Childhood Peanut Allergies Decline Significantly After New Guidelines

New research indicates that approximately 40,000 children in the United States avoided being diagnosed with peanut allergies following updated guidelines on introducing peanuts to infants. This significant decline comes a decade after a pivotal study revealed that early exposure to peanut products could reduce the likelihood of developing an allergy by more than 80%.

For many years, parents were advised to delay introducing common allergens, such as peanuts, to their infants. In 2015, this guidance began to shift, particularly for children at high risk of allergies. By 2017, the recommendations expanded further, prompting researchers to investigate the impact of these changes.

A study published on Monday in the journal Pediatrics found that rates of peanut allergies in children under the age of three dropped by approximately 43% after the new guidelines were implemented. Overall, cases of food allergies in this age group decreased by about 36%.

Dr. David Hill, an attending allergist at the Children’s Hospital of Philadelphia and senior author of the study, expressed surprise at the magnitude of the results. He stated, “Even being able to say that allergy rates plateaued would be huge news, but the fact that we actually saw a reduction in the onset of new food allergy in kids under three is incredible.”

The study involved an analysis of electronic health records from nearly 50 pediatric practices, tracking food allergy diagnoses among around 120,000 children aged zero to three. According to the findings, the peak onset of peanut allergy occurs around 15 months. Children were classified as newly allergic if they received a diagnosis code for a food allergy and were prescribed an EpiPen.

Interestingly, the reduction in diagnoses occurred despite reports indicating that only about 29% of pediatricians and 65% of allergists adhered to the expanded guidelines issued in 2017. Confusion regarding the best methods for early peanut introduction contributed to this lag, as noted in a commentary accompanying the study.

Sung Poblete, chief executive of the nonprofit organization Food Allergy Research and Education, praised the study for relying on real-world data. She commented on the significance of demonstrating that the “eat early, eat often” approach, shown to work in clinical settings, also effectively reduces the incidence of allergies in the general infant population.

Peanut allergies occur when the immune system mistakenly identifies peanut proteins as harmful, leading to symptoms ranging from hives and gastrointestinal distress to severe anaphylaxis. Poblete emphasized the importance of policy changes to further reduce the risk of life-threatening allergies, suggesting that the U.S. Department of Agriculture should consider including peanut products in infant food packages.

The prevalence of food allergies has been rising, with approximately 2.2% of children in the U.S. currently diagnosed with a peanut allergy. Dr. Hill highlighted additional risk factors, including cesarean section births and exposure to antibiotics, which may contribute to the development of these allergies.

“This is just a call to double down our efforts to understand why it is that children develop food allergies and how we can better treat and ultimately cure these diseases,” Hill stated.

Since the research period, guidelines for introducing allergenic foods have continued to evolve. In 2021, the Academy of Pediatrics recommended that all infants be introduced to major food allergens, including peanuts and eggs, between the ages of four to six months.

This ongoing evolution in dietary recommendations aims not only to address current rates of food allergies but also to foster a healthier future for children worldwide.