Health

New Study Shows Tools That Help Pediatricians Prevent Peanut Allergies in Infants

In a promising advancement for childhood allergy prevention, a newly published trial shows that relatively simple tools, such as training videos, electronic health record prompts, and informational handouts, can dramatically enhance pediatricians’ ability to counsel families on early peanut introduction—a strategy known to reduce peanut allergy risk.

The randomized study, conducted across 30 pediatric practices in Illinois and involving over 18,000 infant visits, revealed that clinicians with access to these supports adhered to best practice guidelines 84% of the time for low-risk infants, compared to just 35% in control practices. The intervention also improved care for higher-risk infants, including more referrals to allergists or ordering tests. (Northwestern University press release)

Why Early Peanut Introduction Matters

Since 2017, U.S. and international guidelines have pivoted from recommending delayed introduction of peanuts to encouraging introducing peanut-containing foods between 4–6 months for most infants, including those at higher risk (e.g., infants with eczema or egg allergy). The change was driven by landmark trials showing reduced rates of peanut allergy when exposure begins early.
A 2015 U.K. trial—part of the LEAP (Learning Early About Peanut) study—demonstrated that early peanut introduction cut peanut allergy risk by over 80% in high-risk infants. Subsequent pooled analyses of LEAP and EAT (Enquiring About Tolerance) cohorts reaffirm that early exposure reduces both sensitization and clinical peanut allergy across risk groups.

Yet despite the robust evidence, adoption among pediatricians has been uneven. Surveys find many physicians remain unaware of or hesitant to implement updated recommendations.

What the New Trial Did

The intervention practices received:

  • A training video for clinicians
  • EHR (Electronic Health Record) prompts reminding physicians to discuss peanut introduction
  • Visual handouts for families
  • A “scorecard” tool to flag infants with severe eczema or higher allergy risk

These combined supports were used during 4‑ and 6‑month well-child visits to prompt appropriate counseling and clinical actions.

The control practices continued standard care without these supports.

In the control group, only about one in three low-risk infants received the guideline-consistent counseling, whereas intervention practices raised that to eight in ten. For high-risk infants (those with severe eczema or egg allergy), adherence rose more modestly—but still noticeably.

The trial investigators will continue to follow the infants to see whether improved guideline adherence translates into reduced rates of peanut allergy over time.

  • Time pressure: Pediatric well visits are packed, making it hard to cover multiple preventive topics
  • Clinician reluctance: Some physicians remain uneasy about introducing allergens early, worrying about reactions or lacking confidence in testing and follow-up
  • Parental fear: Many caregivers delay peanut introduction due to fear of allergic reactions or lack of knowledge about the guidelines

Moreover, disparities exist in who receives guideline‑based advice. A separate Northwestern study found that Black, Hispanic, and lower-income parents were less likely to report their pediatrician mentioning early peanut introduction. Early peanut feeding rates were also lower in minority and lower-income groups.

That gap raises equity concerns: children from underserved communities might miss out disproportionately on a potentially protective intervention.

What This Means Going Forward

If improved guideline adherence ultimately lowers peanut allergy incidence, the implications could be significant:

  • Pediatric practices might widely adopt these low-cost tools
  • Allergy prevalence in children could decline
  • Health systems may need to integrate prompts, handouts, and education into routine care

Dr. Ruchi Gupta, lead author of the study and a pediatrician at Northwestern, summed the hope succinctly: “Because pediatric visits at 4 and 6 months are so busy, this support is critical … Our hope is that these conversations will help parents feel confident introducing peanut products early.”

Leave a Reply

Your email address will not be published. Required fields are marked *