Conclusion
To our knowledge this is the first trial to explore a novel pragmatic
strategy for the primary prevention of tree nut allergy in infants at
highest risk of tree nut allergy, and if effective will provide evidence
for a management guideline for direct translation into clinical practice
for reducing the risk of development of multiple nut allergies for
infants with peanut allergy. It is expected that supervised introduction
of several tree nuts in the first year of life will prevent tree nut
allergy, facilitate ongoing ingestion, improve parental anxiety and
quality of life and reduce the healthcare costs associated with the
management of multiple nut allergies.