Despite national guidelines recommending early peanut introduction to reduce allergy risk, a new study shows many Black, Hispanic and low-income parents are not receiving or acting on this advice, leading to disparities in peanut allergy prevention.
Introducing peanut-containing foods to infants can significantly reduce the risk of peanut allergies later in life. However, a new study from Northwestern Medicine reveals that many parents — especially those who are Black, Hispanic, lower-income or less educated — are not receiving this critical guidance from their pediatricians, resulting in much lower rates of early peanut introduction.
The study, published on July 8 in Academic Pediatrics, surveyed over 3,000 U.S. parents of children aged seven to 42 months.
It found that by age one, only 36% of Hispanic, 42% of Black and 35% of Asian American parents had introduced peanut-containing foods to their children, compared to 51% of white parents.
Early introduction to peanuts was also more prevalent among higher-income and college-educated parents.
Since 2017, national guidelines have advised parents to introduce peanut-containing foods around four to six months of age to reduce the risk of peanut allergies. This shift stemmed from a landmark clinical trial showing that early peanut introduction can cut allergy risk by more than 80%.
Before these guidelines, parents were often told to delay peanut feeding to prevent allergies.
First author Christopher Warren, an assistant professor of preventive medicine at Northwestern University Feinberg School of Medicine, emphasized the disparities in access to this guidance.
“Our findings suggest that families from racial and ethnic minority groups and those with lower incomes are less likely to receive accurate, timely guidance from their primary care provider on how to introduce peanut during infancy,” Warren said in a news release.
The study also highlighted a troubling gap in pediatric advice: Only about half of Black and Hispanic parents reported receiving recommendations on early peanut introduction from their doctors, compared to nearly two-thirds of white parents.
Moreover, only 29% of Black parents believed that introducing peanuts before 12 months could help prevent allergies, compared to 53% of white parents.
These disparities have real-world consequences, as children from low-income and minority families already experience higher rates of food allergies and more severe outcomes.
“It’s surprising how inequitable implementation of guidelines remains, especially given how safe and effective early peanut feeding appears to be,” Warren added.
This study is the first to closely examine how food allergy prevention advice varies based on race, income and other background factors, according to Warren.
In response to these findings, Warren suggested that primary care providers, particularly those serving underserved communities, need better resources and tools.
“We know that parents and primary care providers have limited time together during well-child visits, and many other topics compete for attention,” he added.
Providing linguistically and culturally tailored handouts can help parents feel more confident about introducing peanuts safely at home.
Larger policy efforts could also make a difference, such as including peanut-containing products in WIC food packages to improve access for low-income families.
Additionally, Medicaid programs, which insure about 40% of U.S. infants, could play a crucial role in scaling education and outreach.
Source: Northwestern University