A THIRD OF BABIES WITH A PEANUT ALLERGY DIAGNOSIS MAY NOT BE ALLERGIC AT ALL
If your baby has been told they have a peanut allergy, new Australian research suggests it is worth asking whether that label is really the final word.
A study led by the Murdoch Children's Research Institute has found that more than a third of infants thought to be allergic to peanut did not react at all when they were carefully tested in hospital.
What the peanut allergy study found
The research looked at 1,275 babies under 18 months old who were referred to the ADAPT Peanut Oral Immunotherapy Program at 10 public children's hospitals in Victoria, New South Wales, Queensland, South Australia and Western Australia.
Of those, 778 went on to have an oral food challenge, where a baby is given gradually increasing amounts of peanut under close medical supervision.
All of the babies tested had a recent reaction to peanut and a positive allergy test, which would usually be enough for a diagnosis.
Yet about 35 per cent of them showed no reaction during the challenge, so their allergy label could be removed.
The results were published in The Journal of Allergy and Clinical Immunology: In Practice, with MCRI senior research clinician Dr Tim Brettig as lead author.
Why the diagnosis can be wrong
Professor Kirsten Perrett, who leads the ADAPT program and directs the National Allergy Centre of Excellence, told the ABC that the result was surprising.
She explained that a child's history and standard allergy tests alone were not enough to accurately diagnose peanut allergy in many cases.
Her view is that a supervised food challenge should be routinely considered to confirm the diagnosis before a baby starts long-term treatment.
Dr Brettig said spotting these children early means they can avoid an unnecessary allergy label and the daily burden of steering clear of peanut.
That matters, because peanut allergy affects around one in 30 Australian children, and Australia has some of the highest reported rates of childhood food allergy in the world.
One family's story
Melbourne parents Leah and Jake noticed facial redness and hives when their son Arthur first tried peanut at five months old.
The reaction settled within an hour, but skin prick and blood tests suggested he was at high risk, so the family avoided peanut while waiting for more tests.
At about a year old, Arthur was referred to the ADAPT program at The Royal Children's Hospital and passed his supervised challenge.
His mum described the result as a relief and said she hopes families in regional and remote areas will get the same access, as they had to travel to Melbourne.
What about the babies who did react?
Around 65 per cent of the babies tested did react, and 12 per cent of those had anaphylaxis, a potentially life-threatening reaction.
The hospital teams managed every reaction safely, which is exactly why these challenges are done in a proper medical setting.
Nearly all of the babies who reacted went on to peanut oral immunotherapy, which involves giving a small daily dose of peanut to help build tolerance over time.
The ADAPT program, launched in 2024, was the first of its kind offered to infants in Australian public hospitals outside a clinical trial.
The team now hopes to expand it to include cashew allergy, which is almost as common.
What parents can do
The most important message from the researchers is that you should never try a food challenge at home.
If you suspect your baby has a peanut allergy, or you have been given a diagnosis and have questions, start by talking to your GP.
Your GP can refer you to a paediatric allergy specialist, who can explain whether a supervised challenge might be right for your child.
University of Melbourne biostatistics professor Lyle Gurrin, who was not involved in the study, told the ABC that these challenges need proper medical facilities and cannot be done in a GP surgery or maternal health clinic.
Keep following your specialist's advice until any label is officially changed.
For parents who have been living with the worry of a peanut allergy, this research offers a hopeful reminder that a second look can sometimes change everything.
