For decades, parents in the United States were told to keep peanuts far away from their babies, fearing that early exposure would only increase the risk of dangerous allergies. But in a striking reversal, new research and updated medical guidelines are now painting a very different picture—one that’s already changing lives for tens of thousands of children and their families.
According to a groundbreaking study published in Pediatrics and reported by the Associated Press, about 60,000 children have avoided developing peanut allergies since early introduction guidelines were first issued in 2015 and expanded in 2017. Dr. David Hill, an allergist and researcher at Children’s Hospital of Philadelphia, emphasized, “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.”
The numbers are compelling. Analysis of electronic health records from nearly 50 pediatric practices across the U.S. found that peanut allergies in children ages 0 to 3 declined by more than 27% after the 2015 guidance and by over 40% following the expanded recommendations in 2017. Overall food allergies among children under three dropped by 36%, with peanut allergies specifically dropping 43%, as highlighted by the American Academy of Pediatrics.
What’s behind this dramatic shift? The answer lies in a simple but powerful change: introducing peanut-containing foods to infants as early as 4 to 6 months of age. As Dr. Ali Raja, vice chair of emergency medicine at Mass General Brigham, explained to local news outlets, “Early exposure really can make a difference. When babies try peanut butter containing foods around 4 to 6 months of age, their immune systems actually learn to tolerate them.”
This advice is a far cry from the old recommendations, which urged parents to delay peanuts and other potential allergens until children were much older. That approach began to unravel after researchers noticed that peanut allergies were far less common in countries like Israel, where peanut snacks are a staple of infants’ diets. The 2015 LEAP (Learning Early About Peanut Allergy) trial, led by Gideon Lack at King’s College London, delivered the final blow to the old wisdom. The trial showed that introducing peanut products in infancy reduced the future risk of developing food allergies by more than 80%. Even more encouraging, follow-up studies found that about 70% of children maintained this protection into adolescence.
These findings prompted the National Institute of Allergy and Infectious Diseases to issue new guidelines in 2017, recommending early peanut introduction for most infants. Since then, the benefits have become increasingly clear. “That’s a remarkable thing, right?” Dr. Hill remarked about the tens of thousands of children spared from peanut allergies.
But how should parents go about introducing peanuts safely? Experts from the American Academy of Pediatrics and Mass General Brigham agree: keep it simple and safe. Thin a pea-sized dab of smooth peanut butter with warm water, breast milk, or formula, and mix it into oatmeal or yogurt. Alternatively, peanut powder can be stirred into purees, or softened peanut puffs (like Bamba) can be offered to younger infants. Whole peanuts or thick globs of peanut butter, however, should always be avoided—they’re a choking hazard.
Dr. Raja reassured parents, “For most babies, doing this at home is perfectly fine. But the key is using infant-safe forms. Start with a small amount. Watch your infant for about two hours, because allergic reactions usually happen within minutes.” For high-risk infants—those with severe eczema or known food allergies—consulting a pediatrician or allergist before the first introduction is crucial. Sometimes, these initial exposures are done in a doctor’s office for added safety.
Parents are encouraged to watch for signs of allergic reactions, including hives, vomiting, coughing, wheezing, or swelling. Immediate medical attention is necessary if these symptoms appear. The American Academy of Pediatrics also advises that introducing other common allergens—such as eggs, milk, tree nuts, soy, and sesame—after a baby has started solids and is tolerating them well can further help build immune tolerance. Eggs, in fact, have now overtaken peanuts as the most common allergen in young children, a shift noted in the recent Pediatrics study.
Despite the growing evidence and updated recommendations, adoption among healthcare providers and families has been slow. Only about 29% of pediatricians and 65% of allergists reported fully following the expanded 2017 guidance, according to surveys cited by the Associated Press. A 2023 survey published in Pediatrics found that just 17.2% of caregivers introduced peanut-containing foods before 7 months of age. Many pediatric visits still do not routinely cover early allergen introduction, highlighting a persistent gap in awareness and guidance.
“This research reinforces what we already know and underscores a meaningful opportunity to reduce the incidence and prevalence of peanut allergy nationwide,” said Sung Poblete, chief executive of Food Allergy Research & Education (FARE), in comments to the Associated Press. Tiffany Leon, a Maryland registered dietician and director at FARE, shared her own experience: “As a dietician, I practice evidence-based recommendations. So when someone told me, ‘This is how it’s done now, these are the new guidelines,’ I just thought, OK, well, this is what we’re going to do.”
It’s important to note that while the studies are observational and cannot absolutely prove that the guideline changes caused the drop in allergies, the correlation is strong and consistent with international observations. In Israel, for instance, where early peanut exposure is routine, peanut allergies have long been less common. Epidemiologists believe that these real-world results suggest a path forward that could “reduce—and perhaps even eventually eradicate—the burden of peanut and other food allergies in children,” as one expert told the Financial Times.
For families navigating the sometimes stressful world of introducing solids, these new insights offer hope and a practical way to protect children from lifelong allergies. The message is clear: with careful, informed steps—starting small, staying vigilant, and consulting pediatricians when needed—parents can help their babies build tolerance and potentially avoid the dangers of food allergies down the line.
As more parents and healthcare providers embrace these recommendations, the impact could be profound, not just for individuals but for public health as a whole. The journey from anxiety to action, it seems, is already underway—and for thousands of children, it’s made all the difference.
