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By Deanna Neff HealthDay Reporter
WEDNESDAY, Oct. 22, 2025 (HealthDay News)
—
Encouraging parents to introduce peanuts to their infants early has led to a significant drop in new allergy diagnoses, according to researchers at the Children’s Hospital of Philadelphia.
Their study — published in the November issue of the journal Pediatrics — is the first large-scale analysis to show the real-world impact of the new feeding recommendations and a successful public health intervention.
Anaphylactic food allergies — in which the immune system overreacts to foods like milk, egg or peanut — affect about 4% of children and can cause immediate, severe reactions such as hives, swelling and difficulty breathing.
Peanut is among the most common causes of these reactions, which are also known as immunoglobulin E (IgE)-mediated.
The shift in public health policy was driven by the 2015 Learning Early About Peanut Allergy (LEAP) trial, which found that regularly feeding peanut products to high-risk infants (those with severe eczema or egg allergy) reduced their risk of developing a peanut allergy by 81%.
Following the LEAP trial, major pediatric and allergy organizations released guidelines in 2015 and 2017 focused on high-risk children.
These were broadened in 2021 to support having caregivers introduce major food allergens like peanut and egg at 4 to 6 months of age for all children without a history of a prior reaction.
“Everyone has been wondering whether these landmark public health interventions have had an impact on reducing rates of IgE-mediated food allergies in the United States,” said Dr. Stanislaw Gabryszewski, the study’s first author and an attending physician at Children’s Hospital of Philadelphia (CHOP). “We now have data that suggest that the effect of this landmark public health intervention is occurring.”
Analyzing the Decline
The CHOP team analyzed electronic health record data for more than 124,000 children. They compared food allergy diagnosis rates before the guidelines; after the initial guidelines; and after broader 2021 guidelines were adopted.
From before the 2015 guidelines to after the 2021 addendum, the results showed a significant reduction in new diagnoses of:
Furthermore, egg allergy surpassed peanut allergy as the most commonly diagnosed food allergy after the guidelines were put in place.
While the early exposure approach doesn't completely eliminate food allergies, experts consider the observed reduction a major public health victory.
“Our findings have relevance from those of us who treat patients to those caring for infants, and more awareness, education and advocacy could further increase the positive results we observed in this study,” said senior study author Dr. David Hill, an attending physician with the Division of Allergy and Immunology at CHOP.
Dr. Hill noted that “future studies could potentially explore specific feeding practices that help us better understand the timing, frequency and dose of foods that optimize protection against food allergies.”
In an accompanying editorial, writers welcomed the findings and called for continued follow up on them.
"If confirmed, these findings would represent a meaningful public health advance — affirming that clinical research, when coupled with clear guidelines and committed dissemination, can indeed shift the trajectory of childhood food allergy," wrote a team led by Dr. Ruchi Gupta of Northwestern University Feinberg School of Medicine in Chicago.
More information
The National Institute of Allergy and Infectious Diseases offers resources on food allergies.
SOURCES: Children’s Hospital of Philadelphia, news release, Oct. 20, 2025; Pediatrics, November 2025
Copyright © 2025 HealthDay. All rights reserved.
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For the curious, I will also be attaching the associated 2015 LEAP trial the article makes mention of below:
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Archive
Early Exposure Guidelines Cut Down Peanut Allergy Cases
By Deanna Neff HealthDay Reporter
WEDNESDAY, Oct. 22, 2025 (HealthDay News)
—
Encouraging parents to introduce peanuts to their infants early has led to a significant drop in new allergy diagnoses, according to researchers at the Children’s Hospital of Philadelphia.
Their study — published in the November issue of the journal Pediatrics — is the first large-scale analysis to show the real-world impact of the new feeding recommendations and a successful public health intervention.
Anaphylactic food allergies — in which the immune system overreacts to foods like milk, egg or peanut — affect about 4% of children and can cause immediate, severe reactions such as hives, swelling and difficulty breathing.
Peanut is among the most common causes of these reactions, which are also known as immunoglobulin E (IgE)-mediated.
The shift in public health policy was driven by the 2015 Learning Early About Peanut Allergy (LEAP) trial, which found that regularly feeding peanut products to high-risk infants (those with severe eczema or egg allergy) reduced their risk of developing a peanut allergy by 81%.
Following the LEAP trial, major pediatric and allergy organizations released guidelines in 2015 and 2017 focused on high-risk children.
These were broadened in 2021 to support having caregivers introduce major food allergens like peanut and egg at 4 to 6 months of age for all children without a history of a prior reaction.
“Everyone has been wondering whether these landmark public health interventions have had an impact on reducing rates of IgE-mediated food allergies in the United States,” said Dr. Stanislaw Gabryszewski, the study’s first author and an attending physician at Children’s Hospital of Philadelphia (CHOP). “We now have data that suggest that the effect of this landmark public health intervention is occurring.”
Analyzing the Decline
The CHOP team analyzed electronic health record data for more than 124,000 children. They compared food allergy diagnosis rates before the guidelines; after the initial guidelines; and after broader 2021 guidelines were adopted.
From before the 2015 guidelines to after the 2021 addendum, the results showed a significant reduction in new diagnoses of:
- Peanut Allergy: Down from 0.79% to 0.45% of children in the study
- Any IgE-Mediated Food Allergy: Down from 1.46% to 0.93% of children in the study
Furthermore, egg allergy surpassed peanut allergy as the most commonly diagnosed food allergy after the guidelines were put in place.
