A third of babies have peanut allergy diagnosis removed

Published

Thursday, November 5, 2026 - 9:00 AM

A world-first national program has discovered more than a third of babies thought to have a peanut allergy could safely have the diagnosis removed. And the findings are changing how Australia’s healthcare system approaches infant food allergies.

The research, led by Murdoch Children’s Research Institute (MCRI) and the National Allergy Centre of Excellence (NACE) in partnership with 10 paediatric public hospitals across Australia, found 35 per cent of infants with a recent reaction to peanut and positive allergy test didn’t react during an oral food challenge. Without the challenge, these children would have likely continued to avoid peanut in case they triggered an allergic reaction.

MCRI Population Allergy Group Senior Research Clinician and ADAPT Medical Lead Dr Tim Brettig said the study highlighted the importance of confirming a peanut allergy before committing children to long-term treatment.

Why is confirming a food allergy important?

“We found more than one third of infants who were suspected to have peanut allergy based on their history and initial tests no longer reacted when they underwent a supervised food challenge,” he said. “Being able to identify those children early allows them to avoid an unnecessary allergy label and the burden of avoiding peanut.” 

The findings form part of a study evaluating the ADAPT Peanut Oral Immunotherapy Program, which was launched in 2024 by the NACE, hosted at MCRI. ADAPT is the first peanut allergy treatment program offered in Australian public hospitals for infants outside of a clinical trial setting.

As part of this evaluation, 1275 infants under 18 months old were assessed with 778 undergoing an oral food challenge. The infants presented at participating hospitals across Victoria, New South Wales, Queensland, South Australia and Western Australia. During a food challenge, infants receive increasing doses of peanut under medical supervision to check for an allergic reaction.

Oral food challenges having an impact on allergy rates

Published in The Journal of Allergy and Clinical Immunology: In Practice, it found while 65 per cent of babies had a reaction, including 12 per cent who experienced anaphylaxis, all episodes were safely managed by the teams conducting the food challenges.  

The 35 per cent who had no reaction were considered peanut tolerant and could have their allergy label removed, allowing them to regularly eat peanut in an age-appropriate form, such as peanut butter.

Almost all babies who reacted proceeded to peanut oral immunotherapy, a treatment involving daily doses of peanut to build tolerance, with 97.5 per cent successfully starting treatment at a dose guided by their challenge results.

Australia has some of the highest reported rates of childhood food allergies in the world, with peanut allergy affecting about one in 30 children.

Changing the way peanut allergy is managed

MCRI Population Allergy Group Leader and NACE Director Professor Kirsten Perrett, also the ADAPT Program Lead, said the results had implications for how peanut allergy was managed in Australia.

“Oral food challenges are not currently used routinely for every infant with suspected peanut allergy,” she said. “But our results show that clinical history and allergy testing alone were not enough to accurately diagnose peanut allergy in many cases. A supervised oral food challenge should be routinely considered to confirm the diagnosis before an infant starts oral immunotherapy.

“With peanut allergy one of the most common childhood food allergies, it’s particularly important that we have an accurate diagnosis when a baby first shows signs of a possible peanut allergy. We want to reduce the burden of food allergy for children and their families, and the ADAPT Program is a step in this direction.” 

Correcting the peanut allergy record

When Leah and Jake introduced their infant son to peanuts his face reddened and hives appeared on his shoulders and under his nose. The reaction settled within an hour, but the family was left unsure as to whether Arthur had a peanut allergy.

Arthur was referred to the ADAPT Program at The Royal Children’s Hospital (RCH) for answers.

Read more about Arthur’s experience on having his suspected allergy diagnosis corrected.

The NACE and National Allergy Council (NAC) were funded by the Federal Government in 2022 to transform allergy research and clinical care to help save lives, improve health and reduce the burden of allergic disease.

The National Allergy Helpline, run by Allergy and Anaphylaxis Australia (A&AA), provides advice and support free of charge from allergy educators for families managing allergic conditions. Call 1300 728 000 (Monday to Friday 9am to 4pm AEDT).

If families suspect their baby has a peanut allergy, they are encouraged to talk to their GP, who might refer them to a paediatric allergy specialist.

Support MCRI's end-of-year Allergy Appeal to help more children start school allergy-free. Donate today

Researchers from John Hunter Children’s Hospital, The Children’s Hospital at Westmead, Royal Prince Alfred Hospital, SA Women’s and Children’s Network, The Royal Children’s Hospital, Campbelltown Hospital, Perth Children’s Hospital, Fiona Stanley Hospital, Children’s Health Queensland and Sydney Children’s Hospital, Randwick also contributed to the findings.

Publication: T.W. Brettig, E. McDonald, D. West, R. Bhatia, I. Bosi, A. Cheung, H. Czech, L.S. Ford, C.H. Katelaris, M.D. O’Sullivan, J. Peake, K. Preece, P. Quinn, J. Smart, S. Swamy, B.K. Wainstein, M. Wong and K.P. Perrett. ‘An Oral Food Challenge should be routinely considered for accurate diagnosis of peanut allergy in infants prior to Oral Immunotherapy: Evaluation of the ADAPT Peanut OIT Program,’ The Journal of Allergy and Clinical Immunology: In Practice. DOI: 10.1016/j.jaip.2026.08.044

*The content of this communication is the sole responsibility of MCRI and does not reflect the views of the NHMRC.

Available for interview:

• Dr Tim Brettig, MCRI Senior Research Clinician, Population Allergy and ADAPT Medical Lead
• Professor Kirsten Perrett, MCRI Group Leader, Population Allergy, NACE Director and ADAPT Program Lead

Media Contacts:

Bridie Byrne
MCRI Senior Media and Communications Manager
Ph: +61 457 365 848
E: [email protected]

Margot Taylor
MCRI Media Advisor
Ph: +61 491 025 305
E: [email protected]

About Murdoch Children’s Research Institute:

Murdoch Children’s Research Institute (MCRI) is one of the world’s top three child health research institutes, dedicated to improving the health of children and adolescents in Australia and around the world. In 2026 MCRI celebrates its 40th anniversary, marking four decades of transforming child health through research, discovery and innovation. Its breakthroughs have improved diagnosis, informed global vaccine strategies, advanced precision medicine, and continue to redefine what’s possible for sick children. MCRI is one of the only research institutes in Australia to offer genetic testing to help families find answers for children with previously undiagnosed conditions.

About the National Allergy Centre of Excellence:

The National Allergy Centre of Excellence (NACE), hosted at Murdoch Children’s Research Institute (MCRI), is Australia’s peak allergy research body. Backed by an Australia-wide network of more than 500 experts in drug, food, insect, and respiratory allergies, the NACE is working to address one of our fastest growing chronic conditions - allergic disease.

Funding:

The study was supported by the National Allergy Centre of Excellence (NACE), which is funded by the Australian Federal Government, and philanthropic organisations to the Murdoch Children’s Research Institute. KPP is supported by a Melbourne Children’s Clinician-Scientist Fellowship and a NHMRC fellowship, GNT2008911. Research at Murdoch Children’s Research Institute is supported by the Victorian Government's Operational Infrastructure Support Program.