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Scientists: We Were Wrong About Not Feeding Babies Peanuts

Here are the new official guidelines.

DAVID NIELD
6 JAN 2017
 

New guidelines issued by the National Institutes of Health (NIH) in the US advise introducing peanuts into children's diets as early as possible, to protect them against peanut allergies later in life.

This goes against advice parents were given years ago, to avoid giving peanuts to young children. And it backs up a growing body of research that suggests early, frequent exposure is the best approach.

 

Since early 2015, The American Academy of Paediatrics (AAP) has endorsed the view that high-risk infants as young as four months have peanuts introduced to their diets. Previously, it had recommended avoiding introducing peanuts until at least three years of age.

Now the NIH is adding their voice, also encouraging parents to introduce peanuts into children's diets when they're as young as four months, in consultation with a healthcare professional.

"Living with peanut allergy requires constant vigilance. Preventing the development of peanut allergy will improve and save lives and lower healthcare costs," says Anthony Fauci, a director at the National Institute of Allergy and Infectious Diseases (NIAID), part of the NIH.

"We expect that widespread implementation of these guidelines by healthcare providers will prevent the development of peanut allergy in many susceptible children and ultimately reduce the prevalence of peanut allergy in the United States."

One of the studies taken into consideration by the NIH looked at babies who didn't react to a peanut allergy test at around eight months.

Of those children, nearly 14 percent went on to develop a peanut allergy by age five - but only 2 percent of infants who received a small dose of peanut paste each week became allergic.

 

The research, carried out by a team from King's College London in the UK, involved more than 600 babies identified as being at risk from peanut allergies – that is, babies who've already shown signs of eczema or an allergy to eggs.

Then there are the statistics to take into account: the number of children with peanut allergies in the US has more than tripled since 1997. Researchers aren't yet sure about the reasons behind the rise, but outdated guidelines telling toddlers to keep away from peanuts could be contributing.

Why is this the case? Scientists think being exposed to peanut proteins through the air can cause allergies, whereas actually eating peanuts can help prevent allergies.

That would help explain why peanut allergies are more common in countries such as the US and the UK, where peanuts are a staple food but not often given to babies. In other parts of the world, where either peanuts are rare, or peanuts are eaten by both babies and adults, it's not such a problem.

The idea is known as the dual-allergen exposure hypothesis, which suggests having contact with an allergen through the skin can lead to an allergy, while eating small doses of the allergen at a young age might help them develop a tolerance.

The new guidelines say high-risk babies (with severe eczema or egg allergies) should have peanut-containing foods introduced into their diet as early as four to six months of age.

For those kids with mild to moderate eczema, peanuts can be added from six months, if they're already a part of the family's existing diet.

Finally, for infants without eczema or food allergies, peanut-containing foods can be freely introduced at home in an "age-appropriate manner" together with other solid foods.

In each case the NIAID recommends consulting with a doctor for help determining if your kid is at risk and how peanuts can be safely added to his or her diet – don't do anything until you've got some professional advice.

Other countries are taking note of these studies and other similar research too: parents in Australia are also now advised to feed babies peanuts and egg during their first year.

Let's hope the new approach can help reduce the number of children who develop food allergies, currently estimated to be around one in 13 kids in the United States, and that these guidelines are ones we can stick to.

The guidelines have been published in a number of journals, including the Journal of Allergy and Clinical Immunology.

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