Early Peanut Protein Introduction in Clinical Practice.

Journal Article (Journal Article)


New multiple agency recommendations have encouraged the early introduction of peanut protein (PP) in high-risk children to decrease peanut allergies. However, many providers are hesitant to use these recommendations. Our objective was to increase the recommendation of new guidelines by providers during routine infant care and evaluate caregiver acceptance of early PP introduction.

Design and methods

This QI project focused on changing providers' knowledge and attitudes as a means to change practice using the "Plan-Do-Study-Act" model. Following provider educational sessions in 4 clinical sites providers and caregivers were questioned about instruction on the introduction of PP. Pre and post educational intervention data were collected from providers using chart audit and caregivers' report through the modified Promoting Healthy Development Survey (PHDS).


The educational intervention was effective in increasing provider knowledge (p < .05), providers' dissemination of knowledge to caregivers through provider report (p < .001) and caregiver report (p < .05).


Education increased providers' knowledge about the safety and importance of early introductions of PP, and allayed fears about initiating an allergic reaction. The increased provider recommendation to caregivers was validated by both provider and caregiver report. Caregivers felt comfortable initiating peanut protein.

Practice implications

Provider education led to increased recommendation to caregivers on early introduction of PP and increased caregiver comfort introducing PP.

Full Text

Duke Authors

Cited Authors

  • Pitts, MA; Sashidhar, S; Hudak, P; Blood-Siegfried, J

Published Date

  • November 2020

Published In

Volume / Issue

  • 55 /

Start / End Page

  • 95 - 99

PubMed ID

  • 32721769

Electronic International Standard Serial Number (EISSN)

  • 1532-8449

International Standard Serial Number (ISSN)

  • 0882-5963

Digital Object Identifier (DOI)

  • 10.1016/j.pedn.2020.07.002


  • eng