Early peanut consumption and allergy prevention in high-risk infants
What it found
Feeding peanuts to high-risk infants from early life cut the rate of peanut allergy at age five by 70% to 86%.
This was found in a trial of 640 babies.
What they found
Studies in people
Allergy rates without prior sensitivity
Among 530 infants who showed no reaction on an initial skin test, 13.7% of those avoiding peanuts were allergic at 60 months. Only 1.9% of those eating peanuts developed the allergy.
Allergy rates with prior sensitivity
Among 98 infants who already showed a small skin reaction, 35.3% of the avoidance group were allergic at 60 months. In the group eating peanuts, 10.6% were allergic.
Immune system changes
Babies eating peanuts showed rising levels of an antibody called IgG4, which may play a protective role. More babies in the avoidance group developed high levels of the allergy-linked antibody IgE.
Side effects and safety
Rates of hospital stays and serious side effects were about the same in both groups. Mild issues like colds, stomach bugs, and hives happened slightly more often in the group eating peanuts.
What the authors conclude
- They conclude that feeding peanuts early in life greatly reduced peanut allergy in high-risk infants and changed how their immune systems responded.
- They note that deliberately avoiding peanuts did not prevent allergy and instead led to higher rates of it.
- They say further research is needed to find out whether this protection lasts after children stop eating peanuts.
How it was done
Peanut allergy rates in children have doubled over ten years, and earlier advice told parents to avoid allergenic foods. The authors noticed that children in Israel, who eat peanuts early, had far less allergy than similar children in the UK, so they wanted to test if early eating could prevent it.
The researchers assigned 640 infants aged 4 to 11 months with severe eczema, egg allergy, or both to either eat peanuts or avoid them until age five. One group ate at least 6 g of peanut protein each week, while the other group avoided peanuts entirely.
What it can’t tell you
- This trial only included infants with severe eczema or egg allergy, so it cannot show what happens in low-risk babies.
- The study followed children only to 60 months of age, so it cannot tell us if the protection continues once regular peanut eating stops.
- Infants with large reactions on the initial skin test were excluded, so the results do not apply to them.
Who paid
- Funding
- Funded by Medical Research Council; Department of Health; NIAID NIH HHS; Intramural NIH HHS (from the PubMed record).
- Conflicts
- No other potential conflict of interest relevant to this article was reported. Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.
- Authors work at
- University of California, San Francisco; and the National Institute of Allergy and Infectious Diseases, M.P.
The paper
- Title
- Randomized trial of peanut consumption in infants at risk for peanut allergy
- Type
- Randomised controlled trial
- Evidence
- Studies in people
- Summarised from
- Full text
- Cite
- Du Toit G, Roberts G, Sayre PH, et al (2015). Randomized trial of peanut consumption in infants at risk for peanut allergy. The New England journal of medicine. doi:10.1056/NEJMoa1414850Free full textPubMed 25705822DOI
Summary written 30 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error