Babies could be weaned on peanuts from as early as four months of age to reduce peanut allergies, researchers leading a new study have suggested.
Researchers from King’s College London and the University of Southampton showed that weaning babies on smooth peanut butter and other suitable peanut snacks before they reached six months of age could reduce peanut allergies by 77%.
The new study published in the Journal of Allergy and Clinical Immunology Now identified a ‘window of opportunity’ between four and six months of age, depending on the child’s health.
The findings have provided evidence for recommendations in recent North American and European allergy guidelines, which now recommend introducing peanut products early for all infants.
Peanut allergy has seen a three-fold increase in recent decades, affecting around one in 50 children in the UK. Most peanut allergies have already developed by the time a child turns one year of age. Children with severe eczema and egg allergy and those of non-white ethnicity are also more likely to be affected.
Previous research by the team at King’s College showed that weaning babies on peanut products could decrease the incidence of allergies, but this new study has helped identify the time at which it is optimal to wean babies onto peanuts and how to reverse the allergy trend effectively.
Using data from the Enquiring About Tolerance (EAT) and Learning Early About Peanut Allergy (LEAP) randomised-controlled trials, studies led by King’s College London in collaboration with Guy’s and St Thomas’ NHS Foundation Trust, as well as the Peanut Allergy Sensitisation observational study, the researchers analysed information from over 2000 children, some of whom were at high risk and others at low risk of developing peanut allergy.
The findings show that introducing peanut products into all babies’ diets by six months could reduce peanut allergy by up to 77%. Waiting to introduce peanut products until 12 months of age would lead to only a 33% reduction in allergies. For children with severe eczema, the analysis suggests peanuts are best introduced at four months.
The most significant benefits are achieved if the whole population is targeted, and targeting only the highest-risk infants with severe eczema reduces the population disease burden by only 4.6%. The greatest reductions in peanut allergy were seen when the intervention targeted the larger but lower-risk groups. This is thought to be because most allergies occur in many babies without any known risk factors.
Professor Gideon Lack, from King’s College and Guy’s and St Thomas’ NHS Foundation Trust, said: ‘There is a narrow window of opportunity to prevent an allergy from developing. Introducing peanut products at four to six months of age could substantially reduce the number of children developing peanut allergy.’
The researchers advise that the early introduction of peanuts to the whole population, including those infants who are at higher risk of allergy ‘requires considerable education of health care professionals and families,’ which should include help with weaning strategies to address families’ concerns. Parents also need support in determining whether their baby is ready for solids and support in choosing appropriate peanut products. The researchers state that ‘it is critical that education stresses the need to introduce peanut products such as a peanut butter or peanut puffs—not the whole nut,’ which could be a choking hazard.
The estimated reduction in peanut allergy was shown to reduce with every month of delayed introduction and the benefits of introducing peanut products into babies’ diets decrease as they get older.
Graham Roberts, a professor of paediatric allergy from the University of Southampton, added: ‘Over several decades, the deliberate avoidance of peanut has understandably led to parental fear of early introduction. This latest evidence shows that applying simple, low-cost, safe interventions to the whole population could be an effective preventive public health strategy that would deliver vast benefits for future generations.’