University of Georgia

A website from the College of Agricultural and Environmental Sciences

Peanut Allergy Prevention

What does the research say?

Peanut and other food allergies are on the rise.1 Approximately 6% of children have a food allergy, some of which they are more likely to grow out of, like milk and eggs, and others that are more likely to stick with them over time, like peanuts and tree nuts.2,3 Peanut allergies are one of the leading food allergies among children and are more likely to result in anaphylaxis, a life-threatening allergic reaction.1-4,5 Having a peanut or other food allergy can impact you and your child’s quality of life.6,7  This all sounds pretty grim, but what if there was something you could do to prevent the allergy from developing in the first place? There is, and it’s actually quite simple. 

Research shows that introducing babies to peanut-containing foods around 4 to 6 months can decrease their chances of developing a peanut allergy by up to 86%8. This was demonstrated in the groundbreaking LEAP study.  In that study, infants at the highest risk for a peanut allergy (those with eczema and/or an egg allergy) who were exposed to two teaspoons of peanut-containing foods three times per week were 86% less likely to develop a peanut allergy at age 1.  The follow-up studies to LEAP also showed that this protection was sustained over time.8,9

  At age 5, children who had been exposed to peanut-containing products in the first year of life were significantly less likely to have a peanut allergy than those who avoided peanuts.10  This was true even if the child avoided peanuts for some time after the early exposure. In 2017, the National Institute of Allergy and Infectious Diseases published guidelines for pediatricians and medical practitioners11 recommending that babies be introduced to peanut-containing foods early to prevent peanut allergies.  

Several research studies followed the LEAP study and investigated peanuts and other common allergenic foods, including wheat, eggs, milk, dairy, seafood, and soy products. 12  In most studies, introducing an allergenic food decreased the chances that the child would develop an allergy to that food.  Where there was no decrease in risk, there was also no increase in risk, suggesting that this practice is unlikely to harm the infant. 

Based on the scientific evidence, the Dietary Guidelines for Americans recommend that infants be introduced to peanuts and other allergenic foods in the first year of life.  Children at the highest risk for a peanut allergy, those with eczema, egg allergy, or both, should be introduced to peanut-containing foods between 4 and 6 months of age.  

  1. Gupta RS, Warren CM, Smith BM, et al. The Public Health Impact of Parent-Reported Childhood Food Allergies in the United States. Pediatrics. Dec 2018;142(6)doi:10.1542/peds.20 18-1235 
  1. Zablotsky B, Black LI, Akinbami LJ. Diagnosed allergic conditions in children aged 0–17 years: United States, 2021. NCHS Data Brief, no 459. Hyattsville, MD: National Center for Health Statistics. 2023. DOI: https://dx.doi.org/10.15620/cdc:123250. 
  1. Savage J, Sicherer S, Wood R. The Natural History of Food Allergy. J Allergy Clin Immunol Pract. 2016;4(2):196-203; quiz 204. doi:10.1016/j.jaip.2015.11.024 
  1. Lange L, Klimek L, Beyer K, et al. White paper on peanut allergy – part 1: Epidemiology, burden of disease, health economic aspects. Allergo Journal International. 2021-12-01 2021;30(8):261-269. doi:10.1007/s40629-021-00189-z 
  1. Sampson HA, Mendelson L, Rosen JP. Fatal and Near-Fatal Anaphylactic Reactions to Food in Children and Adolescents. New England Journal of Medicine. 1992-08-06 1992;327(6): 380-384. doi:10.1056/nejm199208063270603 
  1. Warren CM, Otto AK, Walkner MM, Gupta RS. Quality of Life Among Food Allergic Patients and Their Caregivers. Curr Allergy Asthma Rep. May 2016;16(5):38. doi:10.1007/s118 82-016-0614-9 
  1. Golding MA, Batac ALR, Gunnarsson NV, Ahlstedt S, Middelveld R, Protudjer JLP. The burden of food allergy on children and teens: A systematic review. Pediatr Allergy Immunol. Mar 2022;33(3):e13743. doi:10.1111/pai.13743 
  1. Du Toit, G., Roberts, G., Sayre, P. H., Bahnson, H. T., Radulovic, S., Santos, A. F., Brough, H. A., Phippard, D., Basting, M., Feeney, M., Turcanu, V., Sever, M. L., Gomez Lorenzo, M., Plaut, M., Lack, G., & LEAP Study Team (2015). Randomized trial of peanut consumption in infants at risk for peanut allergy. The New England journal of medicine, 372(9), 803–813. https://doi.org/10.1056/NEJMoa1414850 
  1. Du Toit, G., Sayre, P. H., Roberts, G., Sever, M. L., Lawson, K., Bahnson, H. T., Brough, H. A., Santos, A. F., Harris, K. M., Radulovic, S., Basting, M., Turcanu, V., Plaut, M., Lack, G., & Immune Tolerance Network LEAP-On Study Team (2016). Effect of Avoidance on Peanut Allergy after Early Peanut Consumption. The New England journal of medicine, 374(15), 1435–1443. https://doi.org/10.1056/NEJMoa1514209 
  1. Du Toit, G., Huffaker, M. F., Radulovic, S., Feeney, M., Fisher, H. R., Byron, M., Dunaway, L., Calatroni, A., Johnson, M., Foong, R. X., Marques-Mejias, A., Bartha, I., Basting, M., Brough, H. A., Baloh, C., Laidlaw, T. M., Bahnson, H. T., Roberts, G., Plaut, M., Wheatley, L. M., … Immune Tolerance Network LEAP-Trio Trial Team (2024). Follow-up to Adolescence after Early Peanut Introduction for Allergy Prevention. NEJM evidence, 3(6), EVIDoa2300311. https://doi.org/10.1056/EVIDoa2300311 
  1. Togias, A., Cooper, S. F., Acebal, M. L., Assaʼad, A., Baker, J. R., Jr, Beck, L. A., Block, J., Byrd-Bredbenner, C., Chan, E. S., Eichenfield, L. F., Fleischer, D. M., Fuchs, G. J., 3rd, Furuta, G. T., Greenhawt, M. J., Gupta, R. S., Habich, M., Jones, S. M., Keaton, K., Muraro, A., Plaut, M., … Boyce, J. A. (2017). Addendum guidelines for the prevention of peanut allergy in the United States. JAAPA : official journal of the American Academy of Physician Assistants, 30(3), 1–5. https://doi.org/10.1097/01.JAA.0000512231.15808.66 
  1. Dietary Guidelines Advisory Committee. 2020. Scientific Report of the 2020 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Agriculture and the Secretary of Health and Human Services. U.S. Department of Agriculture, Agricultural Research Service, Washington, DC. Available at: https://doi.org/10.52570/DGAC2020