Practice Guidelines for Peanut Allergies

Celeste Sitton, RN, BSN, CMSRN; Heide S. Temples, Phd, APRN, PPCNP-BC


J Pediatr Health Care. 2018;32(1):98-102. 

In This Article

Encouraging New Research

Updated recommendations include data from a clinical study known as the Learning Early About Peanut (i.e., LEAP) trial (Du Toit et al., 2015), which evaluated the effects of early introduction of allergens as a means of prevention. The study randomized potential peanut-sensitive 4- to 11-month-old infants, based on a history of eczema, egg allergy, or both, into two groups. One group received standard-of-care peanut avoidance until 2 years of age, whereas the experimental group received an early introduction to peanuts. By 60 months of age, the peanut avoidance group had a prevalence of allergic symptoms of 13.7%, whereas the early introduction group had a prevalence of allergic symptoms of 1.9%. Thus, the National Institute of Allergy and Infectious Diseases guidelines now recommend early introduction of peanut products as early as 4 months, with the hope of reducing the prevalence of peanut allergies. Although most research is performed using peanut powders, parents are taught to begin introduction of age-appropriate peanut-containing foods starting between 4 and 6 months of age, most commonly recommending peanut butter (Togias et al., 2017).