Health

Introducing Peanuts to Children Early Can Help Cut Allergy Risk. But That Guidance Isn’t Reaching All Families, Study Finds

For nearly a decade, national guidelines have recommended introducing safe forms of peanut-containing foods to infants to help reduce allergy risk; however, a new study by Northwestern Medicine found that many families aren’t receiving that guidance from their pediatrician.

The study found that many parents — particularly those who are Black, Latino, lower-income or have less formal education — aren’t receiving the potentially lifesaving guidance from their pediatrician and are introducing peanuts at much lower rates.

The study, published Tuesday in the journal Academic Pediatrics, was led by researcher Christopher Warren, who directs population health research at Northwestern Medicine’s Center for Food Allergy and Asthma Research.

“We don’t need to throw pediatricians or primary care providers under the bus; we acknowledge that they have a million things that they’re trying to accomplish during these well-child visits,” Warren said. “At the same time, clearly, some of these kids are getting the guidance, and other kids are not, and I can’t help but think some of that is a function of: How much time are these providers spending with the families, breaking down some of the barriers and misconceptions?”

Warren also acknowledged structural barriers in the health care system and insurance coverage as other factors that might contribute to disparities.

For the study, researchers conducted a survey among a representative sample of more than 3,000 U.S. parents with children between the ages of 7 months to 42 months.

The study found that by the time their child turned 1 year old, nearly 50% of White respondents had introduced peanut-containing foods, compared to 42% of Black, 36% of Latino and 35% of Asian parents. Early peanut introduction was also significantly more common among high-income and college-educated parents.

Additionally, only about half of Black and Latino parents said their pediatrician brought it up, compared to nearly two-thirds of White parents. The study also found only about 30% of Black parents believed peanut introduction before 12 months would help prevent peanut allergies, compared to about half of White parents.

“In this case, it’s not a matter of just educating somebody about some new practice, it’s about unlearning the old guidance,” Warren said.

Parents were previously told to delay peanut feeding out of concern it might trigger allergies. But, a landmark clinical trial in 2015 found early introduction cut peanut allergy risk by more than 80%, prompting the American Academy of Pediatrics to recommend the introduction of infant-safe forms of peanut-containing foods to infants about 4 to 6 months of age.

“It’s a careful message,” Warren said. “There is a fair amount of education that needs to be done regarding how to do it safely, but, of course, if it seems overwhelming, and when families have other concerns that are more pressing, often, the idea of preventing this hypothetical thing that might happen in the future is not the most important thing on the agenda.”

Instead of giving whole peanuts to infants, which can lead to choking, the AAP recommends mixing and thinning out a small amount of peanut butter with breast milk or formula and feeding by spoon as one option to safely introduce peanuts to young children.

If a baby has or had severe eczema or an immediate allergic reaction to any food, especially egg, they are considered “high risk for peanut allergy,” according to the AAP, and caregivers should talk with a pediatrician first to best determine how and when to introduce peanuts.

Contact Eunice Alpasan: [email protected]

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