The Window Of Opportunity For Introducing Peanut: New Study Findings From the LEAP and EAT Trials

Results from the landmark LEAP and EAT studies have shown that introducing peanuts to babies can dramatically reduce peanut allergy risk.

But what age is the best time to introduce peanut in order to reduce a child’s risk of developing a peanut allergy? In other words, what is the “window of opportunity” for introducing peanut? Dr. Erika Nolte, our Science Director, answers this based on new findings drawn from the LEAP and EAT studies.

The number of children with peanut allergies has more than tripled in recent years. But, as results from the landmark LEAP and EAT studies have shown, introducing peanuts to babies early and often can dramatically reduce the number of children who develop a peanut allergy in the future. Introducing peanut at the right time is crucial.

Based on these landmark studies, what age is the best timing to introduce peanut in order to reduce a child’s risk of developing a peanut allergy? In other words, what is the “window of opportunity” for introducing peanut? Today, we'll analyze new findings drawn from the LEAP and EAT studies to answer this question.

The Landmark LEAP and EAT Studies: Early, Regular Consumption of Peanut Reduces Peanut Allergy Risk

In 2015, a clinical trial involving more than 600 children revealed that feeding infants peanuts regularly could reduce their risk of developing a peanut allergy compared to those who did not eat peanuts as an infant. The trial, known as the LEAP trial, followed these children until they turned 12 years old and confirmed that regularly eating peanuts in infancy provides long-term protection from developing a peanut allergy. 

Just after the LEAP trial was published, a second trial called the EAT trial, with even more children participating, found that parents could reduce their child’s risk of developing a peanut or egg allergy by feeding these foods regularly to their infants. 

Since these studies were published, every major medical association dealing with infant health or allergies has released guidelines recommending that all infants be fed commonly allergenic foods during infancy, although each guidance offers slightly different directions on how to best do this. 

Now, the authors of the LEAP and EAT studies have re-analyzed the data to understand the infants most at risk for developing a peanut allergy and the best way to reduce peanut allergy in the whole population.

New Findings From the LEAP and EAT Studies: The “Window of Opportunity” for Peanut Introduction.

The authors of the LEAP and EAT studies found that there is a strong relationship between eczema and the risk of developing a peanut allergy. Infants with more severe eczema or eczema for a longer period of time are at greater risk than infants without eczema, with more mild eczema, or with eczema for a shorter amount of time. Babies with eczema, especially moderate to severe eczema, are considered high risk for food allergies.

The authors also discovered that peanut sensitization – the immune system's response to a food without any clinical symptoms of a food allergy – starts early and develops quickly during infancy. In the LEAP and EAT studies, infants who joined the study at an older age had higher rates of sensitization.

Moreover, the authors learned that non-white infants were more likely to develop a peanut allergy than white infants.

With these factors in mind, the authors examined how early introduction of peanuts could reduce the population's peanut allergies. One of the most significant findings from this research was that the impact of early allergen introduction decreased as the age of introduction increased:

  • Waiting longer to introduce peanuts makes it less likely to reduce the risk of a peanut allergy. 
    • Introducing peanuts to all infants at four months old reduced the risk of peanut allergies better than introducing peanuts at four months old only for high-risk babies and six months old for low-risk babies.
    • Both options reduced the risk of peanut allergies better than introducing low-risk babies to peanuts at 12 months old.

      Findings from the study make it clear – it’s important to introduce all infants to peanut before 6 months of age, not just high-risk infants. And 4 months of age is the best “window of opportunity” for peanut introduction.

      The study estimates that:

      • Introducing peanut to all babies at 4 months of age would reduce peanut allergy rates by 82%.
      • Introducing peanut to high-risk babies at 4 months and low-risk babies at 6 months would reduce peanut allergy rates by an estimated 77%. 
      • But waiting to introduce peanut to low-risk babies until 12 months of age would result in only a 58% estimated reduction in peanut allergy rates. 
      • And waiting to introduce peanut until 12 months overall would result in only a 33% estimated reduction in peanut allergy rates.

