By Xantha Leatham Deputy Science Editor For The Daily Mail
Updated: 16:37 17 Mar 2023
Parents should introduce their children to peanut products from as young as four months old to prevent them developing allergies, experts say.
The number of people suffering allergic reactions to peanuts has risen three-fold in recent decades, and in severe cases the consequences can be deadly.
About one in 50 children are now affected, leading to a lifetime of worries about ingredients in their food.
But UK researchers have discovered a ‘window of opportunity’, between the ages of four and six months, which they say is the best time to introduce babies to peanuts.
And doing so could reduce peanut allergy incidences by as much as 77 per cent, 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 Enquiring About Tolerance (EAT) and Learning Early About Peanut Allergy (LEAP) studies.
The Leap study involved 640 babies considered at high risk of developing peanut allergy and examined the early introduction of peanut products.
The Eat project saw more than 1,300 three-month-old babies recruited in England and Wales. They were tracked over several years to investigate the early introduction of six allergenic foods – milk, peanut, sesame, fish, egg and wheat.
Analysis, published in the Journal of Allergy and Clinical Immunology, revealed it was best to introduce peanut products to babies at four to six months of age.
WHAT IS ANAPHYLACTIC SHOCK?
Anaphylaxis, also known as anaphylactic shock, can kill within minutes.
It is a severe 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 medicines, 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 lightheaded or faint; breathing difficulties – such as fast, shallow breathing; wheezing; a fast heartbeat; clammy skin; confusion and anxiety and collapsing or losing 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 in danger.
An incremental build-up of stings can cause a person to develop an allergy, with a subsequent sting triggering the anaphylactic reaction.
Doing so could reduce incidences of peanut allergies by 77 per cent, compared to just 33 per cent if peanuts are introduced when the child is a year old.
Babies at a higher risk of developing an allergy – for example if they already have eczema – should be started closer to four months, they added.
The NHS currently says nuts and peanuts can be introduced from about six months old as long as they’re crushed, ground or a smooth nut or peanut butter.
Based on their findings, the scientists are calling for the Government to review the latest evidence.
Lead author Professor Graham Roberts said: ‘Current guidance suggests that peanut should be introduced from around six months of age.
‘The last government report on introducing food into babies’ diets was published in 2018. Since then, a number of studies have been published that suggest earlier introduction of peanuts and other foods can help prevent allergies from developing.
‘We think that the government should review the current guidance on when to introduce peanuts into babies’ diet. In our view, peanuts should be introduced earlier if infants are developmentally ready for solids.’
He explained that a peanut allergy occurs when the body mistakes peanut as something dangerous and reacts to it.
‘The reaction can involve the whole body – your lips may swell up, you may get an itchy rash and you may start having problems with your breathing,’ he said.
‘A baby’s immune system needs to learn how to differentiate between food and dangerous bugs that need to be kept out of the body.
‘The way the body does this is through the form it sees things in. If it sees peanut in reasonably large amounts in the gut, it will come to see this as a safe food and will not develop an allergy.’
Paediatric dietician Mary Feeney, from King’s College London, said their findings indicate giving babies a heaped teaspoon of peanut butter three times a week is the recommended amount to reduce the chances of them becoming allergic to it.
She warned that babies or pre-school children should never be given whole or chopped nuts, as they carry the risk of choking.
And babies should be developmentally ready to start on solid food 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 decreases as they get older.
‘This reflects the experience in Israel, a culture in which peanut products are commonly introduced early into the infant diet and peanut allergy is rare.
‘There is a narrow window of opportunity to prevent an allergy from developing.
‘Introducing peanut products at four to six months of age could substantially reduce the number of children developing peanut allergy.’
Nine-year-old girl first to benefit from life-changing peanut allergy treatment
Children with peanut allergies across the country will be the first in Europe to receive life-changing treatment.
NHS England has secured a deal for Palforzia, an immunotherapy pill that helps to reduce the severity of symptoms including anaphylaxis after a reaction to peanuts.
Evelina London Children’s Hospital took part in two large peanut allergy trials — the Palisade and Artemis studies.
Sophie Pratt said her family’s lives had changed after her daughter Emily, nine, took part in the Palisade trial.
She said: ‘Being on the clinical trial has changed our whole family’s lives. The treatment we received has meant that Emily is free from limits and the fear that the tiniest mistake could put her life at risk, and it has removed all the tension and worry that the simple act of eating loomed over us every day.
‘It was particularly noticeable at special occasions like birthdays, Christmas and on holidays where there are often special foods like cakes, ice cream and treats that invariable had warnings, ‘may contain peanuts’ or menus not in English.
‘Since the trial, Emily can go to parties and playdates with confidence, eat in restaurants without us having to call ahead to check the menu, and we’ve managed to have her first holiday abroad to New York and even taken part in feeding animals at zoo experiences – which is Emily’s passion.
‘We could not be more grateful.’
The Artemis study found that around six in ten four to 17-year-olds who reacted to around 10g of peanut protein at the start of the trial were able to take a dose of 1,000mg of it by the end, which is well above the amount of accidental exposure.
Up to 600 children aged four to 17 are expected to be treated this year, with those in England to be the first treated in Europe, because of a deal struck by the NHS. Some 2,000 a year after that will be treated.
Currently, peanut allergies affect one in 50 children in the UK.
NHS medical director, Professor Stephen Powis, said: ‘This pioneering treatment can 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.
‘It will reduce the fear and anxiety for patients and their families who may have been living with this allergy for years, and carrying around emergency medication just in case.
‘They should be able to enjoy meals out or holidays abroad together without worrying about an allergic reaction that could land them in hospital or worse.’
Professor George du Toit, children’s allergy consultant at Evelina London, was senior investigator for the UK for both of the trials.
He said: ‘This is great news for children and young people with peanut allergies. The approval of Palforzia represents a significant step forward towards improving the care for allergy sufferers, and we will now have access to the first treatment licensed to reduce the severity of this allergy and to protect against accidental exposure to peanuts.
‘This will make a huge impact to the every day lives of our patients and their families.’