Guideline changes which introduce nuts to children early decrease allergies

Changes to food allergy guidelines have led to a 16 per cent decrease in peanut allergy among infants, new research from the Murdoch Children’s Research Institute (MCRI) has found.

Since the guideline changes, which recommend the introduction of peanut and other allergenic foods before 12 months, researchers have noted the significant increase in parents introducing peanut into their babies’ diet.

The research was presented at the American Academy of Allergy, Asthma & Immunology Virtual Annual Meeting on Sunday, with lead author Victoria Soriano noting the research is the first to test the approach in homes and to analyse what impact the guideline changes have had on peanut allergies.

International infant feeding guidelines were changed in 2016 to recommend the introduction of allergenic foods, such as nuts and eggs, before 12 months of age. Prior to the changes, the Guidelines recommended avoiding allergenic foods until the ages of between one and three years, and as such, avoidance of those foods in infancy became widespread. 

“By 2008, this advice started to be removed based on increasing evidence that delaying allergenic foods was associated with an increased food allergy risk,” Ms Soriano said. 

“However, evidence was still insufficient for specific recommendations for what age these foods should be introduced.”

The Melbourne study compared data from the 1,933 infants enrolled in the EarlyNuts study in 2018-2019 to the 5,276 infants recruited in the HealthNuts study across 2007-2011.

The research found the peanut allergy prevalence in 2018-2019 was 2.6 per cent compared to 3.1 per cent in 2007-2011, which amounted to a 16 per cent decrease after accounting for migration and population changes.

In 2018-2019, infants who did not consume peanuts until 12 months or later, 4.8 per cent were allergic. Severe reactions to introducing peanuts early were uncommon, the data showed.

Despite initial concern that parents may not follow the advice to introduce peanut early, there was a high uptake, Ms Soriano noted, saying that peanut consumption by 12 months increased from 28 per cent to 89 per cent in the 10 years to 2019, which may have halted the rise in peanut allergy, the study found.

MCRI’s Dr Jennifer Koplin said despite the decrease in peanut allergy, the prevalence overall continued to be high.

Australia has the highest reported rates of childhood food allergy in the world, with about one in 10 infants and one in 20 children up to five years of age being allergic.

“The safety of early peanut introduction at home is of significant interest to parents as well as health professionals around the world,” Dr Koplin said. “More research must be done to look closer at these trends to help us understand how well early introduction to peanut works to prevent peanut allergies in real-life situations.”

Researchers from the University of Melbourne, Florey Institute of Neuroscience and Mental Health and The Royal Children’s Hospital also contributed to the study.

To view the findings, please see here.