Researchers in the UK have said they have identified a “clear opportunity” whereby introducing an allergen into a baby’s diet when they are between four and six months old significantly reduces their risk of developing the condition.
They added that waiting to introduce the peanut products until the children are one year old would lead to a reduction in cases of only 33%.
The NHS currently recommends introducing solid foods to babies from around six months of age, when they are considered to be developmentally ready.
Based on their findings, recently published in The Journal Of Allergy And Clinical Immunology, scientists are calling on the government to review the latest evidence.
Professor Graham Roberts, from the National Institute for Health and Care Research (NIHR) Southampton Biomedical Research Center and the University of Southampton, said the latest government review was in 2018 and there have since been numerous studies showing that the introduction of foods from three to four months old “very successfully reduces the chance of developing peanut allergy and also other food allergies.”
Introducing peanut products at four to six months of age could significantly reduce the number of children developing peanut allergies
He added: “So we would suggest that now is the time for the government to review this evidence, and I suspect they will change the recommendations around the introduction of peanuts.”
Professor Roberts said there are challenges to be overcome as for many decades “deliberate avoidance of peanuts has understandably led to parental fear of early introduction”.
He said: “This latest evidence shows that applying simple, low-cost, safe interventions to the entire population could be an effective preventive public health strategy that would yield huge benefits for future generations.”
Peanut allergy affects about 2% (1 in 50) of children in the UK and has been on the rise in recent decades, according to Allergy UK.
Most peanut allergies have already developed by the time a child turns one year old.
It’s more common in children with severe eczema and egg allergies, the researchers said, and children of non-white ethnicity are also more likely to be affected.
As part of the study, the researchers looked at data from the Inquiring About Tolerance (EAT) and Learning Early About Peanut Allergy (LEAP) studies.
The Leap study involved 640 infants who were at high risk of developing peanut allergy and examined the early introduction of peanut products.
The Eat project recruited more than 1,300 three-month-old babies in England and Wales and followed them for several years, examining the early introduction of six allergenic foods: milk, peanuts, sesame, fish, eggs and wheat.
They also looked at data from the Peanut Allergy Sensitization study.
The researchers said their findings showed it was best to introduce peanut products to babies four to six months old.
For babies with eczema, the researchers recommend introducing the products, creamy peanut butter or other suitable peanut snacks, from four months onwards.
Whole or broken peanuts should not be given to babies, the team said.
Education becomes important here, both for health professionals and parents, so that any change in advice is effective and safe
They said the baby must also be developmentally ready to start solids.
The team also advises mothers to breastfeed for at least the first six months of their child’s life, in addition to introducing peanuts into their diet from four to six months.
Babies who develop severe allergic reactions, such as difficulty breathing, should seek immediate medical attention, the scientists said.
Professor Gideon Lack, from King’s College London and Guy’s and St Thomas’ NHS Foundation Trust said: “The benefits of introducing peanut products into babies’ diets diminish as they get older.
“This reflects the experience in Israel, a culture where peanut products are usually introduced early in the children’s diet and peanut allergy is rare.
“There is a small chance of preventing an allergy from developing.
“Introducing peanut products at four to six months of age could significantly reduce the number of children who develop peanut allergies.”
Mary Fewtrell, Professor of Pediatric Nutrition at the UCL CIS Institute of Child Health, commenting on the study, said: “This may be a sensible approach, but it does not make recommendations for infant feeding, taking into account only one outcome, such as food allergies.
“The risks and benefits of any proposal for a range of outcomes should be considered, which is what the expert groups will do when deciding whether to change existing advice.”
She added: “As the authors point out, education becomes important here, both for health professionals and parents, so that any change in advice is effective and safe.”
Margaret Kelman, acting head of clinical services for Allergy UK, added: “For parents-to-be and parents of young babies, there will hopefully be a change in weaning advice, particularly for babies who are considered to be at high risk of allergy.
“For those considering introducing peanut products around four months, we believe it is important to do so under the guidance of a healthcare professional.
“Notwithstanding, this latest research supports previous studies showing that adopting this practice could potentially lead to a reduction in the incidence of peanut allergy in the food-allergic population.”