New Peanut Study Does Not Say Parents Are to Blame
The food allergy community, including allergists, parents, and anyone living with peanut allergy, has been abuzz since the unveiling of the results from the landmark study Learning Early About Peanut Allergy (LEAP). The increased chatter has unfortunately included many different interpretations of the data, many by unqualified people (including some physicians!). Research studies can be difficult to interpret. There are often very situational-specific issues regarding the methods used to conduct the study, select participants, and how applicable the results may be. In an effort to gain extra clicks or more readers, headlines often defer to eye catching and misleading statements - or do a better/worse job at explaining those aforementioned issues. That’s why it’s so important to read past the headlines when forming opinions about medical research findings.
- For parents who currently have children with peanut allergy and withheld peanuts during infancy – this is the most important message: IT’S NOT YOUR FAULT! Development of peanut allergy is an extremely complicated mixture of genetics and environment that remains poorly understood. For years, the world’s experts recommended avoidance of peanut, and have now admittedly delivered confusing messages with conflicting recommendations.
- It is very hard to make any conclusions about what is “right” or “wrong” to do based on one study. This study was very well done, but its results must be repeated.
- The LEAP study had absolutely NOTHING to do with treatment of peanut allergy. It was a study designed to assess a possible prevention strategy, only in very young infants before they were exposed to peanut.
- The findings of the LEAP study do not apply in ANY WAY to anyone currently living with peanut allergy. Again, it only deals with small babies who do not have peanut allergy.
- This does not change food allergy management or all of the sudden make it safe for people at risk of reactions to peanut to start eating peanut.
- This study should not change anyone’s current food allergy avoidance strategies, including that at home, school, work, or during travel.
- Parents should NOT start feeding high risk infants peanut at home. Every single participant in the LEAP study had a thorough evaluation with both skin prick test and oral food challenge to peanut before being enrolled in the study. Roughly 10% were deemed too risky to proceed.
- The LEAP study looked at a very specific set of children, which included those living in the United Kingdom with severe eczema and/or egg allergy. These results may not apply to other groups, such as babies in the US or other countries, or those with other “high-risk” conditions for food allergy such as other food allergies or history of wheezing.
- The LEAP study was not 100% successful. It tried to show if a smaller percentage of children would develop peanut allergy with early introduction of a fixed amount, compared to avoiding peanut. Peanut allergy developed in both groups. Amazingly, allergy occurred significantly less in the early avoidance group, but again, it did occur in BOTH groups.
- There were some interesting points learned about how peanut allergy evolves. About 2% of children with negative skin tests and 10% of infants with mildly positive skin prick tests still developed peanut allergy even with keeping it in their diet until 5 years of age.
- Lastly, there has never been sufficient evidence to demonstrate that infants at low risk of developing allergy (no parents with allergy, no history of eczema or other food allergy) need to avoid peanut or any foods until later in childhood. The LEAP study has no bearing on these prior recommendations.
- Medicine is an imperfect science, and even highly trained individuals do not always have the answers. We try to do the best we can with the information and experience we have at the time. Updates to recommendations are not unique to food allergy. In fact, there have been similar recent seismic shifts with regards to diabetes, cholesterol, hormone replacement therapy, and breast cancer screening.
We want to reiterate a key point. Don't blame yourself, feel guilt/shame and feel somehow you “gave” peanut allergy to your child. This couldn’t be any further from the truth. We sense that there may be many parents out there right now harboring such thoughts. Go hug your food allergic child, tell them you love them, and praise them for living as good a life as they can with food allergy. Do the same to yourself, too. The jury is not yet out on if early peanut intervention works and should be followed. This is not the promise of a cure, but rather a potential means of reducing the risk of developing peanut allergy. Again, this is one study, which like all studies has its good points and its limitations, but for us, it is important to guide you to read past the headlines, and focus on the key points of any research study.
by Kids With Food Allergies
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