Early peanut food exposure better than avoidance in high risk infants

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Goodfellow Gems

"Early peanut food exposure better than avoidance in high risk infants"

Avoiding early consumption of peanuts has been a strategy to reduce the risk of peanut allergy.

The LEAP trial randomised children aged 4 to 11 months at high risk for peanut allergy (severe eczema and/or egg allergy, family history was not mentioned) to eating up to 6 gm of peanut protein per week and found a decreased risk of developing peanut allergy.1 The rate of peanut allergy (at 60 months tested by food challenge) in the consumption group compared with the avoidance group was 1.9 versus 13.7 percent in children who were skin prick test-negative, and 10.6 versus 35.3 percent in children who were skin prick test-positive (wheal 1 to 4 mm).

Notably, a significant proportion of these high risk children were already allergic/ sensitised to peanuts at enrolment.  Skin testing or specific IgE (RAST) testing should be undertaken in these high risk children.  If positive, further advice should be sought before advising peanut consumption at home.

This gem has been checked by Associate Professor Rohan Ameratunga. Adult and Paediatric Allergy specialist and Immunologist ADHB and Grafton Specialists, Ground Floor, 97 Grafton Road, Grafton ph  09-9192615 or email [email protected]

  1. http://www.nejm.org/doi/full/10.1056/NEJMoa1414850

Gems are chosen by the Goodfellow director Dr. Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice.

As published in NZ Doctor 29/04/2015