A decade after a pivotal study demonstrated that introducing peanut products to infants could prevent life-threatening allergies, new research shows significant real-world benefits. Approximately 60,000 children have avoided developing peanut allergies since guidelines were first issued in 2015, recommending that caregivers introduce peanuts to infants as early as four months old.

Dr. David Hill, an allergist and researcher at Children's Hospital of Philadelphia, stated, "That's a remarkable thing, right? I can actually come to you today and say there are less kids with food allergy today than there would have been if we hadn't implemented this public health effort." Hill and his colleagues analyzed electronic health records from various pediatric practices to track food allergy diagnoses in young children before, during, and after the guidelines were introduced.

The study found that peanut allergies in children aged zero to three declined by more than 27% after the initial guidance for high-risk children was issued in 2015. This decline increased to over 40% following the expansion of recommendations in 2017. Despite these positive outcomes, the overall increase in food allergies in the U.S. persists, affecting about 8% of children, with more than 2% specifically having a peanut allergy.

Peanut allergies occur when the immune system mistakenly identifies peanut proteins as harmful, leading to allergic reactions that can include hives, respiratory issues, and in severe cases, anaphylaxis. For many years, medical advice suggested delaying the introduction of peanuts and other allergenic foods until children reached age three. However, the 2015 Learning Early About Peanut Allergy (LEAP) trial, led by Gideon Lack at King's College London, revealed that early introduction of peanut products could reduce the risk of developing food allergies by over 80%. Further analysis indicated that this protective effect persisted in about 70% of children into their teenage years.

Despite the evidence, the implementation of these guidelines has been slow. Surveys indicated that only 29% of pediatricians and 65% of allergists adhered to the expanded guidance issued in 2017. Confusion and uncertainty about the best methods for early peanut introduction contributed to this delay. A commentary accompanying the study noted that the data analyzed came from a limited number of practice sites, which may not fully represent the U.S. pediatric population.

Nevertheless, the new research provides promising evidence that early allergen introduction is gaining traction and may be making a measurable impact. Advocates for the 33 million Americans with food allergies expressed optimism about the findings. Sung Poblete, CEO of the nonprofit group Food Allergy Research & Education (FARE), remarked, "This research reinforces what we already know and underscores a meaningful opportunity to reduce the incidence and prevalence of peanut allergy nationwide."

The study highlights the current guidelines, updated in 2021, which recommend introducing peanuts and other major allergens between four and six months of age without prior screening or testing. Parents are encouraged to consult their pediatricians with any questions. Dr. Hill suggested that small amounts of peanut butter, milk-based yogurt, soy-based yogurts, and tree nut butters can safely expose infants to these allergenic foods.

Tiffany Leon, a registered dietitian and director at FARE, shared her experience of introducing peanuts and other allergens early to her sons, James, 4, and Cameron, 2. Initially, her mother was surprised by the advice to feed such foods before age three. Leon explained, "As a dietitian, I practice evidence-based recommendations. So when someone told me, 'This is how it's done now, these are the new guidelines,' I just thought, OK, well, this is what we're going to do."