title: Does LEAP change the screening paradigm for food allergy in infants with eczema?
abstract: The LEAP randomized controlled trial provides the first direct evidence that delayed introduction of peanut in an infant's diet significantly increases the risk of peanut allergy. However, as often is the case in ground-breaking research, the LEAP study raises almost as many questions as it resolves. Although the quality of design and excellence in study execution is unquestioned, the particular difficulty this study raises is how to generalize results from a trial of high-risk infants, which screened infants for the presence of peanut allergy prior to peanut introduction, to the general population. Although many existing infant feeding guidelines already allow for the introduction of allergenic foods from 4 to 6 months of age irrespective of co-existent risk factors for peanut allergy, these will now need to be revised to more strongly state that avoidance may be harmful. Interim guidelines have already been published which incorporate these recommendations. However, the question as to how to achieve timely introduction of peanut into an infant's diet in a safe and cost-effective way, particularly in high-risk infants, remains unresolved.
authors.affiliation: Centre for Food and Allergy Research, Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Vic., Australia.|Department of Allergy and Immunology, The University of Melbourne, Royal Children's Hospital, Parkville, Vic., Australia.|Department of Paediatrics, The University of Melbourne, Royal Children's Hospital, Parkville, Vic., Australia.|Institute of Inflammation and Repair, The University of Manchester, Manchester, UK.
authors.forename: K J
authors.initials: KJ
authors.lastname: Allen
authors.affiliation: Centre for Food and Allergy Research, Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Vic., Australia.
authors.forename: J J
authors.initials: JJ
authors.lastname: Koplin
mesh_terms: D000485:Allergens / Q000276:immunology; D010367:Arachis / Q000009:adverse effects; D004485:Eczema / Q000150:complications*; D005260:Female; D005512:Food Hypersensitivity / Q000150:complications* / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007225:Infant Food / Q000009:adverse effects / Q000592:standards; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening; D018673:Nutrition Policy; D021183:Peanut Hypersensitivity / Q000175:diagnosis / Q000276:immunology; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors
chemical_list: D000485:Allergens
keywords: clinical trials; eczema; food allergy; peanut allergy; prevention; screening