Pre-recorded in January 2017, the webinar Early Peanut Introduction: Recent Findings, Latest Guidelines, Q&A is presented by Maria Acebal and James Baker, MD. Ms. Acebal is a member of the FARE Board of Directors and the Allergy and Immunology subcommittee of the National Institute of Allergy and Infectious Diseases (NIAID) Advisory Council. A food allergy mom, she is former CEO of Food Allergy & Anaphylaxis Network (FAAN), one of FARE’s legacy organizations. Dr. Baker is the CEO and chief medical officer of FARE. He has served as chief of the Division of Allergy and Clinical Immunology at the University of Michigan and as senior vice president and global head of vaccines at Merck.
Dr. Baker and Ms. Acebal were part of a 26-member expert panel convened to develop NIAID’s clinical guidelines for the introduction of peanut foods to children. These new guidelines, released in early January 2017, reflect findings from LEAP (Learning Early About Peanut allergy), a prospective study of early peanut feeding funded by FARE, NIAID and others. Among children at high risk for peanut allergy, LEAP found that those who ate peanut foods starting in infancy were 81 percent less likely to develop peanut allergy than those who avoided peanuts until age 5.
The webinar first explains the recent shift in recommendations regarding the introduction of peanut foods, tracing past guidelines from the American Academy of Pediatrics and NIAID, the results of earlier research that led to the LEAP study, the significance of the LEAP findings, and subsequent studies that have reinforced the safety and effectiveness of early peanut introduction.
Next, Ms. Acebal and Dr. Baker summarize the new NIAID guidelines for introducing peanut foods, highlighting the importance of the guidelines as the only tool we currently have to limit the prevalence of peanut allergy. Each of the three guidelines corresponds to a different level of infant risk for developing peanut allergy:
Guideline 1: Infants with severe eczema, egg allergy or both should be introduced to peanut foods at 4 to 6 months of age, after the introduction of other solid foods. Doctors should consider testing the infant for peanut allergy prior to peanut introduction, using a blood test, a skin prick test, or both. Doctors can use these test results to determine whether an infant should be introduced to peanut at home, in a doctor’s office, or at a specialized medical facility where experienced personnel can conduct an oral food challenge.
Guideline 2: Infants with mild to moderate eczema can be given age-appropriate peanut foods at around age 6 months, after the introduction of other solid foods and in keeping with family dietary preferences. A doctor’s evaluation is optional.
Guideline 3: Infants with no eczema or food allergy can be introduced freely to age-appropriate peanut foods, in keeping with the family’s diet.
The webinar concludes by addressing misconceptions about the new guidelines, after which Dr. Baker and Ms. Acebal answer questions about the guidelines submitted to FARE by food allergy families.