Infants cleared of peanut allergy following oral food challenges
“We didn’t have exact expected numbers, but definitely nowhere near a third in itself,” said Dr. Tim Brettig, a senior research clinician at the Murdoch Children’s Research Institute (MCRI). A national study led by the MCRI and the National Allergy Centre of Excellence (NACE) found that 35% of infants previously diagnosed with a peanut allergy showed no reaction during a medically supervised oral food challenge, newsGP reported.
The findings, published in The Journal of Allergy and Clinical Immunology: In Practice, suggest that a significant number of children may be living with unnecessary dietary restrictions. Researchers assessed 1,275 infants under 18 months old across 10 Australian paediatric hospitals between April 2024 and October 2025.
Supervised testing reveals diagnostic uncertainty
While all participants had been diagnosed with a peanut allergy based on clinical history and positive skin or blood tests prior to 12 months of age, the oral food challenge provided a different result for more than one in three babies. The study involved feeding infants increasing amounts of peanut flour under clinical observation. If no reaction occurred within 90 minutes, the infants were monitored for an additional two hours to check for delayed responses.
Dr. Brettig noted that the team was surprised by the results, as clinical practice has traditionally operated on the assumption that a positive test combined with a history of reaction confirms a persistent allergy. “As allergists, it’s sort of changing the way that we think about these assessments in young infants,” he told newsGP.
Clinical risks and the role of specialists
Although the results offer a positive outcome for many families, researchers emphasized that the testing must remain restricted to clinical settings. 12% of the infants who did react during the study experienced anaphylaxis. Professor Kirsten Perrett, who leads the ADAPT program, cautioned parents against attempting food challenges at home.
Australian Medical Association President Dr. Michael Bonning told the Today Show that the high rate of initial diagnoses reflects a cautious approach by both parents and the medical profession. He noted that when a child has an initial reaction, families often head to emergency departments, leading to a “label” that may not always reflect a permanent condition. Dr. Bonning advised that GPs and specialists should work together to determine whether a child has truly developed an allergy or has become tolerant over time.
Future directions for allergy management
The research team is still investigating why 35% of the infants showed such a change in response. Dr. Brettig suggested there may be a specific window in infancy where an allergy is more transient, or where medical intervention can occur before the condition becomes firmly established.
The NACE is currently looking into expanding this model of supervised assessment to other common allergens, including cashews, which are nearly as prevalent as peanuts in Australia.
Common questions regarding infant peanut allergies
Why are oral food challenges not performed for every child?
Oral food challenges require specialized medical supervision, as a significant portion of infants may still react to the allergen. The procedure cannot be safely performed in a standard GP clinic or maternal health center because the facility must be prepared to manage severe reactions, including anaphylaxis.
Does this study mean my child’s allergy test was wrong?
Not necessarily. The study found that while clinical history and initial blood or skin tests are standard, they are not always sufficient to confirm a lifelong allergy in young infants. Researchers suggest that for some children, a supervised challenge is the only way to confirm if the allergy is still present or if the child has developed tolerance.
What happens if an infant reacts during the challenge?
In the study, 65% of the infants reacted to the peanut protein. Almost all of these children proceeded to peanut oral immunotherapy, a process where small, daily doses of the allergen are administered to help build tolerance.
“It’s a huge relief knowing Arthur can tolerate peanut and we can move forward without the uncertainty of managing a suspected allergy,” said one parent, identified as Leah, whose son participated in the study.
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