Peanut allergy prevention strategy does not impact breastfeeding or nutrition, study shows

Introducing peanut-containing foods during infancy as a peanut allergy prevention strategy does not compromise the duration of breastfeeding or affect children’s growth and nutritional intakes, new findings show. The work, carried out by researchers at King’s College London and funded by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, is published today in the Journal of Allergy and Clinical Immunology.

These findings are a secondary result from the Learning Early About Peanut Allergy (LEAP) clinical trial. Primary results from the LEAP trial, published in 2015, found that introducing peanut products into the diets of infants deemed at high risk for peanut allergy led to an 81 percent relative reduction in subsequent development of the allergy compared to avoiding peanut altogether. The goal of the current analysis was to determine whether eating high doses of peanut products beginning in infancy would have any adverse effects on infant and child growth and nutrition.

At the beginning of the LEAP trial, investigators randomly assigned 640 infants enrolled from Evelina London Children’s Hospital, aged 4 to 11 months living in the United Kingdom to regularly consume at least 2 grams of peanut protein three times per week or to avoid peanut entirely. These regimens were continued until the children were 5 years old. The researchers monitored the children at recurring health care visits, and asked their parents and caregivers to complete dietary questionnaires and food diaries.

’An important and reassuring finding of this new analysis was that peanut consumption did not affect the duration of breastfeeding, so countering concerns that introduction of solid foods before six months of age could reduce breastfeeding duration,’ said lead author Mary Feeney, Senior Dietician at the Department of Paediatric Allergy, King’s College London and Guy’s and St. Thomas’ NHS Foundation Trust.

In addition, the researchers did not observe differences in height, weight or body mass index—a measure of healthy weight status—between the peanut consumers and avoiders at any point during the study. This was true even when the researchers compared the subgroup of children who consumed the greatest amount of peanut protein with those who avoided peanut entirely.

In general, the peanut consumers easily achieved the recommended level of 6 grams of peanut protein per week, consuming 7.5 grams weekly on average. They made some different food choices than the avoiders, investigators noted. For example, consumers ate fewer chips and savory snacks. Both groups had similar total energy intakes from food and comparable protein intakes, although the peanut consumers had higher fat intakes and avoiders had higher carbohydrate intakes.

Dr George Du Toit, Consultant in Paediatric Allergy at Evelina London Children’s Hospital and Honorary Reader in Paediatric Allergy, King’s College London, who also led the study said: ‘This study shows that peanut consumption is nutritionally safe when introduced in infancy, even when consumption occurs at high levels. Parents and caregivers must be reminded that whole peanuts should not be given to children below five years due to the risk of choking.’