Health experts have recently challenged the previous recommendations that suggested mothers with a family history of allergies should avoid peanuts during pregnancy and breastfeeding. They also advised parents to hold off on introducing peanut products and other common allergens to their children until they turned three.
New findings, supported by a study from the National Institutes of Health, indicate that this avoidance strategy may have been misguided. This was detailed in a paper published in the American Academy of Pediatrics’ journal, *Pediatrics*, on Monday.
Background
Noticing a troubling trend, researchers found that the number of children with peanut allergies in Western countries had doubled over a decade. An international team took it upon themselves to investigate the research surrounding peanut consumption and avoidance to figure out which approach was more effective.
“Today, the number of children with food allergies is lower than it would have been without this public health effort.”
Funded partially by the National Institute of Allergy and Infectious Diseases, researchers conducted a randomized trial focusing on peanut consumption among infants at high risk for developing allergies. Their findings showed that early exposure to peanuts significantly decreased the risk of developing a peanut allergy and positively influenced the immune response in these children.
The results were consistent with a 2015 study published in the *New England Journal of Medicine*, which garnered consensus among multiple medical organizations and led to interim recommendations that encouraged early exposure to allergens.
Years down the line, the NIAID issued updated guidelines advocating for the early introduction of peanuts for all infants considered low risk, and for those at high risk, when appropriate.
Exposure Therapy
Another recent study in pediatrics emphasizes the effectiveness of exposure strategies. It revealed a 27.2% reduction in the overall incidence of peanut allergies among children from the periods before and after the guidelines were implemented. When comparing the pre-guideline cohort with those who adhered to the latest NIAID recommendations in 2017, the reduction exceeded 40%.
Health records from nearly 50 pediatric practices, monitoring over 120,000 children, were analyzed. The results indicated that food allergy rates in children under three dropped from 1.46% (2012-2015) to 0.93% (2017-2020).
Additionally, a study from Canada found that early peanut introduction was linked to a noteworthy drop in new cases of anaphylaxis in children under two.
Dr. David Hill, an allergist at the Children’s Hospital of Philadelphia and one of the study’s authors, stated, “I can actually come to you today and say that there are fewer children with food allergies today than there would have been without this public health effort.”
Since 2015, around 60,000 children are reported to have escaped food allergies, including 40,000 who might have developed peanut allergies. However, it’s worth noting that approximately 8% of children still suffer from food allergies. One factor contributing to this persistence might be that only a small proportion of pediatricians—about 29%—report following the expanded guidance rolled out in 2017.
