Six Eggs a Week in Pregnancy, and No Difference in Infant Allergy
Primary research located and verified via PubMed.
Pregnancy arrives with a long list of dietary instructions, and that list has reversed itself more than once during my career. For years, women with a family history of allergy were told to avoid peanuts while pregnant. Then the advice changed, and eating allergenic foods during pregnancy and breastfeeding became the recommendation for protecting the baby. A trial published in the New England Journal of Medicine on September 17, 2026 tested that second version properly and found no difference.
What the PrEggNut trial tested
Australian researchers enrolled pregnant women whose unborn child had at least two biological family members with medically diagnosed allergic disease [1]. That is a high-risk group by design. Participants were randomly assigned to one of two diets, lasting from before 23 weeks of pregnancy until four months after birth while breastfeeding. The high-allergen group ate at least 6 eggs and 60 peanuts per week. The standard group ate no more than 3 eggs and 30 peanuts per week.
In total, 1,070 women were assigned to the high egg and peanut diet and 1,067 to the standard diet. The primary outcome was IgE-mediated egg or peanut allergy in the infant at one year. IgE is the antibody behind immediate allergic reactions, so what was counted here is allergy established by testing rather than a parent's report of a bad day.
At one year, 7.8% of infants in the high-allergen group had egg or peanut allergy (83 of 1,066), against 8.4% in the standard group (89 of 1,064). The relative risk was 0.93, with a 95% confidence interval of 0.69 to 1.26, and a P value of 0.65. The relative risk compares the two groups' rates, and a value of 1.00 would mean no difference at all. Safety measures were similar in the two groups.
A confidence interval spanning 0.69 to 1.26 contains 1.00 comfortably, which is the statistical way of saying the trial could not tell the two diets apart. This was a large multi-site randomized trial, designed with enough participants to detect a difference, in the population where a protective effect should have been easiest to detect. A null result means the trial found no difference between the groups, and a null result from a trial this size carries more information than a positive result from a small one.
The trial that did change infant allergy rates, and when it happened
That result becomes more informative next to LEAP, published in 2015 [2]. LEAP randomized 640 infants who already had severe eczema, egg allergy, or both, at ages between 4 and 11 months, either to consume or to avoid peanut until 60 months of age.
A skin-prick test places a tiny amount of a food extract on lightly scratched skin to see whether a reaction develops. Among the 530 infants who started with a negative peanut skin-prick test, peanut allergy at 60 months was 13.7% in the avoidance group and 1.9% in the consumption group (P < 0.001). Among the 98 who started with a small positive skin-prick result, it was 35.3% with avoidance and 10.6% with consumption (P = 0.004). Those are large differences, and LEAP is why infant feeding guidance changed around the world.
So in one trial the researchers fed the mother and found nothing, while in the other they fed the baby and found a great deal. The variable separating them is who ate the food, and when. Exposure through the placenta and through breast milk did not establish tolerance in these infants. Exposure through the infant's own mouth, in the first year, did.
Why a null result is good news for pregnant people
Pregnant people are given an enormous amount of dietary instruction, much of it contradictory, and a fair amount of it delivered with the implication that a child's future health depends on getting it right. On this trial's results, eating six eggs and sixty peanuts a week during pregnancy is not something anyone needs to do. Nor is avoiding those foods, since the standard-diet group still ate eggs and peanuts and their babies did no worse. That takes something off the list, and that is rare in this literature.
From a whole-person view, the question is where prevention actually happens. The infant's own immune system builds tolerance to a food by meeting that food, in the infant's own gut, at a developmental moment when the system is still sorting out what counts as friendly. What supports that process is broader than any single food: an intact gut barrier, a developing microbiome, breastfeeding where it is possible, and skin that is not inflamed.
Eczema is the clearest example of that last point, since infants with severe eczema are precisely who LEAP recruited. The leading hypothesis for why they have such high risk involves food proteins meeting the immune system through inflamed skin rather than through the gut. Neither LEAP nor PrEggNut settles that hypothesis. It is the reason skin care and food introduction get discussed in the same appointment.
There is one smaller finding about maternal diet, and it involves omega-3 fats. A 2025 review of dietary bioactive compounds in allergy reported that omega-3 fatty acids modulate Th2 responses and promote regulatory T cells, with modest clinical benefits observed in pregnancy and early life, while noting that clinical results across this whole field remain heterogeneous [3]. Th2 responses are the branch of the immune system involved in allergy, and regulatory T cells are immune cells that keep those responses in check. Heterogeneous means the results varied from study to study. Modest and heterogeneous is an accurate description, and it is a long way from six eggs a week.
The first-year conversation to have with your pediatrician
If you are pregnant and have been eating eggs and peanuts because somebody told you it would protect your baby, the evidence here suggests you can stop counting. Eat them if you like them. There is no measured benefit to eating more, and no safety signal either way.
Based on these two trials, the time to act is the baby's first year rather than the pregnancy. Infant feeding guidance in most countries now recommends introducing allergenic foods early rather than delaying them, and that guidance was built on trials like LEAP. The details of how and when depend on your own baby's risk.
This is where I stop giving general advice, because the infants in LEAP were screened before they ate anything. Babies with severe eczema or a known egg allergy were skin-prick tested first, and some had their first exposure under medical supervision. If your baby has significant eczema, an existing food allergy, or a strong family history, the first introduction of peanut or egg is a conversation to have with your pediatrician or an allergist before it happens at your kitchen table. For a baby without those risk factors, introducing common allergenic foods in the normal course of starting solids is what current guidance supports.
In this trial, extra eggs and peanuts during pregnancy did not prevent egg or peanut allergy in the babies, and that is one fewer thing to worry about.
References
Palmer DJ, Campbell DE, Nanan R, et al. Trial of a maternal diet rich in eggs and peanuts to reduce infant allergy. N Engl J Med. 2026;395(11):1090-1099. PMID 42748429. https://doi.org/10.1056/NEJMoa2605659
Du Toit G, Roberts G, Sayre PH, et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. N Engl J Med. 2015;372(9):803-813. PMID 25705822. https://doi.org/10.1056/NEJMoa1414850
Zafrilla P, Ballester P, Victoria-Montesinos D, et al. Dietary bioactive compounds and their role in allergy prevention: a comprehensive review. Nutrients. 2025;17(22):3506. PMID 41305557. https://doi.org/10.3390/nu17223506
Secondary coverage: MedPage Today, "Mom's Extra Egg, Peanut Intake Doesn't Reduce Baby's Allergy Risk," September 2026. https://www.medpagetoday.com/allergyimmunology/allergy/123026
A note before you go
This article is educational and is not medical advice. Introducing allergenic foods to an infant who has significant eczema, an existing food allergy, or a strong family history of allergy should be planned with your pediatrician or an allergist, and in some cases the first exposure belongs in a medical setting rather than at home. Nothing here is a substitute for that assessment. If you are pregnant and have questions about your own diet, bring them to the clinician managing your care. Written by Dr. Joyce Knieff, ND, LAc, of Yggdrasil Naturopathic.
If this resonates with what you're experiencing and you'd like to explore a naturopathic approach, book a consultation with our clinic.
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