New Study Rebukes Everything We Thought We Knew About Peanut Allergy Prevention

image source: heather neal
image source: heather neal

Back in my pre-baby, not-quite-married days (it’s not as long ago as it sounds), I was cramming my weeks full of all things health and nutrition as I worked toward becoming a registered dietitian. I was exposed to a whole lot of information and experiences in what felt like a very short amount of time, and many still stick in my mind as if I saw them happening yesterday. One in particular was truly eye-opening (and ended up really hitting home years later). During a pediatric rotation at a children’s hospital, I observed part of a new and exciting — and terrifying — clinical trial that was hunting for a cure for food allergies. The study entailed feeding kids with food allergies exactly the food that was the root of their allergy, in this case milk and then later peanuts. (I’m literally cringing right now as I think of my milk-allergic son trying yogurt for the first time.) It was one of those things that sounded so backwards and bizarre that it actually made sense. The thought behind the research (I’m summarizing here) was to desensitize the kids to the protein that triggered their reaction by feeding them extremely small amounts of the protein over time in an environment that was equipped to handle a reaction.

It was a really cool and innovative trial that seemed promising. I wasn’t there when the study concluded but it had positive results. What I remember most though, wasn’t the science or the nutrition. It was how absolutely terrified those parents must have been, willingly giving their children something that could harm them in order to make them better. Like I said, I had no idea at the time that my son’s story would end up with a similar plot line as these kids’, though not as severe. Now that we’ve been there, I’m hyperaware of food allergy and feeding recommendations. Already knowing my infant son was allergic to dairy, gluten, soy, and eggs, I was understandably hesitant when it came time to feeding him peanuts, a common allergen with anaphylactic (and potentially life-threatening) reactions. Spoiler alert: I fed him peanuts fairly early on after doing my own research and with the blessing of our pediatrician, and he’s not allergic.

I thought we just got lucky with that one, but with new research that’s striking headlines this week, I wonder whether exposing him to the allergen early on had any role in our outcome. I’ll never know the answer to that, but it doesn’t make the news any less exciting: researchers have found that early, small exposures to peanuts may help prevent an allergy from forming. While this is different than curing an allergy, it’s monumental regardless. After all, the best cure is prevention.

It’s no secret that allergies, peanut allergies in particular, are on the rise nationwide. Back in 2000, the American Academy of Pediatrics recommended that parents wait until kids were 3 years old to start eating peanuts, in hopes that delaying introduction would prevent reactions. That didn’t work, as allergy rates rose even further and led to the recommendation being reversed just eight years later (i.e. you shouldn’t wait to give your kid peanuts). Understandably confusing, it left a lot of parents wondering what they should do when it came to their own kids. This new study helps shed a little more light on a complicated situation.

In the study, researchers identified infants between 4 and 11 months old that were at risk for peanut allergies. (Those that were high-risk were excluded for safety purposes.) They were then put into one of two groups. The first group was told to avoid peanut protein. The other group consumed small amounts of peanut protein, the equivalent of 24 peanuts a week. After five years, the outcomes revealed that fewer peanut allergies developed in the group that was eating peanuts — 1.9% versus 13.7% with allergies in the avoidance group. Out of the group of infants that showed mild reactions to peanuts on an initial test, 10.6% developed an allergy compared to 35.3% of those that didn’t eat peanuts.

These results, while not able to be generalized into widespread results or recommendations just yet, are promising in the world of food allergy prevention, especially when it comes to peanuts. (While exciting, it’s important for parents to remember not to try these kinds of things on their own.) A next important step in this type of research is under way now, as the children in the study will be observed for another year as they stop eating peanuts to see what happens.

As terrifying as it may sound to expose kids early on to something they might be allergic to, I’d rather go through that experience than what we have to do now, which is almost the reverse: feed my son foods we know he’s allergic to in order to see if he’s outgrown them or not. It’s either that or get his skin pricked yet again, which gets more and more traumatizing (to both of us) as he gets older. Hopefully studies like this will help solidify best practices and recommendations in the future to be able to prevent as many kids from dealing with food allergies as possible, allowing parents to breathe a small sigh of relief.

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