By Dr. Paul Ehrlich
New guidelines for introducing peanut into the infant diet made it onto the front page of the New York Times. This is the culmination of two years of coverage of the LEAP study, which we have been following all along. The article quotes Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) on the front page who calls it “game changing.” After the jump, the chief voice is Dr. Matthew Greenhawt, chairman of the American College of Allergy, Asthma and Immunology’s food allergy committee, and an author of the new guidelines. He concludes, “This won’t outright prevent every single case of peanut allergy – there will still be some cases – but the number could be significantly reduced by tens of thousands. In the best-case scenario, every allergist across the U.S. could be seeing fewer cases of peanut allergy — and that’s a good problem to have.”
I have nothing new to add to the news of the day, except that as a practitioner I have been coping with it for two years since Dr. Gideon Lack and Dr. George DuToit shook the food allergy world with their finding announced at the 2015 AAAAI meeting (analyzed here), which reversed years of conventional wisdom on withholding allergens from kids’ diets.
Such radical reversals do have consequences in the real world of clinical practice. Just this week I met with a mother and her infant son. Months ago, we determined that he fell within the early parameters for risk and we introduced peanut into his diet. So far so good.
Except that his older brother, who is allergic, has been watching the mother give the baby peanut, and he is good and mad. He wants it, too.