Pitt TJ, et al. - The relationship between maternal peanut consumption while breast-feeding, the timing of direct peanut introduction, and peanut sensitization at age 7 years was examined. As compared with all other combinations of maternal and infant peanut consumption, maternal peanut consumption while breast-feeding paired with direct introduction of peanuts in the first year of life was associated with the lowest risk of peanut sensitization.

Methods

• Experts conducted secondary analysis of a nested cohort within the 1995 Canadian Asthma Primary Prevention Study intervention study.
• By repeated questionnaires during infancy, breast-feeding and maternal and infant peanut consumption were captured.
• They did skin prick testing for peanut sensitization at age 7 years.

Results

• In this study, 58.2% of mothers consumed peanuts while breast-feeding and 22.5% directly introduced peanuts to their infant by 12 months.
• 9.4% of children were sensitized to peanuts, at 7 years.
• They noticed the lowest incidence (1.7%) among children whose mothers consumed peanuts while breast-feeding and directly introduced peanuts before 12 months.
• If mothers consumed peanuts while breast-feeding but delayed introducing peanuts to their infant beyond 12 months (15.1%), or if mothers avoided peanuts themselves but directly introduced peanuts by 12 months (17.6%), incidence was significantly higher (P < .05).
• With the help of interaction analyses controlling for study group and maternal atopy, they confirmed that maternal peanut consumption while breast-feeding and infant peanut consumption by 12 months were protective in combination.
• However, either exposure in isolation was associated with an increased risk of sensitization (P interaction = .003).