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Assessing the Effect of Infant Peanut Exposure Guidelines on Peanut Aspiration Using Google Trends Search Analysis
Dana N Eitan1, Bryant O Noss1, Shauna R Schroeder2
1School of Medicine, Creighton University School of Medicine, Phoenix, USA.
Insights
The American Academy of Pediatrics (AAP) 2017 guideline change recommending early peanut introduction was followed by a 13.8% increase in online searches for peanut aspiration, indicating heightened parental concern or actual events.
Area of Science:
- Pediatric Allergy and Immunology
- Public Health Surveillance
- Consumer Health Informatics
Background:
- The American Academy of Pediatrics (AAP) revised infant feeding guidelines in 2017, recommending early peanut introduction at four months.
- Peanut ingestion poses a significant risk for food-related foreign body aspiration in infants.
- Google Trends analysis is a validated tool for tracking public health trends and healthcare-seeking behaviors.
Purpose of the Study:
- To investigate the association between the 2017 AAP guideline changes and public interest in peanut aspiration.
- To quantify changes in online search volume related to peanut aspiration before and after the guideline revision.
Main Methods:
- Utilized Google Trends to analyze relative search volume (RSV) for peanut aspiration-related terms from January 2012 to January 2022.
- Compared RSV data for the five years preceding January 2017 with the five years following the guideline change.
- Statistical analysis to determine the significance of changes in search trends.
Main Results:
- All analyzed search terms showed a significant increase in RSV post-guideline change (median increase of 13.8%, p < 0.001).
- Search terms like "choke on peanut" and "peanut cough" exhibited substantial RSV growth.
- The median RSV for "peanut cough" increased from 9.6 to 17, and for "peanut and cough" from 50.8 to 63.1.
Conclusions:
- The 2017 AAP guideline shift coincided with increased public online searches for peanut aspiration.
- This rise in search activity may reflect either an increase in aspiration incidents or heightened parental concern regarding peanut safety.
- Emphasizes the critical need for healthcare providers to counsel families on age-appropriate, safe peanut introduction methods to mitigate aspiration risks.
Abstract:
Background The American Academy of Pediatrics (AAP) changed guidelines in 2017 to recommend introducing infants to peanuts as early as four months. Peanuts are also one of the most commonly aspirated food-related foreign bodies. Google Trends search pattern analysis has been validated in epidemiologic research as being reflective of healthcare events. Methodology Google Trends measures the popularity of a search term in a given week compared to the popularity of all search terms in that week, calculated as relative search volume (RSV), yielding a value between 0 and 100. We compiled peanut aspiration-related search data from January 2012 to January 2022 and compared the relative popularity of these searches before the change in guidelines to after. Results All queried search terms significantly increased in RSV when comparing the five years before and following January 2017. When pooling all terms, the median RSV increase was 13.8% (p < 0.001). "Choke on peanut" and the combination of peanut and cough had the highest median RSV increases from 9.6 to 17 and 50.8 to 63.1, respectively. Conclusions The change in 2017 of the AAP guidelines on early childhood peanut exposure was associated with an increase in online searches for peanut aspiration. This may be reflective of increased aspiration events, or possibly increased concern for aspiration. Current results support the need to closely counsel families on infant-safe peanut products to prevent dangerous aspiration events.
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