The National Institutes of Allergy and Infectious Diseases sponsored guidelines on preventing peanut allergy: A new paradigm in food allergy prevention

Peanut allergy is a significant public health problem without proven treatment or cure at present. In 2000, the American Academy of Pediatrics recommended that solid-food introduction be delayed in infants at high risk, including peanut introduction, until age 3 years. In 2008, the American Academy of Pediatrics revised these recommendations based on limited evidence of benefit and, instead, recommended solid-food introduction not be delayed past 4‐6 months of life. In 2015, the Learning Early About Peanut Allergy study showed that early peanut introduction (between 4 and 11 months of life) was associated with a significant absolute and relative risk reduction in the development of peanut allergy compared with delayed introduction. Based on these findings, the National Institutes of Allergy and Infectious Diseases sponsored an expert panel to create an addendum to the 2010 Food Allergy Guidelines that specifically focuses on peanut allergy prevention. The addendum recommends that children with severe eczema, egg allergy, or both have peanut introduced as early as 4‐6 months of life, after assessment by a trained allergy specialist. For children with mild-to-moderate eczema, peanut can be introduced at ∼6 months, without the need for specialist evaluation. For children with no eczema, peanut can be introduced in accordance with family and cultural preferences, without the need for specialist evaluation. Adherence to these clinical practice recommendations can help potentially reduce the number of cases of peanut allergy per year. However, this can only be accomplished with the cooperation of parents and health care providers who adhere to these recommendations.