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Feeding six-month-olds with peanut powder or puree can increase their food tolerance in later years: Why new study has a lesson in peanut allergy

US study shows about 60,000 children avoided food allergies since 2015, including 40,000 children who otherwise would have developed peanut allergies

peanut, peanuts, food choking,Peanut allergies have begun to decline in the US after the recommendation was first made in 2015. (Representational Image/File)

Can peanut allergy or any food allergy be tamed if babies are introduced to such food groups early on? New research, which followed up on an earlier landmark study that recommended feeding babies peanut products in their early years to prevent allergies later in life, finds that such a change actually works in the real world.

Peanut allergies have begun to decline in the US after the recommendation was first made in 2015. It suggested introducing the allergen to infants starting as early as four months. The rate of peanut allergies in toddlers up to three years of age fell by more than 27 per cent after guidance for high-risk kids was first issued in 2015, and by more than 40 per cent after the recommendations were expanded in 2017.

What is peanut allergy?

Peanut allergy is caused when the body’s immune system mistakenly identifies proteins in peanuts as foreign invaders and releases chemicals that trigger allergic symptoms. These include hives, respiratory symptoms, breathing difficulties and a sudden drop in blood pressure, sending the body into a shock.

What the study says

Dr David Hill, an allergist and researcher at Children’s Hospital of Philadelphia, and author of the study that was published in Paediatrics, analysed electronic paediatric health records to track diagnoses of food allergies in children before, during and after the guidelines were issued. About 60,000 children have avoided peanut allergies since 2015, including 40,000 children who otherwise would have developed them.

“For decades, doctors had recommended delaying feeding peanuts and other foods likely to trigger allergies until age three. But the groundbreaking Learning Early About Peanut Allergy, or LEAP, trial in 2015 had shown that introducing peanut products in infancy reduced the future risk of developing food allergies by more than 80 per cent. Later analysis showed that the protection remained in about 70 per cent of kids into their adolescence. This study clears the air around the uncertainty and suitability of introducing peanuts to children in the first year of their lives,” says Mukta Vashisht, clinical dietician who worked with the Sir Ganga Ram Hospital, New Delhi.

Are babies born with food allergies?

Food allergies are not congenital, infants are not born with it, according to Vashisht. “A baby’s immune system must first be exposed to a food protein for familiarisation. An allergy develops later. However, having a family history of allergies can increase a baby’s risk of developing food allergies. The study works on the premise of early familiarisation with allergenic foods like eggs and peanuts being a key part of the baby’s adaptability to food. Their food tolerance goes up, the immune system, which is not yet fully developed, adapts to the food and recognises it as harmless,” she says.

When can allergenic foods be introduced to babies?

“Introducing allergenic foods like peanut and egg to babies around six months of age can lower their risk of developing food allergies, provided you work with a paediatrician on the child’s general health status and immunity,” says Vashisht. Current guidelines from organizations like the American Academy of Paediatrics advise against delaying the introduction of common allergens, as delaying them may actually increase the risk of allergies.

How should an infant be introduced to allergenic food?

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Obviously, when it comes to nuts, they should be powdered or pureed in water or breast milk, suggests Vashisht. “Start with 1/4th to 1/2 teaspoon of the mix. For infants at a high risk of allergies, introducing allergenic foods early and regularly, such as two to three times a week, can help build tolerance. The continuity is key here. Grade up gradually and stop if there is a reaction,” she says.

After feeding, observe the baby for at least 30 minutes for signs of an allergic reaction like hives, swelling or breathing difficulties.

Almond milk, she advises, can be given to the baby after a year as it is less allergic than peanuts. “Introduce one new allergenic food at a time and watch for a reaction. Always work with a paediatrician,” says Vashisht.

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