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Since 1997, the estimated percentage of children in the U.S. who are allergic to peanuts has quadrupled. A new study challenges conventional wisdom, suggesting that introducing peanuts into infants’ diets could prevent allergies later on. Jeffrey Brown learns more from Dr. Anthony Fauci of the National Institute of Allergy and Infectious Diseases.
For years, doctors had routinely recommended children at risk of food allergies should avoid peanuts until they turn 3. But a new study challenges that medical wisdom, suggesting the opposite, that more infants should be introduced to diets with peanut products as a way of inoculating against allergies later.
Jeffrey Brown has the story.
Peanut allergies are one of the most common forms of food allergy among American children. And the last two decades have seen a dramatic rise in the number of cases. It's estimated that today 2 percent of all children are allergic to peanuts, four times the number as recently as 1997. And it's the leading cause of death from food allergies.
For parents, of course, a key question, how to avoid the risk to their children. And now comes a new twist. A study published in "The New England Journal of Medicine," it finds that exposing higher-risk infants to peanut products greatly reduced the risk of developing an allergy later on.
The study was sponsored by the National Institutes of Health.
And Dr. Anthony Fauci, head of the Allergy and Infectious Diseases Institute, joins me now.
Dr. Fauci, what was generally thought up to now, that exposure to peanuts early on was a bad thing, that was wrong?
DR. ANTHONY FAUCI, National Institute of Health: Indeed.
As we have seen from this case, this study that you just mentioned, is that earlier exposure of a child does what we call tolerizing the child, so you can get less of an incident of later-on peanut allergies. So if you're predetermined to get peanut allergy and you try avoid getting the child to be exposed, you find out the contrary. If you take the child and expose them early on and compare them to people in which you have tried to avoid exposure, there was a highly significant difference, in the sense of less later-on peanut allergies among the children who had the early exposure, as opposed to the avoidance.
Tell us about a little bit about this study, briefly. Is it really aimed at infants who already had a predilection or a higher risk for allergies? How is that defined?
DR. ANTHONY FAUCI:
Well, what you did is you take children who, for a variety of reasons, either children who have a history of egg allergy, milk allergy, asthma, family history of allergic diathesis, as we call it, namely, a predisposed tendency to develop allergic reactions.
Those are the children who would most likely to develop peanut allergies compared to a control population. And if you take those children and divide them into two groups, children who you're going to completely avoid peanuts for a certain period of time vs. those that you expose early, and that's where we got the results.
It's very interesting because it originated from an observation that, in Israel, where they expose children for nutritional reasons very early on to peanuts, these children have a much, much lower rate of peanut allergy compared to Jewish and Israeli children who actually are living in the U.K. And it turned out that that triggered the thought about doing the experiment in a controlled way to determine if deliberate exposure actually avoids the ultimate allergic reactions that you see later on. And it was a success.
Translate this now for parents and for doctors. What should they do now?
Well, right now, since this study was just published literally today, what you need to do is to just wait a bit, because what we at the National Institute of Allergy and Infectious Diseases are going to do is going to convene and be the host of a convening of individual stakeholders, the American Academy of Pediatrics, the various allergy societies, to take a close look at the data and to come up with guidelines or recommendations.
You don't want parents now, on the basis of this study, to go ahead and be challenging the children early on, because you have got to be careful that you don't precipitate a reaction in a child who might actually have a reaction immediately. So you have got to be a bit careful about that. We don't want parents on their own deciding what they're going to do.
Let's wait — and it won't be very long — for some solid guidelines and recommendations.
And there's, in the meantime, still no cure for children who have this allergy? It's still really all about avoidance?
Well, it's avoidance if you have the allergy. What this study is all about, Jeff, is getting children to not develop the allergy. And it's almost paradoxical, because the study says that if you give them early on in life peanuts, you dramatically lessen the likelihood that they will develop an allergy and then will subsequently have to avoid.
So you want to get away from having to avoid by exposing them early on.
And very briefly, Dr. Fauci, is there potential application in all of this to other allergies?
The mechanism that allows for this tolerance to peanut very well might actually be applicable to other food allergies. And there are studies that are going to be planned and that are ongoing to see if you can replicate these exact mechanisms and results with other food allergies.
All right, Dr. Anthony Fauci, thanks so much.
Good to be with you.
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