Expert panel issues clinical guidelines to prevent peanut allergy

January 5, 2017, NIH/National Institute of Allergy and Infectious Diseases
peanuts
Credit: Daniele Pellati/public domain

An expert panel sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, issued clinical guidelines today to aid health care providers in early introduction of peanut-containing foods to infants to prevent the development of peanut allergy.

Peanut allergy is a growing health problem for which no treatment or cure exists. People living with , and their caregivers, must be vigilant about the foods they eat and the environments they enter to avoid allergic reactions, which can be severe and even life-threatening. The allergy tends to develop in childhood and persist through adulthood. However, recent scientific research has demonstrated that introducing peanut-containing foods into the diet during infancy can prevent the development of peanut allergy.

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 addendum provides three separate guidelines for infants at various levels of risk for developing peanut allergy and is targeted to a wide variety of providers, including pediatricians and family practice physicians.

"Living with peanut allergy requires constant vigilance. Preventing the development of peanut allergy will improve and save lives and lower health care costs," said NIAID Director Anthony S. Fauci, M.D. "We expect that 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."

Addendum Guideline 1 focuses on infants deemed at high risk of developing peanut allergy because they already have severe eczema, or both. The expert panel recommends that these infants have peanut-containing foods introduced into their diets as early as 4 to 6 months of age to reduce the risk of developing peanut allergy. Parents and caregivers should check with their infant's before feeding the infant peanut-containing foods. The health care provider may choose to perform an allergy blood test or send the infant to a specialist for other tests, such as a skin prick test or an oral food challenge. The results of these tests will help decide if and how peanut should be safely introduced into the infant's diet.

Guideline 2 suggests that infants with mild or moderate eczema should have peanut-containing foods introduced into their diets around 6 months of age to reduce the risk of peanut allergy. Guideline 3 suggests that infants without eczema or any 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.

Development of the Addendum Guidelines was prompted by emerging data suggesting that peanut allergy can be prevented by the early introduction of peanut-containing foods. Clinical trial results reported in February 2015 showed that regular peanut consumption begun in infancy and continued until 5 years of age led to an 81 percent reduction in development of peanut allergy in infants deemed at high risk because they already had severe eczema, egg allergy or both. This finding came from the landmark, NIAID-funded Learning Early About Peanut Allergy (LEAP) study, a randomized clinical trial involving more than 600 infants.

"The LEAP study clearly showed that introduction of peanut early in life significantly lowered the risk of developing peanut allergy by age 5. 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," said Daniel Rotrosen, M.D., director of NIAID's Division of Allergy, Immunology and Transplantation.

In 2015, NIAID established a coordinating committee representing 26 professional organizations, advocacy groups and federal agencies to oversee development of the Addendum Guidelines to specifically address the prevention of peanut allergy. The coordinating committee convened a 26-member expert panel comprising specialists from a variety of relevant clinical, scientific and public health areas. The panel, chaired by Joshua Boyce, M.D., professor of medicine and pediatrics at Harvard Medical School, used a literature review of food allergy prevention research and their own expert opinions to prepare draft guidelines. The draft guidelines were available on the NIAID website for public comment from March 4 to April 18, 2016. The and coordinating committee reviewed the 104 comments received to develop the final Addendum Guidelines.

Explore further: When and how to introduce peanut-containing foods to reduce allergy risk

More information: The Addendum Guidelines will be published January 5 in the Journal of Allergy and Clinical Immunology and co-published in the Annals of Allergy, Asthma and Immunology; Journal of Pediatric Nursing; Pediatric Dermatology; World Allergy Organization Journal; and Allergy, Asthma and Clinical Immunology. DOI: 10.1016/j.jaci.2016.10.010

Related Stories

When and how to introduce peanut-containing foods to reduce allergy risk

November 11, 2016
Parents may be confused with how and when to introduce peanut-containing foods to their infants. Presentations at the American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting will offer guidance, ...

Study explores factors linked to successful peanut OFC

December 5, 2016
(HealthDay)—Early peanut introduction is associated with increased probability of a successful oral food challenge (OFC), with higher odds for introduction between 6 to 11 versus 4 to 6 months, according to a study published ...

Doctors recommend early exposure to prevent peanut allergies

August 25, 2015
A pediatricians' group is recommending that infants at high risk of peanut allergies be given foods containing peanuts before they turn 1.

Anaphylaxis risk up for siblings of peanut allergic children

June 14, 2016
(HealthDay)—The risk of anaphylaxis is increased upon peanut introduction in siblings of children with peanut allergy, according to a study published online June 13 in Allergy.

Peanut allergy prevention strategy is nutritionally safe, study shows

June 10, 2016
Introducing peanut-containing foods during infancy as a peanut allergy prevention strategy does not compromise the duration of breastfeeding or affect children's growth and nutritional intakes, new findings show. The work, ...

Gene-environment connection seen in peanut allergy study

December 15, 2014
(HealthDay)—Infants of a particular generation born in Australia to Asian-born parents appeared to have an increased risk of peanut allergy compared with those of Australian-born parents, according to research published ...

Recommended for you

Newly identified T cells could play a role in cancer and other diseases

December 6, 2018
Researchers from the UCLA Jonsson Comprehensive Cancer Center and the La Jolla Institute for Immunology have identified a new type of T cell called a phospholipid-reactive T cell that is able to recognize phospholipids, the ...

Classifying brain microglia: Which are good and which are bad?

December 6, 2018
Microglia are known to be important to brain function. The immune cells have been found to protect the brain from injury and infection and are critical during brain development, helping circuits wire properly. They also seem ...

Memory B cells in the lung may be important for more effective influenza vaccinations

December 5, 2018
Seasonal influenza vaccines are typically less than 50 percent effective, according to Centers for Disease Control and Prevention studies. Research at the University of Alabama at Birmingham, published this week in Nature ...

Tuberculosis survives by using host system against itself, study finds

December 5, 2018
In a new study published in the Journal of Experimental Medicine, scientists at the University of Notre Dame have discovered that the pathogen Mycobacterium tuberculosis (MTB) releases RNA into infected cells. This RNA stimulates ...

RSV study reveals age when infants are most vulnerable to asthma

December 5, 2018
New research suggests a maternal vaccination against RSV should be augmented with active immunisation in a child's first two years to reduce the onset of asthma.

New Zika vaccine effective in preclinical trials

December 4, 2018
Researchers at the University of Hawaii medical school have successfully developed a vaccine candidate for the Zika virus, showing that it is effective in protecting both mice and monkeys from the infection.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.