The latest government advice to parents is: Let them eat peanuts!
Guidelines for new parents is known to shift with the times and the latest government recommendations on when to expose children to peanuts represents a dramatic shift from previous advice to delay exposing children to peanuts until at least after infancy.
On Thursday the National Institute of Allergy and Infectious Diseases presented new guidelines, recommending giving babies food containing peanuts as early as 4 to 6 months old, and even earlier if a child is prone to allergies and a child's doctor offers the green light.
"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. in a statement. "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."
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The new guidelines reflect a shift in understanding how peanut allergies develop. Advice given out by the American Academy of Pediatrics as recently as 2000, had instructed parents to avoid exposing their children to peanuts until they were at least 3 years old.
The new recommendations are a clear departure from earlier guidelines and stem from a landmark study in 2015 that suggested feeding foods containing peanuts to babies appears to prevent allergies.
The February 2015, NIAID-funded Learning Early About Peanut Allergy (LEAP) study was a randomized clinical trial involving more than 600 infants. The infants, aged four to 11 months, were considered at high risk of becoming allergic to peanuts either because of a pre-existing egg allergy or eczema.
Researchers randomized the children into two groups - some were fed foods containing pureed peanuts and others were told to avoid peanuts until they turned five - to see if avoiding peanuts was really the best way to prevent peanut allergy.
They found that by age five, fewer than one percent of the children who ate food containing peanuts three or more times each week developed a peanut allergy, compared to 17.3 percent in the group that avoided peanuts entirely.
Put another way: regular peanut consumption before the age of 5 years led to an 81 percent reduction of peanut allergies in infants deemed at high risk of developing the allergy.
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The findings, and others like it, suggest that the new guidelines could dramatically lower rates of severe peanut allergies if parents take the advice to heart.
Peanut allergies cause more deaths from anaphylaxis, or constriction of the airways, than any other food allergy. Though deaths are rare, children who develop a peanut allergy generally do not outgrow it and are burdened with avoiding exposure to peanuts their whole lives.
Despite the change in strategy, the panel advised proceeding with caution for children with severe eczema or egg allergies. The panel recommends exposing such children to peanuts by four to six months of age, but only after being tested first by a medical professional.
Children who don't show signs of these severe allergies can be exposed to moderate levels of peanuts, without prior medical testing, according to the panel.
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