If parents are willing to introduce peanut to a baby under six months old, they’re then far more likely also to try feeding their infant other potential allergenic foods, according to research presented at the 2022 AAAAI allergists’ meeting.
The pivotal LEAP study proved that introducing peanuts to children in infancy reduced the odds of a child developing a peanut allergy by as much as 80 percent. But since the publication of U.S. peanut feeding guidelines based on that study, actually getting families to take their own ‘leap’ into early introduction of peanut, as well as other allergens, has yet to find wide acceptance.
In a national survey of 3,062 U.S. parents with children under 7 months of age, fewer than 18 percent reported feeding their baby peanut products before 7 months of age. The survey, conducted by Dr. Ruchi Gupta’s team at Northwestern University’s school of medicine, was designed to gauge how many families were following the updated guidelines sponsored by National Institute of Allergy and Infectious Diseases (NIAID). Those guidelines recommend introducing infants at high risk for peanut allergy to peanut products between 4 and 6 months of age.
However, the survey results, presented at the AAAAI 2022 allergists’ meeting, show the percentage of parents undertaking early peanut feeding rose considerably – to 31% – among those who were informed about the NIAID peanut guidelines.
Starting More Possible Allergens
In a separate analysis of the study’s data, it turns out that families with older children with food allergies are among those significantly more likely to introduce peanut to babies, as well as other allergenic solids.
“I think this shows people who have education and awareness about food allergies are more open to trying to prevent the disease as younger children are being born, said Gupta, a professor of medicine and director of the Center for Food Allergy & Asthma Research (CFAAR) at Northwestern.
Another study stemming from the data reveals that parents who started their babies on peanut by 6 months old introduced 5.4 additional foods that are among the top allergens by 12 months of age. In contrast, those who didn’t feed peanut by 6 months only introduced 3.2 additional top allergenic foods. (Although most current data relates to peanut and egg allergies, allergists now lean toward introduction of more allergens, on the concept that food avoidance may skew to the development of allergies.)
This paper was co-authored by dietitian Dr. Carina Venter (University of Colorado Medicine) and Christopher Warren, PhD (director of health medicine research with CFAAR). Here’s how the allergen introduction at 12 months broke down among caregivers who had fed a child peanut by 6 months:
- 42% also introduced egg by a year old;
- 50.1 also introduced wheat;
- 32.3% also introduced milk;
- 13.2% also introduced tree nuts;
- 10.5% also introduced finned fish;
- 7.1% also introduced shellfish;
- 11.8% also introduced sesame seed;
- 7.2% also added soy.
While food allergy families are starting grasp the early feeding message for allergy prevention, there’s still a long way to go within the population as a whole. “Sadly, we have a lot of room to improve because most parents are not introducing these common allergenic solids early in the first year of life,” Warren told Allergic Living.
He says that many are not yet hearing this information from their primary care provider. “Only about a quarter of parents received guidance from their PCP to introduce peanut in the first year of life.”
Gupta noted that it’s vital to step up communication on early introduction of peanut, especially in kids with eczema, who are at higher risk for developing food allergies. “We’ve got to get the message out to pediatricians and family practices,” Gupta, an expert on food allergy prevalence and societal patterns, said in an interview. “But also get the message out to the general population of parents and caregivers, so that they’re asking for this intervention.”
She adds: “we have to remember how busy pediatricians are, so it is a challenge to get on their radar.”
Gupta’s CFAAR team is now undertaking a three-year controlled trial that analyzes the benefits of an early introduction of multiple allergenic foods in allergy prevention. This will be compared to the standard of pediatric care in a large group of infants. The clinical trial, known as SEED, for the Start Eating Early Diet, will include parents (or caregivers) and their infants from across the U.S., recruited from different socioeconomic and racial backgrounds.
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