A groundbreaking study suggests that children with mild peanut allergies may be able to consume peanut butter safely under medical supervision, potentially overcoming their sensitivity over time. The research, published in NEJM Evidence, found that 32 children who underwent 18 months of oral immunotherapy were able to tolerate the equivalent of three tablespoons of peanut butter without experiencing severe allergic reactions.
The trial involved a total of 73 children aged 4 to 14, all of whom had mild peanut allergies. To qualify, participants needed to be able to tolerate at least half a peanut but no more than 20 peanuts without experiencing a severe reaction. The study, funded by the National Institute of Allergy and Infectious Diseases, randomly assigned 38 children to undergo immunotherapy, while 35 others continued avoiding peanuts as a control group.
Under the supervision of an allergist, children in the treatment group started with one-eighth of a teaspoon of peanut butter. Their intake was gradually increased every eight weeks until they reached a maintenance dose of half a teaspoon. After reaching this level, they were allowed to substitute peanut butter with other peanut-containing foods, such as candies. Eventually, once they could tolerate one tablespoon per day, they were instructed to consume at least two tablespoons per week to maintain their desensitization.
The results of the trial were encouraging. None of the children in the immunotherapy group experienced severe allergic reactions requiring emergency epinephrine injections at home, and only one child needed the medication during a visit to the study site. These findings suggest that, under controlled conditions, children with mild peanut allergies may gradually build tolerance to peanut protein.
Dr. Scott Sicherer, the study’s lead author and director of the Elliot and Roslyn Jaffe Food Allergy Institute at Mount Sinai in New York, emphasized the significance of the results. “We thought if we could target children who could consume at least half a peanut with a therapy that was much easier to use, we might be able to get them to the point where they could treat peanuts like regular food,” he said. “We were surprised at how successful we were.”
However, Sicherer strongly advised parents against trying this method on their own. He stressed the importance of medical supervision, noting that allergic reactions can be unpredictable and potentially life-threatening. The study highlights that peanut protein increases should always occur in a controlled clinical setting with an allergist present.
This study represents a shift in how peanut allergies are managed. Previously, research primarily focused on children with severe peanut allergies, where even the smallest exposure could trigger dangerous anaphylactic reactions. The new findings open the possibility of early intervention for children with milder sensitivities, potentially preventing the escalation of their allergy over time.
According to the American Academy of Allergy, Asthma, and Immunology, peanut allergies affect between 1% and 2% of children and adults in the United States. Given the rising prevalence of food allergies, the results of this trial offer hope for an effective desensitization strategy that could improve the quality of life for many families.
While the study’s findings are promising, experts caution that any attempt to increase peanut consumption in allergic children must be done under medical supervision. Parents interested in exploring this therapy should consult an allergist before attempting any form of peanut exposure. As research continues, controlled oral immunotherapy could become a widely accepted approach to helping children with mild peanut allergies safely integrate peanuts into their diets.
