- Peanut introduction is not well known among those with less access to health-care information
- Having a pediatrician recommend early peanut introduction was best way for parents/caregivers to be informed
- Fear of an allergic reaction is the main reason parents decline, but only 1% infants had a reaction, which was mild
Newswise — CHICAGO ---
A new study from Northwestern University and the Ann & Robert H. Lurie Children's Hospital of Chicago reports that the National Institutes of Health (NIH) made a significant shift in 2017 regarding peanut-allergy prevention. The NIH now recommends exposing infants as young as four months old to peanuts to prevent peanut allergies.
Over the past five years, the practice of early peanut introduction has been gaining popularity among parents and caregivers in the United States. However, the study highlights the need for better dissemination of these guidelines, especially to individuals with limited access to health-related information. Among the surveyed parents and caregivers in the U.S., only 13% were aware of the guidelines, and 48% believed that introducing peanuts early could prevent peanut allergies, regardless of their knowledge of the guidelines.
Dr. Waheeda Samady, associate professor of pediatrics at Northwestern University Feinberg School of Medicine and director of clinical research at Northwestern’s Center for Food Allergy and Asthma Research, noted that many families had a general awareness that early introduction of certain foods could be beneficial, even if they were unaware that these recommendations came from the NIH guidelines. However, there remains ample room for improvement in educating families and healthcare providers about these guidelines.
According to the study, the most significant factor influencing a parent's awareness of the early peanut introduction guidelines was having a pediatrician who recommended it. The research, led by senior author Dr. Ruchi Gupta, director for the Center for Food Allergy and Asthma Research and a pediatrician at Lurie Children’s Hospital, sheds light on a relatively new aspect of U.S. health systems.
Dr. Gupta acknowledged the challenges faced by pediatricians in managing numerous responsibilities during four- or six-month appointments and emphasized the need to find ways to support them in incorporating these preventive guidelines into their workflows.
The study, which will be published in Pediatrics on July 21, represents the first nationwide survey to investigate the impact and implementation of the early peanut introduction guidelines since their release five years ago.
The findings provide valuable insights into the attitudes of American parents regarding peanut feeding and highlight existing gaps, such as:
- Access to care barriers and systemic racism, which have resulted in less awareness of this information among non-white, less-educated, and lower-income parents.
- The importance of supporting primary care providers in delivering this information in a timely manner.
- The need for effective public health messaging about peanut reactions, as fear of adverse reactions emerged as a primary concern among the survey participants.
A closer look at the findings:
According to the study's findings, the 13% of parents and caregivers who were aware of the 2017 guidelines were more likely to belong to specific demographic groups. They tended to be white, aged between 30 and 44, well-educated, and from higher-income households. Additionally, many of them either had a child with a food allergy or eczema under their care.
The survey asked participants about their children's exposure to peanuts, dividing the responses into two categories: 1) exposure before seven months (around four to six months old) and 2) exposure after seven months (between seven months and a year old). The study found that 17% of all parents introduced peanut-containing foods before their child reached seven months, while 42% did so between the ages of seven and 12 months.
Interestingly, among parents and caregivers who were aware of the guidelines, a higher proportion (31%) introduced peanuts before their child turned seven months old, indicating that guideline awareness may have influenced the timing of peanut introduction.
Fear of reaction was No. 1 reason for delayed introduction
The study revealed that 33% of parents who delayed introducing peanuts to their children did so out of fear of a potential peanut reaction, which was the most common reason for the delay. However, the actual percentage of reported reactions during peanut introduction was only 1.4%.
Dr. Waheeda Samady, commenting on the findings, pointed out that previous research has consistently shown that reactions in infants are generally milder compared to older children. Therefore, the concern about peanut reactions should be directed more towards older children rather than younger ones. Statistically, reactions tend to be much milder in the early stages of life.
Among the reported reactions that did occur, they were predominantly dermatological, such as a rash, or gastroenterological, like vomiting. It is worth noting that the perception of U.S. parents and caregivers regarding the frequency of reactions in children appears to be much higher than the actual reality observed in the study.
Broad dissemination of information, resources to integrate are key
According to Samady, reaching all U.S. parents and caregivers with the guidelines requires a multi-pronged approach.
"We cannot solely focus on pediatricians in academic or affluent areas," Samady emphasized. To ensure broad dissemination, the efforts should extend beyond traditional channels. Thinking outside the box is essential.
Samady suggested sharing the information at various community-centric locations, including community centers, daycares, and supplemental nutrition programs like WIC clinics (Women, Infants, and Children). By doing so, a wider range of parents and caregivers can be reached, including those from diverse backgrounds and with varying access to healthcare resources.
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