      The impact of the early introduction of peanut products was most effective when applied as early as possible. 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.” – Dr. Graham Roberts, Dr. Gideon Lack and others

      What Do These Findings Mean for Parents?

      This research has provided important evidence that all parents should introduce allergens to their babies before they turn six months old to have the best chance of preventing food allergies. It is important to remember that the children in these studies were not just introduced to peanuts on a single occasion – they were fed peanuts multiple times a week. Regular feeding, not just introduction, is necessary to prevent food allergies.

      Graph showing the relative reduction in peanut allergy by eczema severity groups based on the age of introduction to peanuts (in months)

      Image courtesy of "Defining the window of opportunity and target populations to prevent peanut allergy" from the Journal of Allergy and Clinical Immunology. 

      A note on introducing peanut safely:  You’ll need to introduce peanut in a baby-safe way, because whole peanuts, peanut pieces, and unmodified peanut butter are all choking hazards. The American Academy of Allergy, Asthma, and Immunology (AAAAI) recommends introducing peanut powder (peanut flour) as a safe option, and states in their guidelines,  "Peanut-containing products, such as powders/flours… have...been used as safe forms of peanut for infants.” 

      Ready. Set. Food!: Safely introduce peanut (plus other allergens) to baby

      Although the best time to introduce allergens to baby is at 4 months of age (and before baby turns 6 months of age), many babies in this age group aren’t yet ready for solids. Plus, introducing allergens daily with a DIY approach can be difficult, because of all the time it takes to measure out different allergen foods. 

      Fortunately, there’s an easy way to consistently feed your little one peanut (plus other allergens), starting at the opportune time and in a baby-safe way.

      Ready. Set. Food! Stage 1 and 2 Mix-Ins let you safely and easily introduce allergens to your baby each day, using pre-measured packets that mix with baby’s food, breastmilk, or formula. The amount of peanut we use aligns with landmark studies and medical guidelines, and is in powder form.

      And since our Stage 1 and Stage 2 Mix-Ins fully dissolve into a bottle of breastmilk or formula, you can safely introduce peanut (plus egg and milk) to any baby as early as 4 months of age, even if baby is not yet ready for solids.

      As baby grows, you can continue to feed them peanut and other allergens (egg, milk, almond, cashew, walnut, sesame, soy, wheat), with our system that grows with your baby:

      • Stage 3 Mix-Ins and Organic Baby Oatmeal, with peanut, egg, milk, and 6 more top allergens inside (for babies consistently eating solids)
      • Organic Puffs, a first-of-their kind yummy snack with 9 top allergens inside (for babies 8+ months old and accustomed to chewing solids)
      • Organic Oat and Fruit Bars, to keep feeding your little one 8 top allergens on the go (for toddlers 12+ months old standing or walking without support, who can use their back teeth to chew through a variety of foods)

      Ready. Set. Food! is organic and non-GMO. It only contains real, organic food ingredients, with no added sugar and no artificial additives. It’s recommended by over 1,000 pediatricians and allergists.

      Start your baby's journey towards food freedom today with Ready. Set. Food!

       

      Introduce Allergens Safely and Easily with Ready. Set. Food!

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      All health-related content on this website is for informational purposes only and does not create a doctor-patient relationship. Always seek the advice of your own pediatrician in connection with any questions regarding your baby’s health.

      These statements have not been evaluated by the Food and Drug Administration. Products are not intended to diagnose, treat, cure or prevent any disease.  

      See the FDA Peanut Allergy Qualified Health Claim at the bottom of our homepage.

      All health-related content on this website is for informational purposes only and does not create a doctor-patient relationship. Always seek the advice of your own pediatrician in connection with any questions regarding your baby’s health.

      These statements have not been evaluated by the Food and Drug Administration. Products are not intended to diagnose, treat, cure or prevent any disease.  If your infant has severe eczema, check with your infant’s healthcare provider before feeding foods containing ground peanuts.