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Study finds advice to feed babies peanuts early helped reduce allergies

LEILA FADEL, HOST:

Peanut allergies in young children are way down after guidance from doctors to introduce peanuts to infants as young as 4 months old. A new study published in the journal of the American Academy of Pediatrics followed nearly 125,000 children across the country. It found a 43% drop in peanut allergies in young children since the guidance came out in 2017. We've got one of the authors on the line to talk about this. Dr. David Hill is an attending allergist at the Children's Hospital of Philadelphia and an assistant professor of pediatrics at the University of Pennsylvania. Dr. Hill, thanks for joining us.

DAVID HILL: Good morning, Leila. Thanks for having me.

FADEL: Good morning. So first off, do we know why this seems to work?

HILL: Yeah. So actually, it's a really interesting story. So let me take your listeners back to 2015. In the period immediately before that, there had been a couple of key observations. So the first one was that children with eczema, which is an inflammatory skin condition, were at a two- to sixfold higher risk of developing food allergy.

FADEL: Oh.

HILL: And we learned that that was because the food allergens were actually getting introduced to the immune system via the skin. Simultaneous to that, we also learned that if food allergens are introduced to the immune system via the gut - right? - by eating them that the body actually learns that those food allergens are safe and should be tolerated.

FADEL: Interesting.

HILL: And so that led to the 2015 study, which was called the LEAP study, or Learning Early About Peanut allergy. And that study actually showed in a very rigorous, controlled way that if we took children at risk for peanut allergy and we fed them peanut early, between 4 to 6 months of age, we could actually reduce the risk that they would go on to develop a peanut allergy.

FADEL: But that can sound scary for parents who are worried that they'll do this and their child will have an allergic reaction. So what exactly is the guidance? How do you introduce peanuts to such a young baby?

HILL: And I absolutely understand that, and I hear that from my patient families all the time, right? First, we want to, you know, protect the most vulnerable in our society, including young children. So what I tell those families is that, one, this has been shown to be safe. It's been shown to be effective. In addition, really young children and infants - while anybody's at risk for a severe allergic reaction, those severe allergic reactions occur less often in the youngest kids. They're actually more frequent in the older children who have avoided these foods.

So what I tell my families is around 4 to 6 months of age, once the child is developmentally ready for solid foods - meaning they're not going to choke on the food - you know, start to introduce these allergens. So, for example, peanut you can introduce as peanut butter. A small amount the size of your pinky nail is a good amount, and you want to just do exposure. You don't want to go for nutrition. So you're just doing tastes, right? Small amounts by the mouth three times a week is a great way to start, and try to make your way through the major allergens.

FADEL: Could the same technique be used for other food allergies?

HILL: Absolutely. So the 2021 guidelines have actually expanded this recommendation to all the major food allergens.

FADEL: Dr. David Hill with the Children's Hospital of Philadelphia and the University of Pennsylvania. Thank you so much for your time.

HILL: Thanks for having me.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Leila Fadel is a national correspondent for NPR based in Los Angeles, covering issues of culture, diversity, and race.