Best Way to Potentially Prevent a Peanut Allergy

BY VANDANA K. PATEL, M.D. AND JENNIFER L. CAICEDO, M.D. (Providers at Asthma & Allergy Specialists, PA)

As allergists, we often get the question, “Why do so many kids have a peanut allergy?” This isn’t an incorrect observation, as the number of children in the United States with peanut allergy has tripled in the past 10 years, while doubling in most other Western countries. The rate of increase was so alarming that Professor Gideon Lack and his team at King’s College in London wanted to see if early introduction of peanuts would offer protection from developing peanut allergies.

The study titled “Learning Early About Peanut Allergy”(LEAP) randomly assigned 640 infants between the ages of 4 and 11 months with severe eczema, egg allergy, or both, to either avoid or consume peanuts until 5 years of age. Remarkably, the overall prevalence of peanut allergy in the avoidance group was 17 percent compared to only 3 percent in the consumption group. Earlier introduction of peanuts to infants in the study decreased their risk of developing peanut allergy by a staggering 70 percent to 80 percent.

Lack and his research team concluded that there is a narrow window of opportunity to prevent peanut allergy and we must now feed our very young children peanuts. The study recommends that peanuts (in a safe/non-choking hazard form) can be introduced to infants as early as 4 months of age, but how would we in the U.S. use these learnings to help our patients?

In order to make the results from the LEAP study practical, the National Institutes of Health has released a guideline to help prevent peanut allergy in the U.S. This guideline, which speaks to BOTH the primary care provider and the pediatric allergist, is divided into three parts, depending on varying levels of risk:

The first part of the guideline addresses the HIGH RISK infants who are the ones with severe eczema, egg allergy, or both. These patients should get foods containing peanuts in their diet by 4-6 months of age, but only after either skin or blood testing. The health care provider may then give guidance regarding the introduction. A referral to an allergy specialist may also be recommended.

The second part of the guideline addresses the MODERATE RISK infants with mild to moderate eczema who should also have peanuts in their diet by 4-6 months of age.

The third part of the guideline states that children without eczema or any other food allergy can have peanuts freely introduced into their diet. Peanuts should be introduced into an infant’s diet after other solid foods have been started.

The medical community is not yet sure if the results from LEAP can be extrapolated to the introduction of other highly allergenic foods, but we anticipate that such studies (especially with regard to tree nuts and sesame) are forthcoming. Parents and caregivers are encouraged to discuss this with their primary care provider at their infant’s 4- to 6-month well visits.

Do you think you or your child might already have a peanut allergy? Schedule an appointment with us for a food allergy test.

How to Help your Kids Make Healthy Food Choices


Through our 30 years, Asthma & Allergy Specialists, PA has grown to offer a variety of services. As part of our services, we offer nutritional counseling through our on-site registered dietician, Raquel Durban. Whether you or your child is coping with food allergies, weight management, picky eating or general nutrition, Raquel can help. In addition to working with our physicians, she will partner with your health care provider to ensure everyone is in the know on helping you reach your goals.

You or your child may have struggled with or currently struggle with food, whether it be restriction or over indulgence. You’ve probably experienced, at least to some degree, a child pitching a fit about eating a new food, but this doesn’t have to be the case.

7 tips for getting your children to make nutritious food choices.

1. Avoid being the food police. Forcing kids to eat foods they dislike is a recipe for rebellion, resentment and frustration. Instead, only stock your pantry and fridge with a variety of nutritious options. That way, every dietary choice your child makes in your home will be a good one.

2. Introduce healthy new dishes each week, while continuing to serve one or two familiar foods. The goal is to quickly eliminate the worst foods your kids currently eat, followed by less-than-ideal options, as you replace them with more wholesome choices. Keep in mind that kids often need to try a new food several times before deciding they like it.

3. Make food fun! Add greens to a fruit smoothie for and create a super hero name for it. Also let kids have fun helping you cook meals or arrange foods on a plate. For younger kids, veggies may taste better when shaped into a smiley face, while older children may take pride in cooking greens they like, then being creative with spices or garnishes. Adding a little vanilla, cinnamon or cacao often goes a long way in getting kids interested in otherwise bland food.

4. Play with your food. Make learning about nutrition enjoyable by turning it into a game. You can present your kids with different foods and have thumb put thumbs up or thumbs down depending on if the snack is healthy or not.

5. Let kids choose their own “parent-approved” snacks. Another easy way to help kids make great food decisions, even at a young age, to have a “snack shelf” of nutritious foods they can reach themselves. By encouraging your kids to make their own decisions about what to eat (from an assortment of healthy options), they start learning to take responsibility for their nutrition.

6. Allow kids to make dietary mistakes — and learn from them. Since you don’t want to be the food police, avoid scolding your kids about poor dietary choices. Instead, look for opportunities to help them learn from the consequences. For example, you might point out that the gooey birthday cake your son or daughter ate a friend’s party could be what caused the tummy ache or nausea that struck afterward.

7. One of the best ways to help your kids form a healthy relationship with food is by teaching them to connect what they eat with how they feel. If your kids eat something nutritious, ask them how they feel. Suggest names for these feelings, such as “energized” or “happy.”


If you are interested in nutritional services, feel free to make an appointment on our website. Appointments are at your convenience, whether in office or through a virtual consult. We can’t wait to help you!