Preventing Peanut Allergies

Early Introduction May Provide Protection

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What is a peanut allergy?

A peanut allergy is when the body's immune system mistakenly identifies peanut proteins as something harmful, and launches an immune response. A peanut allergy is an Immunoglobulin-E (Ig-E) mediated hypersensitivity reaction. In this reaction, IgE and other anaphylatoxins release histamine and other mediator substances from mast cells. This causes constriction of bronchial smooth muscles, increases vascular permeability, causes vasodilation, and increases gastric acid secretion. Peanut allergies are one of the most common causes of severe allergy attacks, and the allergic response usually occurs within minutes after exposure.

Clinical Manifestations:

  • Runny nose
  • Skin reactions (hives, redness, swelling)
  • Itching and tingling in and around the mouth and throat
  • Digestive problems (diarrhea, stomach cramps, nausea, vomiting)
  • Tightening of the throat
  • Shortness of breath & wheezing

Peanut allergy is the most common cause of Anaphylaxis, which is life-threatening and requires an injection of epinephrine and a trip to the emergency room.

Signs & Symptoms of Anaphylaxis:

  • Constriction of airways
  • Swelling of the throat
  • Severe drop in blood pressure (shock)
  • Rapid pulse
  • Dizziness, light-headedness, or loss of consciousness

There are 3 ways exposure can occur for peanut allergy.

  1. Direct contact- eating peanut products, or skin contact.
  2. Cross-contact- cross-contamination of peanut products that usually occurs during preparing or handling.
  3. Inhalation- inhaling dust or aerosis containing peanuts.

* 1 in 3 children have a food allergy, and the number of children with peanut allergies more than tripled between 1997 and 2008.

Theory: Early exposure to peanuts may prevent peanut allergies.

In 2000, the American Academy of Pediatrics (AAP) recommended that children who were at high risk for having peanut allergies should avoid peanut products entirely. Back then, it was also recommended by the AAP that all children not be given peanut products until the age of 3. These guidelines were withdrawn in 2008 as evidence began to show that giving infants peanut products may actually protect them from developing peanut allergies. "Wait until the child is older" is no longer the general advice.

In February 2015, a study done by LEAP (Learning Early About Peanut Allergy), was published in the New England Journal of Medicine, that indicated giving some children peanut products at a young age may prevent peanut allergies. This study was done with 640 infants aged 4-11 months living in England who were at high risk for peanut allergies due to having severe eczema or egg allergies. The study followed these children for 5 years. Starting out, 2/3 of these children didn't develop any positive skin tests to peanuts (indicating a mild sensitization), and the other third had done so. They were divided into 2 groups: one group was given 2 grams of peanut protein three times per week, and the other group of children avoided peanuts entirely.

Results of this study:

  • Among those who originally tested negative for peanut allergy, 13.7% who avoided peanuts developed an allergy, and only 3.2% of children given peanut protein developed an allergy.
  • Among those who initially showed a mild sensitization (positive skin-prick test), 35% in the avoidance group got a peanut allergy, and only 10.6% in the consumption group got the allergy.
  • Early consumption reduced the risk of peanut allergy by 86% for children with negative skin-prick tests, and by 70% for infants with a mild sensitization.

"There appears to be a narrow window of opportunity to prevent peanut allergy" -Dr. Gideon Lack

"Early consumption is effective not only in high-risk infants who show no sensitivity to peanuts early on, but it is also effective in infants who already demonstrate peanut sensitivity" -Dr. George Du Toit

This study is continuing with the LEAP-ON (Persistence of Oral Tolerance to Peanut) study, which will investigate whether the participants who consumed peanut will continue to remain protected even if they stop eating peanuts.

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Precautions to take when introducing peanuts to your child:

  • Talk to an allergist first about getting a food allergy test done if one of the child's siblings has a peanut allergy, or if your child has poorly controlled eczema, another known food allergy, or shows possible signs of an allergy.
  • Introduce this highly allergenic food at a time when you are going to be home for the day to monitor your child, and not before naps or bedtime.
  • Start with a small quantity and gradually increase the amount you give.
  • Use nut butters or pastes, NEVER nuts, as they pose a serious choking hazard.


I came across this topic while reading through a magazine my midwife had given me, titled The Baby Guide. I felt it was an interesting topic for me personally, because as an expecting first-time mom I have been doing as much research as I can on what foods are safe both for during pregnancy and breastfeeding, and for the first few years of my child's life. I think this new theory is highly significant to the medical community because peanut allergy is such a common and serious health problem, and these new findings provide the basis for new research to be done that will ultimately have a huge impact on the prevention of childhood allergies.