Advice to pregnant women to avoid eating peanuts should be withdrawn, says Lords committee

Department of Health advice for pregnant women with a family history of atopic diseases to avoid eating peanuts and food that contains peanuts and not to give such food to their children until the age of 3 years is out of date and should be immediately withdrawn, says a report from the House of Lords.

The health department advice, which was first issued in 1998 and is repeated in government booklets given to pregnant women and new parents, is totally without evidence, the House of Lords Science and Technology Select Committee heard during its inquiry into allergy in the United Kingdom.

Avoiding food that contains peanuts in early life could in fact be helping to fuel the rise in peanut allergy seen in the UK, says the report. The prevalence of peanut allergy in England increased by 117% between 2001 and 2005, and an estimated 25 700 people are affected. But similar increases in prevalence have not been found in developing countries.

Gideon Lack, head of paediatric allergy at Evelina Children's Hospital in London, told the committee that a number of recent epidemiological studies had indicated that early peanut consumption in countries such as Israel was associated with a low incidence of peanut allergy in the population. These observations had led many academics to say that exposing a child's immune system to peanut allergen at an early age might result in tolerance.

Baroness Finlay of Llandaff, chairwoman of the committee, said, “We have serious doubts about the advice given to some pregnant women to avoid eating peanuts. A growing body of evidence suggests that in countries where peanuts form a major part of the diet of pregnant women and young children there is actually a lower incidence of peanut allergy in later life. The government should withdraw this advice with immediate effect.”

The report calls for a comprehensive review of the effect on children of exposure to peanuts. It also says that although other common allergic diseases have reached epidemic levels—with the prevalence of conditions such as asthma, rhinitis, and eczema trebling in the past 20 years—the provision of specialist clinics in the UK is woefully poor.

Although the committee did not initially set out to examine the state of allergy services in the UK, it said it had decided to do so after expert witnesses reported that health provision for patients with allergy has an effect on “the accuracy of data collection methods, influences research strategies, and is responsible for the way in which patients approach their disorders.” It concluded that services for allergy patients in the UK lag far behind those of many other Western European countries.

Every strategic health authority should have an allergy centre, headed by a full-time allergy specialist, the report recommends. Training in allergy also needs to be improved at both undergraduate and postgraduate levels to improve the diagnosis and treatment of complex allergies.