Victoria X Soriano1, Rachel L Peters1, Anne-Louise Ponsonby2, Shyamali C Dharmage3, Kirsten P Perrett4, Michael J Field5, Andrew Knox5, Dean Tey6, Sasha Odoi5, Grace Gell5, Beatriz Camesella Perez5, Katrina J Allen7, Lyle C Gurrin8, Jennifer J Koplin9. 1. Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia. 2. School of Population and Global Health, University of Melbourne, Parkville, Australia; Neuroepidemiology Research Group, Florey Institute for Neuroscience and Mental Health, Parkville, Australia. 3. School of Population and Global Health, University of Melbourne, Parkville, Australia. 4. Murdoch Children's Research Institute, Parkville, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia; School of Population and Global Health, University of Melbourne, Parkville, Australia. 5. Murdoch Children's Research Institute, Parkville, Australia. 6. Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia; Melbourne Allergy Centre and Children's Specialists (MACCS) Medical Group, Royal Children's Hospital, Parkville, Australia. 7. Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia; Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Australia. 8. Murdoch Children's Research Institute, Parkville, Australia; School of Population and Global Health, University of Melbourne, Parkville, Australia. 9. Murdoch Children's Research Institute, Parkville, Australia; School of Population and Global Health, University of Melbourne, Parkville, Australia. Electronic address: jennifer.koplin@mcri.edu.au.
Abstract
BACKGROUND: Randomized controlled trials demonstrate that timely introduction of peanut to infants reduces the risk of peanut allergy. However, much debate remains regarding how to best achieve earlier peanut introduction at the population level. Our previous study in 2007-2011 (HealthNuts, n = 5300) indicated that few infants were consuming peanut in the first year. Australian infant feeding guidelines were updated in 2016 to recommend introducing peanut before 12 months for all infants. There were no data available on the subsequent effect on peanut introduction or peanut reactions. OBJECTIVE: We sought to assess the consequences of a nonscreening approach to allergenic food introduction in a population-based sample of infants in their first year of life. METHODS: EarlyNuts is a population-based, cross-sectional study of 12-month-old infants in Melbourne, Australia, recruited by using an identical sampling frame and methods to HealthNuts (72% response rate vs 73% response rate in HealthNuts). We report here on the first 860 participants recruited between November 2016 and October 2018. RESULTS: Most infants (88.6%; 95% CI, 86.1% to 90.7%) had introduced peanut by 12 months (median age, 6 months), an increase from 28.4% (95% CI, 27.2% to 29.7%) in the HealthNuts study. By 12 months, the majority of these (76.4%) had consumed peanut more than 4 times, and 28% were eating peanut more than once per week. Preliminary results on parent-reported reactions show that 4.0% of those consuming peanut by 12 months had possible IgE-mediated reactions. CONCLUSIONS: There has been a striking shift toward earlier peanut introduction, with a 3-fold increase in peanut introduction by age 1 year in 2018 compared with 2007-2011.
BACKGROUND: Randomized controlled trials demonstrate that timely introduction of peanut to infants reduces the risk of peanutallergy. However, much debate remains regarding how to best achieve earlier peanut introduction at the population level. Our previous study in 2007-2011 (HealthNuts, n = 5300) indicated that few infants were consuming peanut in the first year. Australian infant feeding guidelines were updated in 2016 to recommend introducing peanut before 12 months for all infants. There were no data available on the subsequent effect on peanut introduction or peanut reactions. OBJECTIVE: We sought to assess the consequences of a nonscreening approach to allergenic food introduction in a population-based sample of infants in their first year of life. METHODS: EarlyNuts is a population-based, cross-sectional study of 12-month-old infants in Melbourne, Australia, recruited by using an identical sampling frame and methods to HealthNuts (72% response rate vs 73% response rate in HealthNuts). We report here on the first 860 participants recruited between November 2016 and October 2018. RESULTS: Most infants (88.6%; 95% CI, 86.1% to 90.7%) had introduced peanut by 12 months (median age, 6 months), an increase from 28.4% (95% CI, 27.2% to 29.7%) in the HealthNuts study. By 12 months, the majority of these (76.4%) had consumed peanut more than 4 times, and 28% were eating peanut more than once per week. Preliminary results on parent-reported reactions show that 4.0% of those consuming peanut by 12 months had possible IgE-mediated reactions. CONCLUSIONS: There has been a striking shift toward earlier peanut introduction, with a 3-fold increase in peanut introduction by age 1 year in 2018 compared with 2007-2011.
Authors: Victoria X Soriano; Rachel L Peters; Margarita Moreno-Betancur; Anne-Louise Ponsonby; Grace Gell; Alexsandria Odoi; Kirsten P Perrett; Mimi L K Tang; Lyle C Gurrin; Katrina J Allen; Shyamali C Dharmage; Jennifer J Koplin Journal: JAMA Date: 2022-07-05 Impact factor: 157.335
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