peanut allergy by age five by 81%, compared to children who avoided peanuts for the same period. The latest study, known as the Leap-Trio trial, followed 508 of the children until an average age of 13, during which time they were free to eat or avoid peanuts as they chose.
The trial found that children in the early peanut consumption group had a 71% lower risk of peanut allergy compared to those in the peanut avoidance group. As expected, a small percentage of the children outgrew their allergy naturally. The results published in NEJM Testimony showed that the protection remained intact regardless of the children’s peanut eating habits after the age of five.
Lack said there is a “double benefit” to starting kids on peanut products early. “You’ll prevent the vast majority of peanut allergies, but for the cases where you can’t prevent it, you can identify the kids earlier when it’s much easier to treat them,” he said.
“Once they’re seven, eight, nine months old, you’ve really missed the boat. But even if you miss the boat, you identify children who have peanut allergy early and can treat them with immunotherapy.”
The researchers said peanut butter or peanut puffs could be given to breastfed children as soon as they could manage soft food.
The goal should be to give the equivalent of a heaped teaspoon of peanut butter three times a week. While whole or chopped peanuts should be avoided due to the choking risk, peanut puffs can be ground into a paste suitable for babies.
