Early Allergen Introduction: Policy Strategies to Prevent Food Allergy in the United States.

Abstract

Food allergies affect millions of children and adults in the United States and globally. Early introduction of allergenic foods, especially peanut and egg, reduces allergy risk, as shown by the Learning Early About Peanut, LEAP-On, Enquiring About Tolerance, and Beating Egg Allergy Trial studies. Despite strong evidence, adherence to early introduction guidelines is low due to changing guidelines, limited clinic time, caregiver concerns, and structural barriers. At the Center for Food Allergy and Asthma Research annual Food Allergy Summit in July 2025, clinicians, researchers, and advocates discussed strategies to improve implementation. Six policy levers were highlighted: Bright Futures, the U.S. Preventive Services Task Force, insurance coverage, the Special Supplemental Nutrition Program for Women, Infants, and Children, medical society guideline alignment, and public education campaigns. Across these levers, a 3-pronged approach is recommended to increase early introduction of allergens that focuses on (1) standardizing published guidelines, (2) increasing access through insurance, and (3) educating clinicians and caregivers. This strategy could improve guideline adherence and reduce the burden of food allergies.