y: Claire McCarthy, MD, FAAP
When I was growing up, peanut butter and jelly sandwiches were really common in the school lunchroom. These days, most parents wouldn’t even think of sending one. We’ve moved from peanut-free lunch tables to peanut-free schools—and many camps and afterschool programs have banned anything peanut too.
They do it to save lives. Not only has the prevalence of peanut allergy doubled in Western countries over the past 10 years, it is the leading cause of food allergy related death in the United States.
For many years, experts thought that the best way to fight peanut allergy was to avoid peanut products in the first years of life—that’s why in 2000 the American Academy of Pediatrics (AAP) recommended that any child at high risk of peanut allergy (like those with a family history of it, or with other food allergies, or eczema) not eat any before they turned 3. But that didn’t help, which is why in 2008 the AAP stopped recommending it.
New Research on Peanut Allergies:
Around this time, researchers in the UK noticed something interesting: peanut allergy in Jewish children living in the UK was about 10 times more common than it was in Jewish children living in Israel. Since these children shared a similar ancestry, the difference had to be something that they were doing.
It turned out there was a big diet difference. Children in the UK rarely ate peanut products in the first year or so of life—whereas children in Israel commonly ate a snack called Bamba, a corn puff made with peanut butter. The researchers wondered: Could this be the important difference—that the Israeli children ate peanut products from an early age?
So they tested it. They did a study on about 600 babies who had severe eczema or egg allergy, which are known to increase the risk of peanut allergies. They divided them up into two groups: one was given Bamba to eat regularly (if they didn’t like Bamba, they could eat smooth peanut butter), and the other was told to stay away from foods containing peanuts. They did this until the children were 5 years old.
At 5 years, only 3 percent of the kids who ate peanut products were allergic to them—compared with 17 percent of those who didn’t eat peanuts. This included children who tested positive for a peanut allergy as infants (those with strong positive tests, however, were not included in the study).
This is huge, amazing news.
Now, this doesn’t necessarily mean that everyone with a baby should run out and buy peanut butter—or that doing so will guarantee that the child never has a peanut allergy. We still have questions to answer; for example, we don’t know how much peanut needs to be eaten to prevent an allergy, or how long it needs to be eaten (is it okay to eat it a few times and stop, or do families need to keep giving it?). We also don’t know if this approach will work for other kinds of food allergies. But it gives us reason to be hopeful that we can do something to prevent peanut allergies, and possibly other food allergies as well.
What Does This Mean for Parents?
- If your child has ever had a rash or other reaction to peanuts, please don’t give them peanuts. That’s not what the findings of this study would recommend. This study is about preventing allergies; the children who had the positive test who stayed in the study were children who didn’t have any reaction when they ate peanut products (this can happen, as odd as it sounds).
- If your child is at high risk for peanut or other food allergies for any reason (other people in the family have allergies, the child has other food allergies or eczema), talk with your doctor before giving any peanut products. It might be helpful, but you should talk with your doctor. Doing some allergy testing first might be a good idea, and it also might be a good idea to have that first taste of peanut happen at the doctor’s office (with help and medicines nearby) rather than in your home.
- If your child doesn’t have any food allergies and or extra risk, consider introducing some peanut products into his or her diet. You should never give whole peanuts or peanut pieces to children under the age of 4, (young children can die from choking on a peanut), but you could spread a thin layer of creamy (not chunky) peanut butter on a cracker or piece of bread, or give foods that have peanut butter in them. Always make sure that children are supervised and sitting down while they eat.
- We aren’t sure if this approach will work for all food allergies—so if there are other food allergies you are looking to prevent, talk with your doctor.
Additional Information & Resources:
- Diagnosing Food Allergies in Children
- Infant Allergies and Food Sensitivities
- Managing Food Allergies
- Avoid a Food Allergy Scare on Halloween
- Healthy Children Radio: Food Allergies in the Community (Audio)
- Healthy Children Radio: Helping Children with Food Allergies (Audio)
- Management of Food Allergy in the School Setting (AAP Clinical Report)