Childhood Peanut Allergies Plummet After New Guidelines Implemented

A significant decline in peanut allergies among children has been observed following updated guidelines on introducing peanuts into infants’ diets. Research indicates that an estimated 40,000 children have avoided peanut allergy diagnoses due to these changes. The findings emerge almost a decade after a pivotal study demonstrated that early exposure to peanut products could decrease the likelihood of developing an allergy by more than 80%.

For years, parents were advised to refrain from introducing common allergens, like peanuts, to infants. In 2015, recommendations shifted for high-risk children, with further expansions in 2017. A study published in March 2023 in the journal Pediatrics revealed that peanut allergy rates in children under the age of three dropped by approximately 43% following the broader recommendations. Overall rates for all food allergies decreased by about 36%.

Significant Findings from the Study

Dr. David Hill, an attending allergist at the Children’s Hospital of Philadelphia and the senior author of the study, expressed surprise at the extent of the results. He noted, “Even being able to say that allergy rates plateaued would be huge news, but the fact that we actually saw a reduction in the onset of new food allergy in kids under three is incredible.”

Hill and his research team examined electronic health records from nearly 50 pediatric practices, tracking food allergy diagnoses in approximately 120,000 children aged zero to three. Notably, the peak onset of peanut allergies occurs around 15 months of age. A child was classified as newly allergic if they received a diagnosis code for a food allergy and were prescribed an EpiPen.

Despite these encouraging findings, surveys indicated that only about 29% of pediatricians and 65% of allergists adhered to the expanded guidelines issued in 2017. A commentary accompanying the study pointed to confusion and uncertainty regarding the best approach to introducing peanuts early in life.

Real-World Implications and Future Directions

Sung Poblete, chief executive of the nonprofit Food Allergy Research and Education, praised the study for its reliance on real-world data. She highlighted the significance of demonstrating that the practice of “eat early, eat often” can effectively reduce food allergy incidence in everyday settings.

Peanut allergies occur when the immune system reacts to peanut proteins as if they are harmful, leading to symptoms that can vary from hives and digestive issues to anaphylaxis, which can be life-threatening. Poblete emphasized the need for policy changes to decrease the rates of severe allergies, suggesting that the U.S. Department of Agriculture could include peanut products in infant food packages.

The prevalence of food allergies has been increasing, with 2.2% of U.S. children affected by peanut allergies, according to commentary related to the study. Additional risk factors contributing to this trend include the timing of allergen introduction, cesarean births, and exposure to antibiotics.

Dr. Hill called for intensified efforts to understand the factors leading to food allergies and to explore better treatment and potential cures. Since the research period, children’s food guidelines have continued to evolve. In 2021, the Academy of Pediatrics recommended introducing major food allergens, including peanuts and eggs, to all infants between four and six months of age.

This study marks a crucial step forward in the effort to mitigate peanut allergies among children, underscoring the importance of adapting dietary guidelines to reflect current scientific evidence.