A decade after the landmark LEAP trial (Learning Early About Peanut Allergy) proved that introducing peanut products into infancy could significantly reduce peanut-allergy risk, new real-world research finds that the change in guidance is already making a measurable difference.
The study, led by David Hill of the Children’s Hospital of Philadelphia and published in the journal Pediatrics, analyzed electronic health records from dozens of U.S. pediatric practices. It tracked trends before and after the 2015 guidance (for high‐risk infants) and the expanded 2017 guidelines recommending peanuts for broader infant populations.
Results show that among children aged 0-3 years, peanut-allergy diagnoses declined by more than 27% following the 2015 recommendations and by over 40% after the 2017 expansion. Using these declines, the researchers estimate that roughly 60,000 children have avoided developing peanut allergies in the U.S. since the guidelines changed.
Historically, doctors advised delaying exposure to allergenic foods until the age of 3, but the LEAP trial upended that approach by showing an 80%+ risk reduction when peanuts were introduced early — a protection that persisted into adolescence.
Despite the positive findings, the adoption of early peanut introduction has been patchy: surveys show only about 29% of pediatricians and 65% of allergists reported that they followed the revised 2017 guidance. The researchers caution that while the decline is real, the data are drawn from a subset of practice sites and might not yet reflect all U.S. children.
Experts emphasize that the updated 2021 guidance now recommends introducing peanuts and other major food allergens between 4-6 months of age without prior allergy screening or delay for otherwise healthy infants — though children with severe eczema or egg allergy may still need evaluation first.
Clinical dietitians suggest that introduction doesn’t require large quantities — even small tastes of peanut butter mixed into yogurt or soft solids a few times a week can help establish immune tolerance.
Why It Matters
Major public-health impact — Preventing tens of thousands of peanut allergies translates into fewer anaphylaxis risks, fewer emergency treatments, and less lifelong burden of food avoidance.
Shift in allergy prevention paradigm — The move from avoidance to early exposure represents a major reversal in paediatric-nutrition advice, grounded in strong evidence.
Health-equity implications — Food allergies disproportionately affect children from certain demographic groups; broader adoption of early introduction could reduce disparities.
Cost-savings potential — Fewer allergies means fewer medical visits, less need for expensive immunotherapies, and less burden on families.
Implementation challenge highlighted — The slow uptake underscores how translating guidelines into everyday paediatric practice, and getting buy-in from parents, remains difficult.
Key Social Outcome
Changing parental perceptions of allergens — Many parents who were once told to delay allergenic foods are now being encouraged to introduce them early, leading to a shift in household feeding strategies and parental confidence.
Empowerment of caregivers — With clearer guidelines, parents feel more equipped to proactively reduce their child’s allergy risk rather than react once allergy develops.
Public awareness of early‐exposure strategy — The broad media coverage is amplifying knowledge that allergy prevention can start in infancy, increasing demand for informed paediatric advice.
Normalization of previously avoided foods — Peanuts and other allergenic foods are increasingly being incorporated into infants’ diets, reducing the stigma or fear around them and helping reshape early weaning practices.
Community conversations & peer sharing — As more families adopt early introduction, social media groups, parent forums, and healthcare networks are sharing strategies, recipes, and successes, building a community-based support for the new approach.
