Maternal diet rich in eggs and peanuts and infant food allergy risk

Overview

• multi-site RCT assessed whether maternal consumption of high quantities of eggs and peanuts during pregnancy and lactation reduces IgE-mediated egg or peanut allergy in high-risk infants at 1 year of age
• included 2,137 pregnant women whose unborn child had >=2 first-degree biological relatives with medically diagnosed allergic disease
• participants randomised before 23 weeks' gestation to either a high egg–peanut diet or a standard diet, continuing until 4 months postnatally during lactation

Intervention vs. control diets

• high egg-peanut group (n=1,070):
  • maternal intake of >=6 eggs and >=60 peanuts per week
• standard-diet (control) group (n=1,067):
  • maternal intake of <=3 eggs and <=30 peanuts per week

Primary outcome and main findings

• primary outcome:
  • IgE-mediated egg or peanut allergy in the infant at 1 year of age
• results:
  • high egg–peanut group: 7.8% (83/1,066)
  • standard-diet group: 8.4% (89/1,064)
  • no statistically significant difference between groups (RR 0.93, 95% CI 0.69 to 1.26; p=0.65)
• safety:
  • safety measures and adverse event profiles were similar across both study arms

Clinical application and conclusion

• high maternal intake of egg and peanut during pregnancy and early lactation does not significantly lower the risk of egg or peanut allergy in high-risk infants by 1 year of age compared with standard maternal dietary intake
• findings do not support recommending high-dose maternal allergen ingestion during pregnancy or breastfeeding solely for primary prevention of infant food allergy

Reference:

1. Palmer D et al. Trial of a Maternal Diet Rich in Eggs and Peanuts to Reduce Infant Allergy. N Engl J Med 2026;395:1090-1099.