A landmark Australian study has found that roughly one in three babies previously classified as having a peanut allergy show no reaction when given a supervised oral food challenge, raising significant questions about how peanut allergies are diagnosed in infants and potentially sparing thousands of families from years of unnecessary dietary restriction.
The findings emerged from the national ADAPT Peanut Oral Immunotherapy Program, launched in 2024 by the National Allergy Centre of Excellence and hosted at the Murdoch Children's Research Institute. The program was originally designed to improve tolerance to peanuts, beginning with an oral test to determine each infant's level of sensitivity. What researchers did not expect was just how many babies would pass that initial challenge without any reaction at all.
What the Study Found About Peanut Allergy Misdiagnosis
Of 778 infants enrolled in the program and given an oral food challenge, 35 per cent showed no reaction to peanut, meaning their allergy diagnosis could safely be removed. Senior clinician Dr Tim Brettig said the scale of the finding surprised even the research team.
"We expected some to tolerate peanut at a food challenge, but the rate's much higher than we would have thought," Dr Brettig said. "To get such a large number of infants not react and therefore not even need treatment because of an allergy was really exciting."
Dr Brettig acknowledged that it remains unclear why some babies who initially showed sensitivity to peanuts no longer did when formally tested. The disconnect between standard skin and blood tests and the results of the oral challenge points to a potential gap in how allergy risk is currently assessed in very young children.
At the same time, the oral food challenge is not without risk. During the initial testing phase, 12 per cent of infants had an anaphylactic reaction requiring treatment from medical staff on hand. Dr Brettig stressed that the testing must be conducted carefully. "It needs to be done in a controlled and safe way," he said, cautioning against any suggestion that oral challenges could or should be attempted outside a clinical setting.
One Family's Story: Arthur's Diagnosis Removed
Among the families whose lives were directly changed by the study is that of one-year-old Arthur Cameron. At around five months of age, Arthur broke out in hives and became red in the face after being given peanut butter. Skin and blood tests that followed indicated a high risk of reaction, and his parents, Leah and Jake Cameron, were told he was likely allergic to peanut.
The diagnosis prompted immediate and significant changes to the family's daily routine. His mother Leah described the stress of navigating food labels and rethinking meals as a considerable adjustment, particularly for a first-time parent already managing the demands of a new baby.
"Being a first-time new mum there's enough kind of stress and anxiety around having a child," Leah said. "And then finding out he had this peanut allergy, it certainly made us worry a bit how we'll manage this through his life."
When Arthur underwent the oral food challenge as part of the program, he tolerated peanut without any reaction. His diagnosis was removed. The family's relief extended well beyond being able to serve satay chicken again. Leah said the bigger comfort was knowing her son would not face a lifetime of serious allergy-related complications.
"We were very surprised, but very ecstatic," she said.
Implications for How Peanut Allergy Is Assessed in Infants
The results suggest that oral food challenges should potentially be considered in more cases than current practice allows, particularly for infants who have been classified as high-risk based on skin or blood testing alone. Those tests, while useful, may not reliably predict a true clinical reaction in every case.
Researchers say the findings could be a genuine turning point for families whose lives have been reshaped by a peanut allergy diagnosis. Without the ADAPT program, children like Arthur would in all likelihood have continued avoiding peanuts indefinitely, managing a risk that, for a significant proportion of them, may never have existed in the first place.
As Australian researchers continue to investigate how diet and health intersect across different life stages, the ADAPT study adds important weight to calls for more thorough, evidence-based approaches to food allergy testing from the earliest months of life.
