Rates of New Peanut Allergy and Discontinuation Following Introduction in High-Risk Infants.

Abhilasha Banerjee, Robert Wood, Joan Dunlop, Jennifer Dantzer, Mihaela Plesa, Alkis Togias, Corinne Keet

The journal of allergy and clinical immunology. In practice 2024 Mar

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Peanut introduction guidelines recommend that infants with severe eczema and/or egg allergy consume 6 g of peanut protein weekly to prevent peanut allergy. Rates of new peanut allergy after introduction and adherence remain under study. To determine compliance with peanut introduction guidelines, rates of new peanut allergy, and reasons for discontinuation of peanut consumption in a cohort of high-risk infants. A prospective cohort of 4- to 11-month-old high-risk infants (defined as moderate-severe eczema or non-peanut food allergy or a first-degree relative with peanut allergy) with no prior peanut exposure who were determined to not be peanut allergic were recommended to introduce 6 g of peanut protein weekly. Participants were followed to 30 months with 2 in-person visits and monthly questionnaires. Two hundred seventy-seven infants were followed. At last follow-up, 245 (88%) were consuming some peanut protein with median weekly consumption of 3 g (interquartile range: 1-5 g). New peanut allergy developed in 6 (2%), with 2 of those cases consistent with food protein-induced enterocolitis syndrome. Fear of reaction in another household member was the most common reason for peanut discontinuation. Reactions to peanut after introduction in the index infant occurred in <2% of peanut-allergic siblings and in 20% of peanut-allergic parents. We found low rates of new peanut allergy and generally low rates of peanut discontinuation after introduction in our high-risk cohort. However, families of high-risk infants require significant support with introduction, especially those with another peanut-allergic member. Copyright © 2023. Published by Elsevier Inc.

Citation

Abhilasha Banerjee, Robert Wood, Joan Dunlop, Jennifer Dantzer, Mihaela Plesa, Alkis Togias, Corinne Keet. Rates of New Peanut Allergy and Discontinuation Following Introduction in High-Risk Infants. The journal of allergy and clinical immunology. In practice. 2024 Mar;12(3):645-651.e1