Peanut allergies have long been a source of anxiety for parents and pediatricians alike, with the threat of severe reactions—sometimes even fatal anaphylaxis—casting a shadow over childhood meals and snacks. But a sweeping shift in medical guidelines over the past decade appears to be paying off in a big way. According to a major new study published on October 20, 2025, in Pediatrics, the early introduction of peanuts and other allergenic foods into infants’ diets is leading to a sharp decline in allergy rates among young children across the United States.
The new research, conducted by a team at the Children’s Hospital of Philadelphia in collaboration with the American Academy of Pediatrics (AAP) Comparative Effectiveness Research through Collaborative Electronic Reporting (CER²) network, analyzed electronic health records from 48 pediatric practices nationwide. The practices included both academic health system-affiliated offices in the mid-Atlantic and independently owned clinics scattered across the country. The study’s scope was impressive, tracking tens of thousands of children from birth to age three, all of whom had at least one primary care visit before their first birthday.
To understand the impact of changing guidelines, the researchers broke their analysis into three periods: before the guidelines (September 2012 to October 2014), after the initial guidelines (September 2015 to August 2017), and after the expanded recommendations (February 2017 to January 2019). The timing is crucial—before 2015, the prevailing wisdom was to delay the introduction of peanuts and other common allergens. But mounting evidence began to suggest that early exposure might actually help prevent the development of allergies, rather than cause them.
After pediatricians began encouraging parents to introduce peanuts—and later, other allergenic foods—into infants’ diets, the study found that the rates of peanut and overall food allergies in young children dropped dramatically. In the two-year period after the guidelines were adopted, peanut allergy rates fell from 0.92% to 0.67%, representing a 27% decrease. The numbers were even more striking in a one-year window after the expanded recommendations: peanut allergy rates plummeted from 0.79% to 0.45%, a 43% drop.
And it wasn’t just peanuts. Diagnoses of any immunoglobulin E-mediated food allergy (IgE-FA)—the kind of allergy that can trigger dangerous reactions—also fell. Overall food allergy diagnoses dropped from 1.98% to 1.23% in the two-year analysis (a 38% reduction), and from 1.46% to 0.93% in the one-year analysis (a 36% drop). The findings, published in Pediatrics, were echoed by NBC Palm Springs, which reported on October 23, 2025, that peanut allergies have dropped significantly following the shift in guidelines, aligning with expert recommendations encouraging early introduction of peanuts to infants.
The study’s methodology was rigorous. To confirm cases of food allergy, the team used a combination of medical codes, documented allergies in electronic records, and prescriptions for epinephrine auto-injectors—the go-to treatment for anaphylaxis. Statistical models helped account for differences in age, sex, race, and ethnicity, ensuring that the results reflected genuine trends and not demographic quirks. The researchers even conducted an “interrupted time series” analysis, a technique that can pinpoint shifts in trends before and after major policy changes.
One of the most encouraging findings was that the decline in peanut allergy rates was seen in children both with and without eczema. Since eczema is often an early warning sign of allergy risk, this suggests that the benefits of early peanut introduction may extend beyond just high-risk infants. In fact, the study found that children who already had egg allergies were less likely to develop peanut allergies after the guidelines took effect. However, for children with eczema, the change was not as pronounced.
The types of food allergies shifted as well. Before the guidelines, peanut was the most common allergen, followed by egg and cow’s milk. After the guidelines were implemented, egg allergy became the most common, peanut dropped to second place, and cow’s milk allergy rates fell significantly. Demographic patterns also shifted: after the guidelines, fewer Black, Asian or Pacific Islander, and Hispanic children were diagnosed with food allergies compared to earlier years.
What do these numbers mean for parents worried about introducing peanuts to their infants? Experts are clear: early introduction is now the recommended approach for nearly all babies. Amiirah Aujnarain, MD, a board-certified pediatrician, allergist, and immunologist, told Healthline, “For infants at high risk of peanut allergy (such as those with severe eczema or an existing egg allergy), the recommendation is to consider introducing peanut as early as 4 to 6 months, after ensuring readiness and in a safe form, and ideally in consultation with a healthcare provider.” For babies at low to moderate risk, parents can introduce peanut-containing foods around 6 months of age without allergy screening beforehand.
Dr. Aujnarain emphasized the importance of using non-choking forms of peanut products: “Once peanut‐containing foods are introduced, it’s recommended to continue regular ingestion (for example, a few times per week) to maintain tolerance of at least two teaspoons in each serving.” She added that smooth peanut butter thinned out with water or breast milk is a safe option, while whole peanuts or thick peanut butter should be avoided for infants.
Michael Pistiner, MD, MMSc, a pediatric allergist with the Allergy & Asthma Network, described the decline in peanut allergies as “both reassuring and encouraging.” He noted that parents can also introduce other common allergens, such as egg and cow’s milk, to babies around the same 4-to-6-month window. “For the majority of infants, this can be done safely at home without prior testing,” Pistiner explained. “Families should then keep these foods in the infant’s diet routinely.”
Dr. Pistiner further explained that fewer than 5% of babies are considered to be at high risk for food allergies, but it’s especially important to target the 4- to 6-month window for early introduction in these children. He advised, “Early discussion with the child’s primary care clinician can help ensure peanut and other allergenic foods are introduced safely and without delay.” Pistiner summed up the new consensus: “Overall, early introduction, rather than delay, is now the recommended approach for all infants, as it supports immune tolerance and long-term nutrition.”
The evidence is now stacking up: early introduction of peanuts and other allergenic foods is not only safe for most infants, but it’s also making a real difference in reducing the risk of life-threatening allergies. As these practices become more common in pediatric care, the hope is that the next generation of children will grow up with fewer dietary restrictions and less fear at the lunch table.
