{Big Ideas} On Peanuts, Babies, and Big Fancy Allergy Studies


The fine print on that story about peanut allergy

We interrupt your Tuesday morning to address media reports regarding a new study from the New England Journal of Medicine and its findings that:

“The early introduction of peanuts significantly decreased the frequency of the development of peanut allergy among children at high risk for this allergy and modulated immune responses to peanuts.”

What’s missing in many of these stories is the fact that exposure therapy has been around for awhile. Here they’re talking about prevention (big difference), but most parents of peanut-allergic kids are aware of ongoing trials that involve exposure to small amounts of peanuts over time.

We’re sort of “d’uh.” [ETA: This is a big development–the idea of peanuts as prevention–but it’s not entirely surprising. Docs have been going back and forth on the issue of early introduction of peanuts to kids for years. And for low risk kids, it makes perfect sense. For high risk kids? Not so much as I explain later.]

And I’m also chuckling at the big ol’ web ads featuring “Mr. Peanut” up on the CNN website with this story.

Way to insert yourself into a hot topic, Mr. Peanut!

I mean…

Peanut ads on CNN website on story re peanut allergy


Peanut promoting aside*, there’s something missing in the broad strokes journalists are painting with this story. It’s summed up in this paragraph buried over on the CNN page:

“Parents of infants and young children with eczema or egg allergy should consult with an allergist, pediatrician, or their general practitioner prior to feeding them peanut products.” {Read full story}

Translation: don’t assume that giving a kid a peanut will do the trick at preventing a problem–especially after they had a reaction or if there’s a family history of allergies.

The new plan of action may work for many (YAY!) but not all (BOO!) and you could accidentally create a problem if you go all Dr. House and DIY with the exposure.

Also, small kids can choke on peanuts. Just sayin’.

Families with a history of food allergies, gastrointestinal issues (including celiac disease), skin problems like eczema (and my personal pain-in-the-butt, dermatitis herpetiformis), and autoimmune diseases should always talk with a qualified medical professional before giving a kid a peanut product.

That’s not Sanjay Gupta, either. I mean your personal doctor. The one that will help you expose your kid to peanuts in a medical setting and then respond quickly if there’s a reaction in your child that needs to be addressed on the spot. [If you’ve got these family history “flags,” then your kiddo is at higher risk and extra caution is needed.}

From some stuff I’ve seen online this morning, I can tell that Internet “experts” are piling on one another in comment sections declaring this one study as proof of the hygiene hypothesis.

Well, guess what? My kitchen is routinely a mess. You can eat off my floor not because it’s clean but because there’s food on it most of the time. Plus, I consumed peanuts while pregnant and nursing. I ate peanut M&Ms while in labor and delivery, for pete’s sake. Peanut dust was all over my dining room table and kitchen until the kid had a negative reaction during his second year of life.

This study, while hopeful, isn’t the end of the story.

Let’s keep our heads on straight, people.


UPDATE: Since publishing this post quickly this morning then and watching the traffic rise, I’ve been conducted extra online research. I’m not the only person urging caution in the wake of mainstream media interest as this tweet from Dr. Dave Stukus, a pediatric allergist who wrote an editorial that accompanied the study, demonstrates.

Screen Shot 2015-02-24 at 12.20.03 PMHe’s also cited here, in an excerpt from the editorial that accompanied the study, as having written:

“…formal evaluation and consultation by a board-certified allergist will be paramount in making sure this is the proper and safe choice to make before giving peanut to high-risk infants….Roughly 2% of children with negative skin tests and 11% of children with mild skin tests developed peanut allergy. More research is needed to better determine why some children still developed peanut allergy and also whether this can be applied to other foods as well.”

This doctor sounds like a wise man. Now if journalists will clue into the nuances.

UPDATE 9 March 2015:

Robyn O’Brien has revealed that the study was funded by The National Peanut Board–a fact overlooked by the New England Journal of Medicine. The appearance of Planter’s Mr. Peanut isn’t funny any more as much as aggravating. No disclosure about the study’s funding origins and two ads (one still and a video) on the CNN website. Tsk, tsk.

The fine print on the study’s funding  is found here, on the National Institute of Health’s website in an article dated March 9, 2015.

For convenience, here’s a screen shot.National Peanut Board funds LEAP studyThe page also reports that “The study was funded primarily by NIH’s National Institute of Allergy and Infectious Diseases (NIAID).” Granted, one would hope that the peanut industry would be engaged with research but in both science and journalism, disclosure of a funding relationship between an industry and a study like this matters.

Update March 9 (part 2)

Curiously, the blog post about the study on the National Peanut Board’s own website, PeanutAllergyFacts.org, doesn’t mention the organization’s funding of the study. Nor does it clearly describe the exceptions to the testing recommended in the editorial.

To be fair, the American Peanut Council doesn’t do a responsible job with their post, either, saying of the study: “The evidence is now strong that early exposure is an effective way to encourage tolerance to peanut protein.”

* Because this is one of my most popular posts, a peanut ad sometimes shows up in the box below. Let me know if you see it and I’ll approach Federated Media and have it pulled.


  1. Thank you for your post. I was having a hard time finding the right words for how I feel about this study, and you have covered it well.

    • You’re welcome. I feel sheepish because I cranked it out, published it and then tinkered with it all day. But it hit in that hot spot between logic and emotion for me and I can’t put it down.

      Like a lot of parents, I’m just worried about how the understandable excitement about this development may make some of the cultural burden of food allergies (like skepticism) more difficult to manage.

      As much as I’m delighted that in the long run more kids may get to avoid peanut allergies, there are a lot of kids who have it and a lot of kids who will be the “exception” to the rule of this procedure working.

  2. Your personal experience is amazing to share. I don’t think any studies can capture these vivid details which you so eloquently wrote about. The problem with studies is they are designed to simplify things and everyone is so different and it is such a complex issue. So boiling it down to a one minute story will miss so much. Thanks for sharing.

Comments are closed.