While the early exposure approach doesn't completely eliminate food allergies, experts consider the observed reduction a major public health victory.
“Our findings have relevance from those of us who treat patients to those caring for infants, and more awareness, education and advocacy could further increase the positive results we observed in this study,” said senior study author Dr. David Hill, an attending physician with the Division of Allergy and Immunology at CHOP.
Dr. Hill noted that “future studies could potentially explore specific feeding practices that help us better understand the timing, frequency and dose of foods that optimize protection against food allergies.”
In an accompanying editorial, writers welcomed the findings and called for continued follow up on them.
"If confirmed, these findings would represent a meaningful public health advance — affirming that clinical research, when coupled with clear guidelines and committed dissemination, can indeed shift the trajectory of childhood food allergy," wrote a team led by Dr. Ruchi Gupta of Northwestern University Feinberg School of Medicine in Chicago.
More information
The National Institute of Allergy and Infectious Diseases offers resources on food allergies.
SOURCES: Children’s Hospital of Philadelphia, news release, Oct. 20, 2025; Pediatrics, November 2025
Copyright © 2025 HealthDay. All rights reserved.
-
For the curious, I will also be attaching the associated 2015 LEAP trial the article makes mention of below:
-
Archive (Expanded here at this pdf)
Background
The prevalence of peanut allergy among children in Western countries has doubledin the past 10 years, and peanut allergy is becoming apparent in Africa and Asia.We evaluated strategies of peanut consumption and avoidance to determine whichstrategy is most effective in preventing the development of peanut allergy in infantsat high risk for the allergy.
Methods
We randomly assigned 640 infants with severe eczema, egg allergy, or both to consumeor avoid peanuts until 60 months of age. Participants, who were at least 4 months butyounger than 11 months of age at randomization, were assigned to separate studycohorts on the basis of preexisting sensitivity to peanut extract, which was determined with the use of a skin-prick test — one consisting of participants with nomeasurable wheal after testing and the other consisting of those with a wheal measuring 1 to 4 mm in diameter. The primary outcome, which was assessed independently in each cohort, was the proportion of participants with peanut allergy at60 months of age.
Results
Among the 530 infants in the intention-to-treat population who initially had negative results on the skin-prick test, the prevalence of peanut allergy at 60 months ofage was 13.7% in the avoidance group and 1.9% in the consumption group (P<0.001).Among the 98 participants in the intention-to-treat population who initially hadpositive test results, the prevalence of peanut allergy was 35.3% in the avoidancegroup and 10.6% in the consumption group (P=0.004). There was no significantbetween-group difference in the incidence of serious adverse events. Increases inlevels of peanut-specific IgG4 antibody occurred predominantly in the consumptiongroup; a greater percentage of participants in the avoidance group had elevated titersof peanut-specific IgE antibody. A larger wheal on the skin-prick test and a lower ratioof peanut-specific IgG4:IgE were associated with peanut allergy.ConclusionsThe early introduction of peanuts significantly decreased the frequency of the development of peanut allergy among children at high risk for this allergy and modulatedimmune responses to peanuts. (Funded by the National Institute of Allergy and Infectious Diseases and others; ClinicalTrials.gov number, NCT00329784.)
Background
The prevalence of peanut allergy among children in Western countries has doubledin the past 10 years, and peanut allergy is becoming apparent in Africa and Asia.We evaluated strategies of peanut consumption and avoidance to determine whichstrategy is most effective in preventing the development of peanut allergy in infantsat high risk for the allergy.
Methods
We randomly assigned 640 infants with severe eczema, egg allergy, or both to consumeor avoid peanuts until 60 months of age. Participants, who were at least 4 months butyounger than 11 months of age at randomization, were assigned to separate studycohorts on the basis of preexisting sensitivity to peanut extract, which was determined with the use of a skin-prick test — one consisting of participants with nomeasurable wheal after testing and the other consisting of those with a wheal measuring 1 to 4 mm in diameter. The primary outcome, which was assessed independently in each cohort, was the proportion of participants with peanut allergy at60 months of age.
Results
Among the 530 infants in the intention-to-treat population who initially had negative results on the skin-prick test, the prevalence of peanut allergy at 60 months ofage was 13.7% in the avoidance group and 1.9% in the consumption group (P<0.001).Among the 98 participants in the intention-to-treat population who initially hadpositive test results, the prevalence of peanut allergy was 35.3% in the avoidancegroup and 10.6% in the consumption group (P=0.004). There was no significantbetween-group difference in the incidence of serious adverse events. Increases inlevels of peanut-specific IgG4 antibody occurred predominantly in the consumptiongroup; a greater percentage of participants in the avoidance group had elevated titersof peanut-specific IgE antibody. A larger wheal on the skin-prick test and a lower ratioof peanut-specific IgG4:IgE were associated with peanut allergy.ConclusionsThe early introduction of peanuts significantly decreased the frequency of the development of peanut allergy among children at high risk for this allergy and modulatedimmune responses to peanuts. (Funded by the National Institute of Allergy and Infectious Diseases and others; ClinicalTrials.gov number, NCT00329784.)
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