American Academy of Pediatrics National Conference and Exhibition
American Academy of Pediatrics National Conference and Exhibition
Source/Disclosures
Source:

Jiang J, et al. Early Introduction of peanut, egg, and milk among Black and white food-allergic children in the FORWARD study. Presented at: AAP National Conference & Exhibition; Oct. 2-5, 2020; virtual.

Disclosures: Jiang reports no relevant financial disclosures. Gupta reports receiving research support from the NIH and others and numerous ties to industry. Please see the abstract for all other authors’ relevant financial disclosures.
October 08, 2020
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What age foods are introduced may contribute to racial differences in allergies

Source/Disclosures
Source:

Jiang J, et al. Early Introduction of peanut, egg, and milk among Black and white food-allergic children in the FORWARD study. Presented at: AAP National Conference & Exhibition; Oct. 2-5, 2020; virtual.

Disclosures: Jiang reports no relevant financial disclosures. Gupta reports receiving research support from the NIH and others and numerous ties to industry. Please see the abstract for all other authors’ relevant financial disclosures.
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The earlier introduction of white children to peanuts, milk and eggs compared with Black children may contribute to racial differences in food allergy prevalence, according to findings presented at the AAP National Conference & Exhibition.

Ruchi Gupta
Jialing Jiang

For the study, Northwestern University Center for Food Allergy & Asthma Research Director Ruchi Gupta, MD, MPH, research study coordinator Jialing Jiang, BA, and colleagues enrolled Black and white children aged 0 to 12 years into a prospective, multisite, cohort study. They asked the parents of children with peanut allergies (68 Black, 114 white), egg allergies (37 Black, 99 white) and milk allergies (27 Black, 55 white) when the children were introduced to each food. The authors then separated the groups by age of introduction — age 6 months or younger, 7 to 10 months and 11 months.

According to the findings, 2.9% of Black children allergic to peanuts had been introduced to them at age 6 months or younger, 8.8% were introduced between age 7 and 10 months, and 88.2% at 11 months, compared with 21.9%, 25.4% and 52.6% of white children.

“When specifically looking at timing of peanut introduction among children with peanut allergy, both Black and white children were introduced to peanuts later than the current [National Institute of Allergy and Infectious Diseases (NIAID)] guidelines' recommendation of 4 to 6 months published in 2017,” Jiang told Healio. “This was expected, as our cohort included children 0 to 12 years old with food allergies and the guidelines for peanut introduction have changed drastically in the last 2 decades.”

Jiang said it was surprising to see that the mean age of peanut introduction among Black children was significantly higher than that among white children.

“The mean age of peanut introduction was 21.6 months among Black children compared to 12.8 months among white children,” she said.

Among Black children, 25.9% of those with milk allergies were introduced at age 6 months or younger, 18.5% between 7 and 10 months and 55.6% at 11 months. Among white children, data showed 49.1% with milk allergies were introduced at age 6 months or younger, 23.6% at 7 to 10 months and 27.3% at 11 months.

Lastly, 10% of Black children with egg allergies were introduced at age 6 months or younger, 27% between 7 to 10 month, and 62.2% at 11 months, compared with 25.3%, 32.3% and 42.4%, respectively, among white children.

The reason why white children are introduced to these foods at an earlier age “is unclear, but it is possible that the late timing among both racial groups and the differences by race may be due to the change in guidelines and a general lack of knowledge and education on the importance of early introduction,” Jiang said.

“All clinicians — pediatricians and allergists, especially — should make a strong effort to educate their families about the importance of early peanut introduction,” Gupta told Healio. “They should take note that Black families have a later introduction of peanuts and higher rates of food allergy and therefore commit to reducing this disparity.”