Peanut allergy prevention: Current evidence and implications for clinical practice

Abstract

In the last decade there has been a major shift in clinical practice guidelines from the avoidance of allergenic foods for the purpose of preventing allergy development toward their early introduction before six months of age. The purpose of this article is to review current evidence for this change in recommendation and to evaluate its impli- cations for clinical practice. A literature review and analysis were conducted focusing on key clinical studies that influenced this change in practice over the past decade. The main findings supported the early introduction of peanut to the diet and highlighted two areas of uncertainty in the literature that have implications for adopting the new guidelines in clinical practice. First, current evidence lacks a clear definition of “high risk” for determining allergic predisposition in infants; and second, defining the ideal timing, amount, and frequency with which peanut and peanut containing foods are introduced into a child‘s diet is not yet established in the literature. The principal conclusion underscored the importance of early and continual exposure to peanut regardless of risk of atopy.