VIDEO: Intervention spurs pediatricians to counsel caregivers in early peanut introduction

Key takeaways:

• NIAID guidelines encourage pediatricians to counsel caregivers to introduce infants to peanuts.
• Clinician education, clinical decision support and caregiver handouts help pediatricians follow these guidelines.

CHICAGO — An intervention improved how many pediatricians followed guidelines for counseling caregivers in introducing their infants to peanuts to prevent allergy, according to a presentation at the Global Food Allergy Prevention Summit.

In 2017, the National Institute of Allergy and Infectious Diseases recommended that pediatricians assess infants to see if they are at high risk for peanut allergy based on the presence of severe eczema or an egg allergy during the 4-month and 6-month well visits.

Infants meeting these criteria should be tested for peanut specific IgE or referred to an allergist, according to NIAID. Infants who did not meet these criteria, however, could begin including peanut protein in their diets.

“In order to help and support pediatricians in doing that, we developed what we call the iREACH intervention,” Lucy Bilaver, PhD, associate professor of pediatrics, Northwestern University Feinberg School of Medicine, told Healio.

The Intervention to Reduce Early (Peanut) Allergy in Children, or iREACH, includes clinician education, clinical decision support embedded in the electronic health record, and a handout instructing caregivers in how to introduce peanut into their infant’s diet.

In a randomized controlled trial involving 30 pediatric practices, pediatricians who received the intervention followed the guidelines in 80% of the cases involving low-risk infants. Pediatricians who did not receive the intervention followed the guidelines in 26% of the cases involving low-risk infants.

“We are pleased and happy to have found that the iREACH intervention did work to affect our primary outcome of pediatric clinician adherence,” Bilaver said.

Next, the researchers will continue to follow the infants to see how many of them develop a peanut allergy.

“If we are able to show and demonstrate that by doing that we can decrease the incidence of peanut allergy in these children, it’s an intervention that we would definitely move to implement more broadly across the country in order to affect peanut allergy incidence nationwide,” Bilaver said.

Reference:

• Bilaver L, et al. Findings from the Intervention to Reduce Early (Peanut) Allergy in Children (iREACH). Presented at: Global Food Allergy Prevention Summit; July 7-9, 2023; Chicago.