Testing of government advice on peanut consumption during early life

Exploring consumer, health professional and other stakeholders' understanding when planning conception, during pregnancy, breastfeeding and until the infant is three years of age, and to capture any feedback regarding whether and how the revised advice could be improved before it is issued to the public.

Background

In August 2009, the Government revised its advice to consumers about eating peanuts during pregnancy, breastfeeding and the first few years of life, in relation to the risk of developing peanut allergy in childhood.

The change in advice followed a major review of the scientific evidence that showed there is no clear evidence that eating or not eating peanuts (or foods containing peanuts) during pregnancy, breastfeeding or early childhood has any effect on the chances of a child developing a peanut allergy. Therefore, the Government’s previous advice that women may wish to avoid peanuts during pregnancy and breastfeeding and not introduce peanuts into their child’s diet before three years of age, if their child has a family history of allergy, was no longer appropriate.

The Government is currently funding a number of studies on peanut and other food allergies, with the aim of improving understanding of how and under what circumstances these conditions develop. It is hoped that these and other studies will provide more conclusive evidence in the future.

Research Approach

The method involved qualitative research amongst consumers, health professionals and other relevant stakeholders.

The consumer research comprised:

• Group discussions with mothers and mothers-to-be with no family history of allergy
• Group discussions with mothers and mothers-to-be with allergy in the family
• In-depth interviews with mothers with a food allergy and mothers of a child under 3 with an allergy (high risk consumers)

The health professional and other stakeholder research comprised 14 x 45 minute depth interviews including two GPs, two health visitors, two midwives, two paediatricians, and two dieticians, two staff from the Anaphylaxis Campaign and advisers from two Royal Colleges (the Royal College of Paediatrics and Child Health and the Royal College of General Practitioners).

Results

Consumers generally wanted a little more context and reassurance as to why the Government is revising the advice on peanut consumption during early life, as well as an indication as to where to find more detailed/broader information on allergies.

There were also consistent requests for an explanation as to why the advice only related to children under three years old or, if this is an arbitrary upper age, then this should be made clear.

In particular, consumers wanted a simple, straightforward and concise explanation of the status of the evidence and what that means for their consumption behaviour, as the current expression of the advice was not felt to offer this.

Where the issue of breastfeeding is raised, consumers wanted this to be done in the context of its relationship with allergy.

In relation to children who are being weaned, it was felt that more information could be included relating to specifically how to go about introducing peanuts and other allergenic foods to children, what allergy symptoms to look out for and what to do in case of spotting them.

In terms of signposting, consumers and health professionals felt it was appropriate to refer readers to their midwife, GP or allergy specialist for further clarification or discussion, if required.

It was also thought that additional signposting relevant to individual sections should also be provided throughout the revised advice rather than as a separate section at the end.