Introducing infants to peanut-containing foods may prevent the development of peanut allergy.

BETHESDA, MD. — Introducing infants to peanut-containing foods may prevent the development of peanut allergy, according to a panel sponsored by the National Institute of Allergy and Infectious Diseases, part of the Bethesda-based National Institutes of Health. The panel provided three separate guidelines for infants at various levels of risk for developing peanut allergy.

Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases

“Living with peanut allergy requires constant vigilance,” said Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (N.I.A.I.D.). “Preventing the development of peanut allergy will improve and save lives and lower health care costs.

“We expect the widespread implementation of these guidelines by health care providers will prevent the development of peanut allergy in many susceptible children and ultimately reduce the prevalence of peanut allergy in the United States.”

The first guideline covers infants deemed at high risk of developing peanut allergy because they already have severe eczema, egg allergy or both. The panel recommends peanut-containing foods should be introduced into the infants’ diets as early as 4 to 6 months of age. Parents and caregivers should check with their infant’s health care provider before feeding the infant peanut-containing foods.

The second guideline covers infants with mild or moderate eczema. They should have peanut-containing foods introduced into their diets at about 6 months of age.

The third guideline covers infants without eczema or any food allergy. They should have peanut-containing foods freely introduced into their diets.

In all cases, infants should start other solid foods before they are introduced to peanut-containing foods.

The new Addendum Guidelines for the Prevention of Peanut Allergy in the United States supplement the 2010 Guidelines for the Diagnosis and Management of Food Allergy in the United States. The new guidelines were published Jan. 5 in the Journal of Allergy and Clinical Immunology and may be found here. They also are scheduled to be co-published in the Annals of Allergy, Asthma and Immunology; Journal of Pediatric Nursing; Pediatric Dermatology; World Allergy Organizational Journal; and Allergy, Asthma and Clinical Immunology.

Tonya Winders, president and chief executive officer of the Allergy & Asthma Network

“These new guidelines are very exciting in that they have the potential to reduce the prevalence of peanut allergy in the United States,” said Tonya Winders, president and chief executive officer of the Allergy & Asthma Network. “Parents of at-risk children can now take steps to prevent the development of peanut allergy by introducing peanut-containing foods as early as 4 months of age.

“However, we continue to strongly urge parents of at-risk children to not introduce peanut into their child’s diet without first consulting a board-certified allergist who can closely supervise and monitor the results.”

The Allergy & Asthma Network, a national non-profit organization based in Vienna, Va., said peanut-containing foods should be given to children only when they are not ill. Whole peanuts, because they are a choking hazard, should never be given to infants.

Clinical trial results reported in February 2015 showed regular peanut consumption that began in infancy and continued until age 5 led to an 81% reduction in the development of peanut allergy in infants deemed at high risk because they already had eczema, egg allergy or both. The finding came from the Learning Early About Peanut Allergy (LEAP) study, which was funded by the N.I.A.I.D.

Daniel Rotrosen, M.D., director of N.I.A.I.D.’s Division of Allergy, Immunology and Transplantation

“The LEAP study clearly showed that introduction of peanut early in life significantly lowered the risk of developing peanut allergy by age 5,” said Daniel Rotrosen, M.D., director of N.I.A.I.D.’s Division of Allergy, Immunology and Transplantation. “The magnitude of the benefit and the scientific strength of the study raised the need to operationalize these findings by developing clinical recommendations focused on peanut allergy prevention.”