New peanut allergy prevention guidelines start in infancy

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Some infants should be introduced to peanut-containing foods as early as 4 months

Peanut allergy affects about 2% of the children in the United States

CNN  — 

Peanut allergy affects about 2% of the children in the United States, and those numbers appear to be growing.

A serious peanut allergy can lead to anaphylaxis and, rarely, even death, which means some parents avoided introducing peanuts to their children.

But on Thursday, an expert panel published new guidelines about when to introduce some infants to peanut-containing foods as a way to prevent food allergies, a technique validated by the Learning Early About Peanut allergy, or LEAP, study.

“Many, many people were asking their doctors, their pediatricians, ‘We’ve heard about this wonderful information; what should we do?’ ” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. “The professional societies – such as the American Academy of Pediatrics, the American Academy of Family Physicians, the American Academy of Allergy, Asthma & Immunology, etc. – all decided they needed to get together and sit down in a few meetings and put together some guidelines.”

The institute sponsored the conference where the new “Addendum Guidelines for the Prevention of Peanut Allergy in the United States” was written to supplement the 2010 Guidelines for the Diagnosis and Management of Food Allergy in the United States.

Intended for pediatricians and other health care providers, the guidelines are published in the Journal of Allergy and Clinical Immunology.

But the real purpose of the guidelines is “to spread the word,” said Fauci.

What are the guidelines?

The recommendations are “really simple and straightforward,” Fauci said, explaining that the intention was to answer the typical questions of family physicians.

Recommendations fall into three categories.

The first category includes children who are believed to be most likely to develop a peanut allergy: infants who have severe asthma, egg allergy or both. Parents can either introduce these children to peanut-containing food at 4 to 6 months or get a reference to an allergist who will give the child a skin prick test or a blood test to see whether the infant is allergic to peanuts.

If not allergic, parents should follow the recommendation of introducing peanut-containing foods at 4 to 6 months. However, if the infant is allergic, parents should refrain.

The second category includes children with mild to moderate eczema; less likely to have an allergy, these infants should be introduced to peanut-containing foods about 6 months of age.

Finally, the third category belongs to children with no eczema or food allergies and no family history of such. These children can either be fed peanut-containing foods or not at any age, based purely on family and cultural preference.

“So if it’s severe, go to an allergist,” summarized Fauci. “If it’s not severe, give (peanut-containing foods), but give it at 6 months.” For infants with no family history of allergy or no food allergies the