Early dietary peanut introduction has been associated with decreased risk of peanut allergy in the general population up to age 3 years and in high-risk infants. We examined the associations between early peanut introduction and peanut sensitization and allergy at age 5 years using Canadian Healthy Infant Longitudinal Development (CHILD) Study data. METHODS: CHILD participants were recruited prenatally from the general population. Every 6 months, caregivers reported food introduction and allergic reactions. At ages 1, 3 and 5 years, sensitization to allergens including peanut and egg was measured by skin prick testing (SPT) and atopic dermatitis diagnosed clinically. Since age 5 years, children with possible peanut allergy (sensitized-positive SPT and not consuming peanut) have been undergoing double-blind placebo-controlled peanut challenges to confirm or exclude peanut allergy. We used multivariable logistic regression to examine associations between peanut introduction, sensitization and allergy at age 5 years. RESULTS: Among 2577 CHILD participants at age 5 years, 4.1% were sensitized to peanut and 3.2% had possible peanut allergy. In preliminary data, 1.8% had peanut allergy. After adjusting for potential confounders, children who were introduced to peanut after 12 months had increased odds of peanut sensitization (OR 3.65, 95% CI: 1.98-6.73) and peanut allergy (OR 5.15, 95% CI: 1.99-13.3) at 5 years. These associations persisted after exclusion of high-risk infants with moderate-to-severe atopic dermatitis and/or egg allergy before age 1 year. CONCLUSIONS: General-population and low-risk infants introduced to peanut after age 12 months were more likely to have sensitization and allergy to peanut at age 5 years.
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