Introduction of Highly Allergic Foods

Introduction of Highly Allergic Foods

Early introduction of Peanut products: The well known LEAP trial came out while I was in residency and was yet to be standard of care during my training, but since its results were published in February 2015 it has made waves in the medical community. As the prevalence of peanut allergy has risen in the past 10 years, there is a question whether early introduction can help prevent peanut allergy. This hypothesis came about after research showed that Jewish children in the UK had a much higher incidence of peanut allergy than Jewish children with the same ancestry in Israel. The only difference that was readily obvious was the timing of the introduction of peanut products. In the UK, most babies were not introduced to peanut products before the age of 1, while in Israel, due to the popular snack Bamba, children on average were introduced to peanut products at 7 months of age. The LEAP trial was a study to determine whether early introduction of peanuts to children at high risk of peanut allergy would be less likely to develop a peanut allergy. In summary, the trial took children at high risk of a peanut allergy (those with egg allergies and/or severe eczema- both of which are risk factors for developing a peanut allergy) aged 4-11 months and randomly assigned them to either receive 6g of peanut protein a week or to avoid peanut products. They followed these children, and at 5 years of age tested them for peanut allergies. Only 3.2% of children who received peanut products between 4-11 months had a peanut allergy versus 17.2% of the children who avoided peanut products had a peanut allergy. While this study is the basis of the new recommendations to introduce highly allergic foods early to infants, it important to remember this was a study that focused on high risk patients and did not test low risk patients which most children are considered. As a doctor, I will explain this data to my patients and let them decide. We have decided to introduce peanut products and other highly allergic foods to our little one early. What were your doctor’s recommendations? What have you decided to do?

 

 

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