Peanut introduction before the age of 6 months and the risk of peanut allergy
Näytönastekatsaukset
Aleksi Raudasoja
9.6.2025
Peanut introduction before 6 months of age decreases the risk of peanut allergy.
A systematic review of early food introduction found early introduction of peanuts
to decrease the risk of peanut allergy by RR 0.31 (95% CI 0.19-0.51) «Scarpone R, Kimkool P, Ierodiakonou D, ym. Timing ...»1. By excluding one trial with peanut avoidance until 5 years of age, RR was still
0.43 (0.24-0.76). With a risk of peanut allergy of 1-2%, translates into an absolute
reduction of 7-14 per 1000 infants. The early introduction increased the study withdrawal,
RR 1.91 (95% CI 1.19-3.05). Relative risks for study withdrawal were lower in one
placebo-controlled trial, suggesting good tolerability, but difficulties in the implementation/acceptability
of the intervention.
Table 1. Description of the included studies
| Reference |
Study type |
Population |
Intervention and comparison |
Outcomes |
Risk of bias |
| SR=systematic review; MA=meta-analysis |
|
«Scarpone R, Kimkool P, Ierodiakonou D, ym. Timing ...»1 |
SR and MA |
Infants 3-10 months old. Both low and high-risk populations. |
Early peanut introduction vs placebo or no intervention until at least 6 months. |
Peanut allergy: double-blind, placebo-controlled food challenge; open food challenge;
medical diagnosis at 18-60 months. |
Low |
Table 2. Additional comments for included studies
| Reference |
Comments |
|
«Scarpone R, Kimkool P, Ierodiakonou D, ym. Timing ...»1 |
The smallest trial was the only placebo-controlled trial, although this may not be
so important as the outcome is not subjective. Two trials had comparison arm with
peanut introduction at 6 months, one trial at 8 months and one trial at 5 years. |
Results
Table 3. Food allergy – confirmed by food challenge
| Reference |
Number of studies and number of patients (I/C) |
Follow-up time |
Absolute number of events I |
Absolute number of events C |
Relative risk (95% CI) |
| I= intervention; C=comparison; CI=confidence interval |
|
«Scarpone R, Kimkool P, Ierodiakonou D, ym. Timing ...»1 |
4 |
18-60 months |
27/1891 |
94/1905 |
0.31 (0.19-0.51) |
| Level of evidence: high |
References
- Scarpone R, Kimkool P, Ierodiakonou D, ym. Timing of Allergenic Food Introduction
and Risk of Immunoglobulin E-Mediated Food Allergy: A Systematic Review and Meta-analysis.
JAMA Pediatr 2023;177(5):489-497 «PMID: 36972063»PubMed
Article ID: nak09995 (050.026)
© 2025 The Finnish Medical Society Duodecim
