Oral immunotherapy for peanut allergies may be safer and more effective in children under 12 months old than in toddlers and preschoolers. The corresponding study was published in The Journal of Allergy and Clinical Immunology.
Peanut allergy is one of the most common causes of severe allergy attacks. Around 1.1% of the US population have the allergy, equating to 3 million Americans. Previous studies have suggested that oral immunotherapy- consuming gradually increasing amounts of the allergenic food over time- can help preschoolers overcome peanut allergy.
In the present study, researchers sought to measure the treatment's efficacy in infants- those under 12 months old. To do so, they analyzed the outcomes for 69 infants from a larger cohort of 452 children aged five and under who partook in oral immunotherapy treatment for peanut allergy.
Treatment involved visiting a pediatric allergist every two weeks for a small peanut dose, with parents providing the same amount daily between visits. After 8- 11 clinical visits, children built up a 'maintenance dose' of 300 mg of peanut protein, or around 1.3 grams of peanuts. Clinicians recorded any symptoms or reactions over the period.
By the end of the study, 42 infants had completed the buildup period alongside a year of maintenance dosing. At this point, none had more than a mild reaction to a 4,000-gram dose of peanut protein, compared to 7.7% of children aged 1-5 years old who completed the protocol.
The researchers noted that the treatment worked well for both age groups nevertheless. After a year of eating around a peanut a day, around 80% of children could tolerate 4,000 grams of peanut protein in one sitting- equivalent to about 15 whole peanuts.
The researchers noted that as a first step for preventing peanut allergies in at-risk children, parents may introduce them to age-appropriate peanut-containing foods from around six months of age, such as peanut flour and peanut butter. Should this fail to work, they then say that oral immunotherapy may be an effective alternative.