A few small changes in how pediatricians talk with parents could make a big difference in preventing peanut allergies, new research shows.
In a large clinical trial published in Pediatrics, doctors who received a short training video, electronic record prompts and educational handouts for families were nearly 15 times more likely to follow national guidelines recommending early peanut introduction. Those simple steps, researchers say, can help reverse the rising trend of peanut allergies among U.S. children.
“Supporting pediatricians with training, electronic health record prompts and educational materials for parents significantly improved their ability to counsel families on early peanut introduction,” said Dr. Ruchi Gupta, professor of pediatrics and medicine at Northwestern University Feinberg School of Medicine and pediatrician at Ann & Robert H. Lurie Children’s Hospital of Chicago. “Because pediatric visits at 4 and 6 months are so busy, this support is critical to ensure families receive clear guidance.”
Since 2017, pediatricians have been encouraged to introduce peanut-containing foods between four and six months of age, once babies are developmentally ready for solids. That shift followed a landmark study showing that early introduction can reduce peanut allergy risk by more than 80%.
Yet, in everyday practice, many doctors haven’t consistently followed those guidelines. The new intervention aimed to change that.
The trial included 30 pediatric practices and nearly 18,500 infant visits across the Chicago and Peoria, Illinois, regions. Clinics that received the training and tools showed dramatic improvements:
Among low-risk infants, 84% received guideline-based care, compared with 35% in clinics without the tools.
Among high-risk infants, adherence was 27% versus 10%.
More high-risk infants in the intervention group were referred to an allergist or tested for allergies.
“While more work is needed, the success of this intervention supports wider dissemination to prevent peanut allergy in children,” Gupta said.
Dr. Lucy Bilaver, lead statistician for the study and associate professor of pediatrics at Northwestern, added that using electronic health record data helped capture outcomes directly from routine well-child visits.
For parents, the message is clear: introducing small amounts of peanut early, such as mixing smooth peanut butter into oatmeal or purees, can help train the immune system and reduce allergy risk. National guidelines now encourage early introduction of peanut, egg, and other common allergens once babies are ready for solid foods.
The study, funded by the National Institute of Allergy and Infectious Diseases, will continue following children until age 2½ to see if the intervention leads to fewer peanut allergies overall.