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Consolidating new data suggest that feeding children soft peanut butter during infancy and early childhood may reduce their risk of developing peanut allergies, even years later.
Compared to removing peanuts. Starting a peanut diet in childhood – Around 4 months oldEating foods like soft pasta, for example — and regularly continuing until age 5 — was associated with a 71% reduction in peanut allergy among teenagers in the United Kingdom, according to a study published Tuesday. NEJM evidence.
“I'm not entirely surprised because infants in Israel are exposed to peanuts at an early age and allergies don't seem to emerge in adolescence or adulthood. This suggests that the protection is long-lasting,” said Gideon Lack, professor of pediatric allergy. King's College London And the author of the study said in an email.
“Peanut allergy develops very early in most children between the ages of six and 12 months. If you want to prevent disease, it has to be done before the disease occurs,” Lac says of exposing children to peanuts. “This biological phenomenon is based on the immune principle known as oral tolerance.” . We've known for decades that young mice or other experimental animals fed foods like eggs or milk or peanuts can't develop these allergies later.
Since 2000, the American Academy of Pediatrics Recommended It delayed the introduction of peanuts for up to 3 years, but that proposal expired in 2008.
Ten years later In 2019, AAP has updated its guidelines Avoid allergic foods as soon as possible. Hurry up, hurry up, hurry up, hurry up, hurry up. Hurry up, hurry up, hurry up, hurry up, hurry up. They said that they prevent allergies.
Food allergies have become a growing public health concern in the United States, and peanut allergy is thought to be harmful 2% of children in the United StatesOr about 1.5 million people under the age of 18. Peanuts are one of the foods that cause the most severe allergic reactions, including the risk of anaphylaxis, a life-threatening reaction.
Dr. Jean Marrazzo, director of the US National Institute of Allergy and Infectious Diseases, said: “Today's findings should strengthen the confidence of parents and caregivers that feeding their young children peanut products according to established guidelines from infancy provides lasting protection against peanut allergy. , He said in a news release. Tuesday. “If widely implemented, this safe and simple strategy could prevent peanut allergies in tens of thousands of the 3.6 million babies born each year in the United States.”
The new study, called the LEAP-Trio trial, included data from children in the United Kingdom who participated in a peanut allergy study as infants. The LEAP test.
That earlier study included infants with eczema and egg allergy after age 5, and at that age the prevalence of peanut allergy was 17% in the group of children who avoided peanuts, compared to 3% in the group that consumed peanut products, representing an 81% relative reduction in peanut allergy. It shows.
The LEAP-Trio trial is set to test whether the reduced risk of peanut allergy persists into adolescence.
About 500 children were reevaluated for the LEAP-Trio trial, which looked at the prevalence of peanut allergy around age 12.
At that age, peanut allergy was “more prevalent” among children who initially avoided peanuts, and 15% had a peanut allergy. About 4% of those who initially eat peanuts have a peanut allergy, the researchers said. They wrote that it represented a “71% reduction in peanut allergy prevalence at the LEAP-Trio time point.”
But in general, when children started eating peanuts in infancy and up to about age 5, this seemed to provide a “lasting tolerance” to peanuts well into adolescence, said the researchers, who are based in the United Kingdom and the United States.
The new findings are “substantial evidence” that not only can early introduction of peanuts reduce the risk of developing peanut allergies. The protection extends into adolescence, even when children stop eating peanuts regularly after age 5, says Dr. Purvi Parikh, MD, an allergist and immunologist at New Langone in New York and a spokeswoman for Allergy and Asthma NetworkHe was not involved in the new research, he said in an email Tuesday.
“So if there are no other risk factors, we should introduce these allergens 4-6 months earlier and continue consistently up to 5 years, but we don't need to be consistent after that,” Park said.
He added that the introduction of peanuts to children with low allergy risk can be done between 4 and 6 months under the guidance of a pediatrician, but children with severe eczema and egg allergy should see an allergist before being introduced.
“As babies cannot have solids yet, it is recommended to have a thin consistency similar to breast milk or formula and mix it to avoid any choking. Start with a small amount and gradually increase it every 3-4 days,” said Parikh.
It is recommended when introducing peanuts to a baby's diet Use soft peanut butter mixed into pure And avoid chunks of peanuts that pose choking hazards.
“Sooner is better for parents in general, especially for children with eczema,” Lak said, noting that children with eczema are more likely to develop food allergies and experience these allergies as early as the first year. Life.
“But the baby needs to be developmentally and neurologically ready to eat solid foods and be able to coordinate chewing and swallowing without choking. Most babies can start breastfeeding between four and six months, but every baby is an individual and needs to be assessed on an individual basis.” He said. “Also, the foods should be given in soft purees to facilitate swallowing and reduce the risk of choking. We do not recommend introducing solids before three months of age.”
The finding that early introduction of peanuts leads to tolerance is supported by previous studies, but introducing your child to peanuts should be a joint decision with your pediatrician, said Dr. Daniel DiGiacomo, a pediatric immunologist at K. Hovnanian Children's Hospital in Jersey Shore. The University Medical Center in Neptune, New Jersey, was not involved in the new study.
“The current expert opinion is to use a shared decision-making method for food introduction once the child is developmentally ready and tolerates other complementary foods without problem,” DiGiacomo said in an email Tuesday.
“I usually start introducing a pea-sized amount slowly, doubling the amount every day for a lifetime (or at least 2 teaspoons). Then continue this in the diet several times a week,” he said. “Typically, I have the family mix in peanut butter at an approved pure consistency, and they can dissolve peanut puffs (if they have peanuts) in water or make peanut sauce with powdered peanut butter or peanut powder. Again, we'll assess the right consistency and start slowly with instructions for stopping and if there are concerns about allergies. Contact your professional.