A new randomized controlled trial from Sweden suggests that some toddlers with confirmed peanut allergies may be able to safely build greater peanut tolerance through a carefully supervised oral immunotherapy program that gradually increases daily exposure over time.
Published in The Lancet Regional Health – Europe, the study followed 75 children ages 1 to 3 with diagnosed peanut allergies. Researchers found that after three years of medically supervised treatment, 82% of children in the therapy group could tolerate at least three and a half peanuts after a four-week break from treatment, compared with 12% in the peanut-avoidance control group.
The study does not mean peanut allergy is “cured,” nor does it suggest parents should attempt peanut exposure at home. Instead, it adds to growing evidence that structured oral immunotherapy may help some young children reduce sensitivity under close medical care.
Researchers assigned 50 children to oral immunotherapy using peanut puffs and 25 children to a control group that avoided peanuts entirely. Treatment began in a hospital setting with extremely small doses, followed by gradual dose increases every four to six weeks until children reached a low daily maintenance dose.
“All children who followed the protocol achieved the goal of eating three and a half peanuts without experiencing an allergic reaction, and most were able to consume up to 25 peanuts,” said senior author Caroline Nilsson of Karolinska Institutet. “We consider the treatment to be safe if it is carried out under controlled conditions in a health care setting.”
That controlled setting is essential. Side effects were common, though most were mild, including itching or skin reactions. More serious allergic reactions occurred primarily during dose increases, and some children required adrenaline treatment.
“The cautious treatment approach appears to play an important role in safety, but this is not something that parents should attempt at home, as serious reactions can still occur,” said co-lead researcher Anna Asarnoj.
This distinction matters because prevention and treatment are not the same. In recent years, parents may have heard guidance about introducing peanut-containing foods early in infancy to help reduce allergy risk in some children. This study focused on toddlers who already had diagnosed peanut allergies and tested a medical treatment strategy, not prevention.
For families living with peanut allergy, the findings may offer cautious optimism. Peanut allergy is often lifelong and can significantly affect daily life, from food choices to school safety to anxiety around accidental exposure.
Still, oral immunotherapy is not risk-free, and it may not be appropriate for every child. Longer-term follow-up is also needed to determine how durable this tolerance remains over time.
As food allergy treatment evolves, this research could help shape how clinicians think about moving beyond avoidance alone for some families.
This study was supported by private non-commercial donations through Karolinska Institutet along with Swedish nonprofit, academic and public health organizations, including the Swedish Asthma and Allergy Association’s Research Foundation, Region Stockholm and the Swedish Research Council. Some authors reported receiving pharmaceutical industry fees unrelated to this study.