Changing the mindset to enable early peanut introduction; and a new allergen introduction study (The SEED study)
Summary:
It is well researched and established that food allergies have increased over the past few decades. One of the contributing factors may have been the general trend to introduce “allergenic” solids (such as peanut, egg, cow’ milk and wheat) in a delayed fashion, which is what “old” paediatric guidelines recommended.
A landmark study in published in 2015 was called the LEAP study (“Learning Early About Peanut Allergy”) and found that earlier introduction of peanut protein to infants “at risk” of peanut allergy can actually help to prevent peanut allergy in around 80% of cases. “At risk” patients are those with severe eczema and those with egg allergy. Slowly this idea has been taken up into international guidelines for solids introduction.
The NIAID (National Institute of Allergies and Infectious Diseases) in the US formally changed their solids introduction guidelines in 2017 to promote (instead of just “allow”) the earlier introduction of allergenic solids. It is recommended that most infants start eating foods containing peanut protein at around 6 months.
Those at high risk of peanut allergy (those with severe eczema and those with egg allergy) may benefit from even earlier introduction between 4-6 months, BUT would benefit from an allergist consultation, peanut allergy test beforehand and in some cases supervised introduction of peanut.
The problem with this early peanut introduction as an allergy prevention strategy is the huge paradigm shift it represents. Many are still sceptical and nervous to introduce allergenic foods such as peanut to children, especially if they are already showing signs of allergy such as eczema. Parents, caregivers and grandparents will need to be convinced of the potential benefits of earlier allergenic food introduction. This is a job which needs to start at grass roots level!
Apart from early introduction of peanut, early introduction of other allergenic foods may reduce the risk of food allergies. To research this further, the Food Allergy Research & Education (FARE), a leading US non-governmental organisation engaged in food allergy advocacy, has launched a multi-million dollar, multi-organisational research partnership project called the Start Eating Early Diet (SEED) study.
The SEED study will explore the benefits of early introduction to multiple allergenic foods (specifically peanut, egg, dairy, cashew, soy, almond and sesame) in a more diverse sample of infants.
We look forward to this study and the results thereof- and in the mean-time encourage the early introduction of peanut protein!
Source: The Start eating early Diet (SEED) Initiative www.foodallergy.org October 15, 2020
