By Xantha Leatham Deputy science editor for The Daily Mail
Updated: 4:26 PM March 17, 2023
Parents should introduce their children to peanut products from four months old to prevent them from developing allergies, experts say.
The number of people who have an allergic reaction to peanuts has tripled in recent decades and in severe cases the consequences can be fatal.
About one in 50 children is now affected, leading to a lifetime of worry about the ingredients in their food.
But British researchers have discovered a “window of opportunity” between four and six months of age, which they say is the best time to introduce babies to peanuts.
And this could reduce the incidence of peanut allergy by as much as 77 percent, they said.
The team, from King’s College London and the University of Southampton, said most peanut allergies have already developed by the time a child turns one.
They looked at data from the Inquiring About Tolerance (EAT) and Learning Early About Peanut Allergy (LEAP) studies.
The Leap study involved 640 infants who were at high risk of developing peanut allergy and examined the early introduction of peanut products.
More than 1,300 three-month-old babies were recruited in England and Wales for the Eat project. They were followed for several years to examine the early introduction of six allergenic foods: milk, peanuts, sesame, fish, eggs and wheat.
Analysis, published in the Journal of Allergy and Clinical Immunology, revealed that it was best to introduce peanut products to babies four to six months old.
WHAT IS ANAPHILACTIC SHOCK?
Anaphylaxis, also called anaphylactic shock, can be fatal within minutes.
It is a serious and potentially life-threatening reaction to a trigger, such as an allergy.
The reaction can often be triggered by certain foods, including peanuts and shellfish.
However, some medications, bee stings, and even latex used in condoms can also cause the life-threatening reaction.
According to the NHS, it occurs when the immune system overreacts to a trigger.
Symptoms include: feeling light-headed or fainting; breathing difficulties – such as rapid, shallow breathing; wheezing a fast heart beat; clammy skin; confusion and fear and collapse or loss of consciousness.
It is considered a medical emergency and requires immediate treatment.
Insect stings are not dangerous for most victims, but a person does not necessarily have to have a pre-existing condition to be at risk.
An increasing accumulation of stings can cause a person to develop an allergy, with a subsequent sting triggering the anaphylactic reaction.
This could reduce the incidence of peanut allergies by 77 percent, compared to just 33 percent if peanuts are introduced when the child is one year old.
Babies at higher risk of developing an allergy — for example, if they already have eczema — should be started closer to four months, she added.
The NHS currently says nuts and peanuts can be introduced from around six months of age as long as they are crushed, ground or a smooth nut or peanut butter.
Based on their findings, the scientists are calling on the government to review the latest evidence.
Lead author Professor Graham Roberts said: ‘Current guidelines suggest that peanuts should be introduced from around six months of age.
The last government report on introducing foods into babies’ diets was published in 2018. Since then, a number of studies have been published suggesting that earlier introductions of peanuts and other foods may help prevent allergies from developing.
“We believe the government should review current guidelines on when to introduce peanuts into babies’ diets. In our opinion, peanuts should be introduced earlier when babies are developing to be ready for solid food.’
He explained that a peanut allergy occurs when the body perceives peanuts as something dangerous and reacts to them.
“The reaction can affect the whole body — your lips can swell, you can get an itchy rash, and you can have trouble breathing,” he said.
‘A baby’s immune system must learn to distinguish between food and dangerous insects that need to be kept out of the body.
“The way the body does this is through the form in which it sees things. If it sees peanuts in reasonably large quantities in its intestines, it will see this as a safe food and will not develop an allergy.’
Pediatric dietitian Mary Feeney, of King’s College London, said their findings indicate that giving babies a heaped teaspoon of peanut butter three times a week is the recommended amount to reduce the likelihood of them becoming allergic to it.
She warned that babies or toddlers should never be given whole or chopped nuts, as they carry the risk of choking.
And babies should be developmentally ready to start solid foods when peanut products are introduced, she added.
Professor Gideon Lack, from King’s College London and Guy’s and St Thomas’ NHS Foundation Trust said: ‘The benefits of introducing peanut products into babies’ diets diminish as they get older.
“This reflects the experience in Israel, a culture where peanut products are usually introduced early into the children’s diet and peanut allergy is rare.
“There is a small chance of preventing an allergy from developing.
“Introducing peanut products at four to six months of age can significantly reduce the number of children who develop a peanut allergy.”
Nine-year-old girl is first to benefit from life-changing treatment for peanut allergy
Children with peanut allergies across the country will be the first in Europe to receive life-changing treatment.
NHS England has struck a deal for Palforzia, an immunotherapy pill that helps reduce the severity of symptoms, including anaphylaxis after a reaction to peanuts.
The Evelina London Children’s Hospital participated in two large peanut allergy studies: the Palisade and Artemis studies.
Sophie Pratt said her family’s life was changed after her daughter Emily, nine, took part in the Palisade trial.
She said: ‘Participating in the clinical trial has changed the lives of our entire family. The treatment we received has freed Emily from limitations and the fear that the slightest mistake could endanger her life, and it has removed all the tension and worry that the simple act of eating loomed over us each day.
“It was especially noticeable on special occasions such as birthdays, Christmas and holidays where there are often specialty foods such as cakes, ice cream and treats that invariably had warnings, ‘may contain peanuts’ or menus that are not in English.”
Since the trial, Emily can confidently go to parties and playdates, eat at restaurants without us having to call ahead to check the menu, and we’ve managed to have her first overseas vacation to New York and even attended feeding animals at zoo experiences – that’s Emily’s passion.
“We couldn’t be more grateful.”
The Artemis study found that about six in ten four- to seventeen-year-olds who responded to about 10g of peanut protein at the start of the trial were able to take a dose of 1000mg at the end, which is well above the recommended dose . amount of accidental exposure.
Up to 600 children aged four to 17 are expected to be treated this year, with those in England the first in Europe, under a deal struck by the NHS. After that, about 2,000 a year will be treated.
Peanut allergies currently affect one in 50 children in the UK.
Professor Stephen Powis, Medical Director of the NHS, said: ‘This groundbreaking treatment could be life-changing for patients and their families and thanks to the deal the NHS has struck, people here will be the first in Europe to benefit from it.
“It will reduce fear and anxiety for patients and their families who may have been living with this allergy for years and in case they are carrying emergency medication.
“They should be able to enjoy meals or holidays abroad together without worrying about an allergic reaction that could land them in hospital or worse.”
Professor George du Toit, pediatric allergy consultant at Evelina London, was senior investigator for the UK on both studies.
He said: ‘This is great news for children and young people with peanut allergies. The approval of Palforzia represents an important step towards better care for allergy sufferers, and we will now have access to the first licensed treatment to reduce the severity of this allergy and protect against accidental exposure to peanuts.
“This will have a huge impact on the daily lives of our patients and their families.”