For decades, parents across the United States were urged to keep peanuts and other potential allergens far from their infants’ plates, waiting until their children turned three before even considering a taste. But that advice, once gospel among pediatricians, has undergone a dramatic reversal in the last ten years—a shift that’s now paying off in a significant and measurable way, according to a major new study published in Pediatrics on October 20, 2025.
The research, which analyzed health records from about 40,000 children, found a steep decline in childhood peanut allergies since the introduction of new early feeding guidelines. These recommendations, first issued in 2015 and expanded in 2017, called for parents and caregivers to introduce peanut products to infants as early as four months of age. The result? A 43% drop in peanut allergies among children whose families followed the updated guidelines, according to the American Academy of Pediatrics (AAP).
"We detected decreased rates of peanut or any IgE-FA (Immunoglobulin food allergy) in the period following the publication of early introduction guidelines and addendum guidelines," the study stated. "Our results are supportive of the intended effect of these landmark public health recommendations."
To put those numbers in perspective, researchers estimate that about 60,000 children have avoided developing peanut allergies since the first guidance was issued in 2015. That’s a remarkable shift, especially given the stubborn prevalence of food allergies in the United States: roughly 8% of children are affected, with just over 2% specifically allergic to peanuts, as reported by Pediatrics in 2018.
The path to this change began with a groundbreaking 2015 study known as the LEAP (Learning Early About Peanut Allergy) trial, led by Gideon Lack at King’s College London. The LEAP trial found that introducing peanut products to infants between four and eleven months old reduced their risk of developing peanut allergies by more than 80%. Even more encouraging, later analysis showed that this protection persisted in about 70% of kids into adolescence.
As Dr. David Hill, an allergist and researcher at Children’s Hospital of Philadelphia and lead author of the new study, told CBC: "I can actually come to you today and say there are less kids with food allergy today than there would have been if we hadn't implemented this public health effort." He added, "That's a remarkable thing, right?"
Following the LEAP trial, the American Academy of Pediatrics first recommended in 2015 that some infants be introduced to allergenic foods between four and six months of age. Those recommendations were broadened in 2017 to include all infants, not just those at high risk. The guidelines were clear: infants with severe eczema should be tested for peanut allergies before introduction, but for those without eczema or food allergies, families could introduce peanuts according to their own cultural practices and preferences.
The data shows that these recommendations are working. After the 2015 guidance targeted at high-risk children, peanut allergies in kids aged zero to three declined by more than 27%. Following the broader 2017 recommendations, that decline jumped to over 40%, as reported by both MedPage Today and Fox News.
Still, the study’s findings also highlight ongoing challenges. Implementation of the new guidelines has been uneven. Only about 29% of pediatricians and 65% of allergists reported following the expanded 2017 guidance, according to surveys cited in the commentary accompanying the study. Confusion and uncertainty among both parents and healthcare providers have slowed adoption, with some unsure about the safest way to introduce peanuts and other allergens to babies.
Chantelle Velmont, a Toronto mother, told CBC about her own experience: she knew she should introduce allergenic foods to her son early, but didn’t feel any urgency—especially since her pediatrician hadn’t emphasized it. When she finally did try giving her son a peanut product at five and a half months, he suffered an immediate allergic reaction. "It's definitely something I'm nervous about," Velmont said, noting that she now carries an EpiPen everywhere. She wishes there was more straightforward guidance from medical professionals: "There's tons of information out there online, but it's almost overwhelming... It would be nice if there was just clear, simple guidance about the main allergens, and how to approach those."
Experts agree that clear communication is key. Dr. Derek Chu, chair in allergy at the Canadian Institutes of Health Research, told CBC that introducing food allergens early and consistently is important, but parents should feel confident that "you can do it and you can do it safely." He recommends thinning peanut butter with breast milk, formula, or water, or mixing a small amount with puree, to make it easier for babies to eat. The advice goes beyond peanuts: all common allergens—including dairy, soy, wheat, sesame, egg, fish, shellfish, and tree nuts—should be introduced between four and six months, when babies are developmentally ready.
Of course, not every child will have a smooth experience. Symptoms of peanut allergy can appear within minutes to hours after ingestion and may include hives, difficulty breathing, swelling, vomiting, or even a drop in blood pressure. In cases where two or more systems are involved—such as skin and respiratory symptoms—anaphylaxis is possible, and immediate medical attention is required. Parents are encouraged to consult their pediatricians before introducing peanuts, especially if their child has severe eczema or a family history of allergies.
The study’s authors and accompanying editorialists caution that more research is needed to validate these trends in larger, more diverse populations, using expanded diagnostic criteria like food allergy testing and oral food challenges. The current study relied on physician-diagnosed cases from electronic health records, which may not capture the full spectrum of allergic reactions or represent all U.S. children. Furthermore, the drop in peanut allergies was more modest than the dramatic reduction seen in the original LEAP trial, suggesting there’s still room for improvement in putting these guidelines into practice.
Interestingly, while peanut allergies declined, the study found no reduction in egg allergies—now the most common food allergy in children—and noted an increase in eczema rates over the same period. This raises questions about broader trends in pediatric diet and diagnosis that merit further investigation.
Nevertheless, the consensus among experts is that the early introduction of peanuts represents a "meaningful public health advance," as Dr. Ruchi Gupta of Northwestern University wrote in her editorial. "Clinical research, when coupled with clear guidelines and committed dissemination, can indeed shift the trajectory of childhood food allergy."
As the science continues to evolve, one thing is clear: a small spoonful of peanut butter, offered at just the right time, may spare thousands of children—and their parents—a lifetime of worry.
