Update on Early Introduction of Peanut to Prevent Allergy Development: Challenges with Implementation
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Purpose of Review
This review summarizes the evidence leading towards the development of new guidelines that recommend early introduction of peanut to prevent the development of peanut allergy. It also reviews the current understanding of challenges faced with implementation of these recommendations on a widespread basis.
Prior recommendations to avoid feeding allergenic foods to infants have been updated and reversed. This paradigm shift in advice has created an opportunity on a population level to try and halt the recent increase in prevalence of peanut allergy. However, challenges with implementation of these new guidelines exist in many areas.
While evidence supports the early introduction of peanut to prevent allergy development, the application and challenges faced with these recommendations are not fully understood. Persistent efforts from pediatricians and allergists, as well as acceptance from parents, will be necessary in order to make a significant impact on the prevalence of peanut allergy.
KeywordsPeanut allergy Early introduction Prevention Food allergy Infant feeding Quality improvement
enquiring about tolerance
learning early about peanut
National Institute of Allergy and Infectious Disease
oral food challenge
Plan Do Study Act
skin prick test
Compliance with Ethical Standards
Conflict of Interest
Dr. Stukus was a member of the expert panel and coauthor of the 2017 NIAID Addendum guidelines for early introduction of peanut to prevent allergy. This was unpaid and his role does not serve as a conflict of interest. Drs. Mikhail and Prince declare no conflicts of interest relevant to this manuscript.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
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