Scott H. Sicherer, MD, left, and Hugh A. Sampson, MD
In a significant departure from past medical practice, new guidelines from the National Institute of Allergy and Infectious Diseases (NIAID) call on parents to introduce peanut containing foods to infants as young as 4 to 6 months as a way to prevent potentially life-threatening peanut allergy. The guidelines, issued in January, were developed by an expert national panel that included two allergist-immunologists from the renowned Elliot and Roslyn Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai.
“About 4 million babies are born each year in the United States, and we know that two to two-and-a-half percent will develop peanut allergy,” says Hugh A. Sampson, MD, Director of the Jaffe Food Allergy Institute and the Kurt Hirschhorn Professor of Pediatrics. “We are not going to eradicate peanut allergy, but our goal with the new guidelines is to get the number of affected children down to about one percent.” Dr. Sampson was a member of the NIAID panel along with Scott H. Sicherer, MD, the Elliot and Roslyn Jaffe Professor of Pediatrics and Chief of the Division of Pediatric Allergy and Immunology.
Peanut allergy has grown alarmingly in recent years. According to a Mount Sinai study, allergy from peanut affected 1 in 250 children in the United States in 1997. By 2002, the incidence had jumped to 1 in 125 children, and to 1 in 70 children by 2008. The advocacy group Food Allergy Research and Education reports that food allergies result in 200,000 emergency room visits each year. “Peanut allergy tends to be severe, is potentially fatal, and is usually lifelong,” says Dr. Sicherer, “so having a strategy to prevent it, particularly one that is inexpensive to implement, offers tremendous benefits.”
For decades, allergists recommended that high-risk infants avoid exposure to peanuts through the first three years, but a landmark international allergy study, first published in 2015, proved to be a game-changer, showing that early introduction to peanut-containing food among allergy-prone infants reduced their chance of developing a peanut allergy by up to 80 percent.
The new guidelines, which were based largely on these findings, define which infants are at high, moderate, and low risk for developing peanut allergy and recommend to allergists and caregivers how to proceed with the introduction of peanut-containing food based upon risk and age. The guidelines also caution parents not to give whole peanuts to infants, and they offer peanut-containing food suggestions and methods to introduce these foods. To learn more about the guidelines, visit niaid.nih.gov.