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ReplacedChanged2015

Keep peanuts away from young children to prevent allergies

An old model or guideline was retired in favor of a new one.

TaughtDo not give peanuts to children under three, especially if allergies run in the family. Avoidance prevents allergy.

NowThe opposite. The LEAP trial in 2015 found that early, regular peanut introduction in high-risk infants reduced peanut allergy by about 80%. Guidelines now recommend introducing peanut protein at around 4 to 6 months.

What actually happened

The American Academy of Pediatrics recommended delayed introduction in 2000. Peanut allergy rates in children then roughly tripled over the following decade. The advice was well-intentioned, widely followed, and appears to have made the problem worse.

The hint came from an observation that Jewish children in Israel, who eat a peanut-based snack called Bamba as infants, had roughly a tenth the peanut allergy rate of demographically similar Jewish children in the UK, who avoided peanuts. Gideon Lack designed the Learning Early About Peanut Allergy trial to test it properly: 640 high-risk infants randomized to eat peanut or avoid it. The results, published in the New England Journal of Medicine in 2015, were decisive enough that the NIH issued new guidelines in 2017 and the AAP formally reversed course. If you were a parent between 2000 and 2015, you were given advice that has since been inverted.

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Sources

  1. New England Journal of Medicine: Randomized trial of peanut consumption in infants at risk for peanut allergy (Du Toit et al., 2015)nejm.org
  2. NIH/NIAID: Guidelines for the prevention of peanut allergyniaid.nih.gov

Who was taught this

Still standard through 2015, so anyone who finished school between 1950 and 2015 learned the earlier version.