Fear may be stalling the use of allergy prevention guidelines

In 2017, new allergy prevention guidelines were issued in the US advising that peanut-containing foods should be introduced in the diet of infants at four to six months of age. A nationwide survey of US paediatricians has indicated that while over 90 per cent were aware of the national guidelines, only 30 per cent were fully implementing the recommended practices.

The survey, conducted one-and-a-half years after the guidelines were published, collected responses from almost 1,800 paediatricians about their use of the guidelines. It also sought to identify common reasons for why the recommended practices were not implemented. Sixty-four per cent reported partial implementation of the recommended practices and around 70 per cent said they needed additional guideline training.

Common barriers that were identified through the survey included parents being unwilling to impose the testing on their infants for fear of allergic reactions. Time constraints, not conducting in-office supervised feeding of peanut-containing food, not performing peanut allergy testing, and concerns about newness of the guidelines were also identified as reasons why the recommended practices were not fully implemented.

Those who responded to the survey indicated there is a need for information to be provided to families explaining the guidelines on early peanut introduction to infants, as well as having prompts in the electronic health record to remind paediatricians to implement the allergy prevention practices.

Although the survey response rate was only just over five per cent, the findings will help to focus future efforts on removing barriers to paediatrician’s adhering to the guidelines, with the ultimate goal to reduce the incidence of peanut allergy in infants.

For more information, see the Lurie Children’s Hospital of Chicago media release.

Reference: Gupta et al. JAMA Network Open, 2020; 3 (7): e2010511 DOI: 10.1001/jamanetworkopen.2020.10511 (Open Access journal)