Food allergy prevention: should we give infants peanuts?

According to the US Centers for Disease Control and Prevention, food allergies in children have increased by about 50% between 1997 and 2011. There is no clear answer as to why this is, but as a result of this dramatic increase, the focus has shifted from treatment to prevention. Now, a new review presents the latest evidence on how to prevent food allergies in children.

The review is published in CMAJ, the Canadian Medical Association Journal, and provides guidance for physicians and families on how they should introduce foods to infants in order to decrease allergy risks.

A food allergy takes place when the body produces an immune response to certain foods. This immune response can be life threatening - as in the case of anaphylaxis. Though the immune system is in place to protect us from germs, in people with food allergies, it mistakes foods for harmful objects.

Though any food can cause an allergic response, the eight foods that account for 90% of all reactions are: cow's milk, eggs, peanuts, tree nuts, soy, wheat, fish and shellfish.

Previous guidelines suggested parents should avoid introducing potentially allergenic foods until 12-36 months of age in babies that have a high risk for reactions - for example, if a sibling has a food allergy.

In 2000, the American Academy of Pediatrics (AAP) recommended that parents avoid introducing high-risk infants to cow's milk until 12 months, eggs until 24 months, and nuts and fish until 36 months.

Introducing peanuts between 4-11 months of age 'beneficial'

The researchers of this latest review - led by Drs. Elissa Abrams and Allan Becker, from the University of Manitoba in Winnipeg, Canada - say a recent randomized controlled trial, called the Learning Early About Peanut (LEAP) study, concluded that giving peanuts to children at high risk of peanut allergy early, rather than late, reduced food allergy risk by 80%.

Fast facts about food allergy in the US

§ There are approximately two kids in every classroom with food allergy

§ Children's food allergies cost the country around $25 billion each year

§ Every 3 minutes, a food reaction sends someone to the emergency department.

Learn more about food allergy

The team cautions, however, that such children should probably have an allergist's evaluation before being introduced to peanuts.

Additionally, a prospective study - conducted in 2006 and involving over 1,600 children who were followed from birth to 5 years of age - concluded that there was an increased risk of wheat allergy among children introduced to wheat from the age of 6 months.

Following on from the LEAP study, the AAP and the American Academy of Allergy, Asthma and Immunology (AAAAI) now advise that high-risk infants should be introduced to peanuts between 4-11 months of age.

Although some women have avoided consuming potentially allergenic foods during pregnancy and breastfeeding to try to prevent allergy development in their babies, the review also notes that current guidelines do not support these avoidance diets.