Children who eat peanuts at an early age may prevent peanut allergies

The No Nuts Moms Group website lists some of the young people who have died from food allergies — many from peanut allergy — going back to 1986. The lengthy list is a sad reminder that a peanut allergy can cause a severe and sometimes deadly allergic reaction. Parents who have a child who is allergic to peanuts do many things to keep him or her out of harm’s way.

A study published online today in The New England Journal of Medicine offers some hope for parents of infants who may be headed toward a peanut allergy. That hope is peanuts.

For the study, an international team of researchers recruited infants who had an egg allergy or eczema, an allergic disorder that affects the skin. Both are indicators that a child is prone to a peanut allergy. The children were randomly divided into two groups. The parents in one group were asked to make sure their children didn’t eat any peanuts, peanut butter, or other peanut-based products until age five. Parents in the other group were asked to give their children a peanut-based snack called Bamba or peanut butter three times a week until age five.

The results were surprising and dramatic. A peanut allergy developed in 1.9% of children who ate Bamba or peanut butter, compared with 13.7% of those who didn’t eat peanuts. One explanation for this difference is that the children who ate peanuts early developed what is called immune tolerance to them. Their young immune systems adapted to the proteins in peanuts so that they did not react to them.

The researchers got the idea for this trial from a previous study of theirs. They knew that Israeli children are typically fed peanuts much earlier in life than British children. So they compared peanut allergies in Jewish children living in Israel with those in Jewish children living in London. Peanut allergies were 10 times higher in the British children than in the Israeli children.

In an unrelated study, a team from the Jaffe Food Allergy Institute at Kravis Children’s Hospital at Mount Sinai in New York City presented similar findings on Sunday at the annual meeting of the American Academy of Allergy Asthma and Immunology in Houston. They showed that a wearable patch that gradually exposes the body to small amounts of peanut protein may be effective in easing the allergy. After wearing the patch for a year, people with peanut allergies could tolerate the equivalent of four peanuts at a time. The patch, called Viaskin, is made by DBV Technologies, which funded the study.

What does this new work mean for parents? If an infant is allergy-prone, it may be a good idea to ask his or her pediatrician about skin-prick testing for peanut allergy. If adding peanuts to the child’s diet early is feasible, the New England Journal of Medicine study suggests that such a strategy may prevent a peanut allergy down the line. And while the Viaskin results are still preliminary, if further research bears out these results, this approach could be a lifesaver.