Peanut allergies can be reversed – study

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Babies as young as four months old should be given peanut butter or peanut snacks, scientists have said after a study predicted that the growing tide of peanut allergies can be reversed, reports The Guardian

In severe cases the allergy can lead to anaphylaxis, which can be fatal and for years, paediatricians and allergy specialists advised that peanuts should be avoided in the early years of a child’s life.

But the researchers say new public health guidelines are needed. A study carried out by King’s College London shows that the number of children developing a peanut allergy can be drastically reduced if children are introduced to peanuts as soon as they begin to eat solid foods.

The Leap (Learning Early About Peanut Allergy) study enrolled 640 children aged 4-11 months from Evelina London Children’s Hospital who were considered at high risk of developing a peanut allergy because they had severe eczema and/or were allergic to eggs. Until the age of five, half the children were given foods containing peanuts three times a week, while the families of the rest avoided giving their child peanuts. By the time they were five, under 1% of the children who had regularly eaten peanuts throughout the study were allergic to them, compared with 17.5% of the rest.

Professor Gideon Lack, lead author of the study, said avoidance of peanuts had in part caused the rise in allergies. “It is fair to say that in part the rise in peanut allergy can be explained by the fact that we have become peanut-avoidant as far as babies and young children are concerned. One reason was a growing perception from the 1970s/1980s that eating whole peanuts could cause choking and be inhaled into the lung. The other driving factor was the perception that we have a lot of peanuts in our society, as do the Americans, and peanut allergy was going up, so it was assumed that one was the cause of the other.”

Lack said: “The American health guidelines came out around 2000, as did the UK guidelines, urging that we avoid giving peanuts to high-risk families.” Eight years later, he said, the guidelines were rescinded on the basis that there was insufficient evidence to support avoidance of peanuts. Only now was there evidence to support introducing them into the diet as a preventive measure. But Lack stressed that it should be done safely. Babies cannot be given whole peanuts, but they can have smooth peanut butter or peanut snacks that will not cause any choking.

Lack notes that “some babies – like those in the trial – will be at higher risk of peanut allergy because they have other food allergies or eczema. They should have a peanut allergy test involving a pinprick in the skin. If there is no reaction, they can start eating peanuts. If their skin comes up in a red weal measuring less than 4mm, then peanuts can be introduced to the diet carefully under medical supervision. But a larger red weal in the skin test means they probably have a peanut allergy already.”

Full report in The Guardian
New England Journal of Medicine article

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