Earlier ingestion of peanut following changes to infant feeding guidelines: The EarlyNuts Study.

Abstract

BACKGROUND\nRandomized controlled trials demonstrate that timely introduction of peanut to infants reduces the risk of peanut allergy. However, much debate remains regarding how to best achieve earlier peanut introduction at the population level. Our previous study in 2007-2011 (HealthNuts, n=5,300) indicated that few infants were consuming peanut in the first year. Australian infant feeding guidelines were updated in 2016 to recommend introducing peanut before 12 months for all infants. There was no data available on the subsequent impact on peanut introduction or peanut reactions.\n\n\nOBJECTIVE\nTo assess the consequences of a non-screening approach to allergenic food introduction in a population-based sample of infants in their first year of life METHODS: EarlyNuts is a population-based, cross-sectional study of 12-month-old infants in Melbourne, Australia, recruited using an identical sampling frame and methods to HealthNuts (72% response rate vs 73% in HealthNuts). We report here on the first 860 participants, recruited between November 2016 and October 2018.\n\n\nRESULTS\nMost infants (88.7%; 95% CI, 86.1-90.9) had introduced peanut by 12 months (median age 6 months), an increase from 28.4% (95% CI, 27.2-29.7) in HealthNuts. By 12 months, the majority of these (76.4%) had consumed peanut more than 4 times and 28% were eating peanut more than once per week. Preliminary results on parent-reported reactions show 4.0% of those consuming peanut by 12 months had possible IgE-mediated reactions.\n\n\nCONCLUSIONS\nThere has been a striking shift towards earlier peanut introduction, with a three-fold increase in peanut introduction by age one in 2018 compared to 2007-2011.