A decade after a landmark study showed that early introduction of peanut products could reduce peanut allergy in young children, experts can definitively say the change in guidelines has had a major impact.
Food allergies have significantly dropped since the National Institute of Allergy and Infectious Diseases adopted new guidelines in 2017, two years after the groundbreaking Learning Early About Peanut Allergy trial.
Now a study published in the November issue of Pediatrics further supports the common practice with findings that food allergy rates in children under 3 fell after the guidelines were put into place — equating to nearly 60,000 fewer children with food allergies.
For nearly a decade, Monroe Carell Jr. Children’s Hospital at Vanderbilt has been a member of the Food Allergy Resource and Education (FARE) Clinical Network, a research coalition of leading food allergy centers dedicated to the development of effective approaches to treatment while improving the quality of patient care.
The Allergy and Immunology Clinic at Vanderbilt Health One Hundred Oaks, a FARE Clinical Network Center of Distinction, works to improve the quality of life and health of individuals with food allergies through transformative research, education and advocacy. It houses the Oral Immunotherapy Clinic, run by Rachel Robison, MD, associate professor of Pediatrics within the Division of Pediatric Allergy, Immunology and Pulmonology at Monroe Carell.
In 2024, the Consortium for Food Allergy Research (CoFAR) awarded Vanderbilt University Medical Center a seven-year, $5 million grant to conduct food allergy research and establish a food allergy clinical research center.
Recently, Robison, who is co-principal investigator of the CoFAR research effort, highlighted the essential information surrounding peanut allergy protocols.
Q: A recent study published in Pediatrics is creating a lot of buzz among allergists and families concerned about food allergies. What’s going on?
A: This is the first study that looks at whether the guidelines put in place in 2017 had any impact. And the answer is, yes, there was a significant decrease in the rates of food allergies. The study revealed a 36% drop in all food allergies and a 43% decrease in peanut allergies.
Q: What is the current guidance for introducing foods to children?
A: First, parents should always consult their pediatrician prior to introducing infants to solid, complementary foods. We usually recommend that families introduce common food allergens at home between the ages of 4 and 6 months when the child is developmentally ready. Very few children are at high risk for the development of a food allergy. Those at highest risk are infants with severe eczema, and they may benefit from evaluation by an allergist prior to allergic food introduction.
Q: How are children tested for food allergies? Does it require a special appointment or expert?
A: The first thing we need to share is that the majority of children do not need to be tested. Oftentimes, early introduction to allergens directly to the infant is the best test. If a child can tolerate eating the food, it’s a far better test than anything I can offer in my clinic.
That said, there are two means of testing for a food allergy — a skin prick or blood-based testing, which can be done under the direction of a board-certified allergist-immunologist when indicated.
Q: What is the biggest takeaway from the latest news on early introduction and allergens?
A: The newest report reinforces what we have been practicing to reduce peanut allergies.
Parents should feel reassured that if a pediatrician directs them to try various foods early in their child’s diet, it’s safe and effective in preventing food allergies.
Pediatricians/primary care providers need to be reminded that it makes a difference when they talk about this practice during well-child visits. Pediatricians are on the front line to advocate these measures to help prevent the development of food allergies.
Q: What if the home introduction doesn’t go as a parent hoped?
A: Unfortunately, despite early introduction, a proportion of children will still go on to develop a food allergy. Evaluation with a board-certified allergist-immunologist can be extremely helpful in helping families navigate food avoidance and discussing potential options for therapies. We want to offer hope to families whose children develop allergies because we have a handful of therapies to help minimize the risk of reactions in food allergic children.
