Say Nuts to Allergies: Another Illusion is Overturned

Say Nuts to Allergies, Another Illusion is Overturned--
Feeding Peanuts Early to Infants Actually Prevents Allergy to Peanuts

For many years, the ruling wisdom has held that if you expose your baby to various foods early, especially peanuts, you will increase the chance your child will develop an allergy to that food.

The advice based on this idea has been to ask pregnant women to not eat peanuts, for nursing mothers to not eat peanuts, and for all mothers to protect there infant and child from any exposure to peanuts for 3-4 years.

We have always been skeptical of this advice, mainly because the premise was invented, not actually observed.

About 5 years ago, in December, 2009, we posted a blog that presented the first indication that if you avoid foods, you do not protect your child, you actually make things worse:      https://www.blogger.com/blogger.g?blogID=6797182962943872595#editor/target=post;postID=2888210640457764870;onPublishedMenu=allposts;onClosedMenu=allposts;postNum=12;src=postname

Since 2009, we have reassured families that not only is it OK to eat any foods during pregnancy, including peanuts, it was a good idea to introduce solids as early as 4 months of age.

Now comes a major new study in The New England Journal of Medicine, the world's leading medical journal:  http://www.nejm.org/doi/full/10.1056/NEJMoa1414850?query=featured_home#t=articleTop
(summarized in the NY Times here:  http://well.blogs.nytimes.com/2015/02/23/feeding-infants-peanut-products-could-prevent-allergies-study-suggests/?ref=health

This study not only proves that exposure to peanuts in infancy does not lead to peanut allergy, it prevents it.

The numbers are rather dramatic.  In the group of children that were fed peanuts during infancy, 1.9% developed peanut allergy by age 5 years.   Now, consider the children who were not exposed to peanuts , by age 5, 13.7% were allergic to peanuts at age 5.   Feeding an infant peanuts dropped the chance of becoming allergic to peanuts by 86%!

And this in a group of infants selected to be very prone to allergy- they all had either severe eczema and/or egg allergy.   The group just described had negative skin testing to peanuts in infancy.    But even in infants who tested positive for peanut allergy on skin test in infancy had less allergy at age 5 if they were fed peanuts: if not fed peanuts, 35% had peanut allergy if not fed peanuts, only 10% in this group were allergic if fed peanuts.

The findings are so dramatic that experts commenting on these findings are calling for a new approach to introducing solids to infants.   There is now real hope that if we feed infants peanuts (in a swallowable texture), we could stop the rise of peanut allergy in the developed world.

Five years after we called for a new look at the very suspect notion that avoiding a food in infancy would reduce the risk of allergy, the evidence appears to be convincing:  feed early, feed peanuts, and you can truly reduce the risk of your child developing food allergies, almost certainly to peanuts.

1.  For many years we have been told that it is best to "protect" your baby from exposure to various foods.  We were told that if you do this, your child is less likely to develop allergies to foods.  And, that this is all especially true in the case of peanuts.
2.  Starting in 2009, Advanced Pediatrics began questioning this concept, noting there was no actual evidence to support it.  And important studies actually proved that it was not true.  We began advising it was not only safe, but a good idea to introduce solids as early as families were comfortable doing so, as early as 4 months old.
3.  Now comes a powerful study that demonstrates that giving infants peanuts to eat sharply reduces the chance they will be allergic to peanuts at age 5, even amongst highly allergic children, whether skin test positive to peanuts early in life or not.
4.  The evidence has reached a level that experts are now moving official advice on infant feeding to one step beyond what we promoted in 2009:  that the introduction of solid foods earlier in infancy, and in particular, the introduction of peanuts into infant diets, could change the face of peanut allergy in the US.
5.  Very importantly: if an infant of any age is fed peanuts, the peanuts must be in a texture the infant can swallow without choking- a thin puree or paste, never a whole peanut.

To your health-
Dr. Arthur Lavin

*Disclaimer* The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

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