Some more good news on the peanut allergy and other food allergy front. In 2015, medical advice changed to : Yes, please introduce tiny amounts of foods such as peanuts and eggs in the first year of life to prevent food allergies. And...since then, the incidence of food allergies, including peanut allergies, in children has dramatically gone down when that advice is followed.
A recent study found that the incidence of peanut allergies in children has really dropped since parents started introducing peanut products in infancy. Introducing tiny amounts frequently of the food of concern (nuts, eggs, etc.) in the first year of life (by 4 to 6 months of age) challenges and trains the immune system. [Official instructions on how to feed peanut products to infants]
Unfortunately, many doctors and parents are still not following the advice because it is so opposite from earlier medical advice, which for decades said to avoid, avoid, avoid the food (e.g., nuts, eggs) in early childhood. It is thought that if more doctors and parents followed the new advice for infants, then food allergy rates would drop even more.
By the way, the rate of dog and cat allergies also drops when there is more furry animal exposure in the first year of life. Same reason.
From Medscape: Food Allergy Rates Fall After 2015 Peanut Feeding Advice
Peanut allergies in babies and children up to age 3 dropped by more than one-quarter since the first consensus statement recommending the introduction of peanut products in infancy was issued in 2015, according to a new study published in Pediatrics.
Although guidelines on early peanut introduction were published nearly a decade ago, their effect on changing rates of food allergy in real-world clinical practice had not been examined, said David A. Hill, MD, PhD, a pediatric allergist, immunologist, and attending physician at Children’s Hospital of Philadelphia, Pennsylvania, who led the study.
“We were encouraged, but not entirely surprised, to see a clear decline in peanut and overall IgE-mediated food allergy rates following the 2015 and 2017 early introduction guidelines,” said Hill. “Clinicians should feel confident recommending introduction of peanut-containing foods around 4-6 months of age for nearly all infants, without waiting for allergy testing.”
Hill and his team reviewed electronic health records from 31 practices within academic health systems and 17 independent practices in the mid-Atlantic region. The study population included two groups: those who received care before the 2015 guidelines were published (38,594 children; mean age, 1.2 years), and another who received care in the 2 years following (46,680 children; mean age, 0.9 years).
Participants were observed for a minimum of 2 years for the development of atopic dermatitis and immunoglobulin E-mediated food allergy (IgE-FA).
Hill and his colleagues also conducted a 1-year “post-addendum” cohort with entry between February 2017 and January 2019 to reflect the publication of addendum guidelines in early 2017 (39,594 children; mean age, 0.8 years). These guidelines formally recommended early peanut introduction for all infants at low risk for developing peanut allergy and for infants deemed at high risk due to severe eczema or egg allergy.
The August 2015 brief consensus statement on introducing allergenic foods to infants was cosigned by the American Academy of Allergy, Asthma & Immunology, the American Academy of Pediatrics, and the American College of Allergy, Asthma & Immunology, among others.
The statement followed the publication of the landmark Learning Early about Peanut Allergy (LEAP) study, in which significantly fewer infants randomized to peanut exposure developed peanut allergies than those who avoided the food completely.
The takeaway of the new study is that early and sustained introduction of peanut and other allergenic foods works, Hill told Medscape Medical News.
“Although the advice has been out for years, studies have suggested some parental reluctance and even some health provider reluctance to follow the advice, probably because it is so different than what was suggested 15-20 years ago, and because peanut is such as well-recognized allergen,” he said.