The NEJM Peanut Study: Is It Better to Introduce Allergenic Foods Early?

In 2000, the AAP advised delaying introduction of peanuts and tree nuts until age 3. But new research finds delaying exposure considerably boosts the chances of a peanut allergy.

By now, you’ve probably heard about the recent study, which showed that early consumption of peanuts lowers the risk of peanut allergy by as much as 86%.

 The study, led by Gideon Lack of King’s College, London, and published in the New England Journal of Medicine in February, is the first randomized clinical trial conducted on preventing peanut allergy in children. Widely hailed as a game changer, the study’s findings are already affecting the advice given to parents.

Just last week my friend’s pediatrician counseled her to “stir a little peanut butter” into her 6-month-old’s rice cereal. She barely managed to avoid gaping at him in astonishment. Just two years earlier, with her first child, he had told her to avoid introducing peanuts for the first year.

After decades of conflicting advice and vague admonitions, parents may wonder whether such a dramatic change is actually warranted. Is the evidence any better now than it was ten years ago? And if the guidelines were so mistaken before, why have confidence in them now?

And, perhaps the biggest outstanding question of all: what, if anything, does this study mean for when to introduce other highly allergenic foods, like fish, tree nuts, or eggs?

Continue reading “The NEJM Peanut Study: Is It Better to Introduce Allergenic Foods Early?”