The
Correction

The health advice that got taken back

Take all of this medicine, even if you feel better.
Ask what the shortest course is.

You're following at least one health rule that has already been taken back. Nothing arrives in the mail when the answer changes. So this is that letter. One a morning: what you were told, what replaced it, how sure anyone really is about the new one — and what you get to stop doing.

What arrives

  • The rule you were given, in the words you heard it in.
  • Why somebody said it in the first place — told kindly, because the people who said it were passing on what they were taught.
  • What replaced it, with the date.
  • What you do now, which is usually nothing at all.

One line in every letter is set on its own, and it is always one of four.

This one is settled.

This one is mostly settled.

Doctors are still arguing about this one.

This was never really a rule.

Four you were probably taught

Tap a rule to see what replaced it.

  • Take them the way your doctor said — and ask for the shortest course that works.

    The line traces back to a warning Alexander Fleming gave in 1945, about people buying penicillin off a shop shelf. In 2017 a group of doctors went looking for evidence that stopping early breeds resistance, and couldn't find it.

    Doctors are still arguing about this one
  • Drink when you're thirsty. Food counts. Coffee counts.

    The number comes from a 1945 food report. The very next line of it says most of that water is already in your food — and that line never got passed along.

    This was never really a rule
  • Ice it for the pain if you want. Then get it moving.

    The doctor who wrote the rest-and-ice advice into the language spent his later years writing that the ice part was a mistake.

    This one is mostly settled
  • Peanut goes in early now, around the time solid food starts.

    A trial of 640 high-risk babies found early peanut cut allergy from about 14 in 100 to about 2 in 100. The guidance flipped in 2017. Nobody wrote to the parents still doing it the old way.

    This one is settled

A morning in full

Today: the peanut rule

"No peanuts until they're three"

You probably know a kid who can't eat them. That's new.

Think about a birthday party now. Somebody reads the label on the cake box twice. One kid has an EpiPen in a bag by the door, and every parent there knows whose kid it is.

There's a sign on the classroom door too.

None of that was there when you were at school.

"Don't give a baby peanuts. Wait until they're three."

That came from the American Academy of Pediatrics in the year 2000, aimed at babies whose families already had allergies. Parents did exactly what they were told, and the peanut butter went to the back of the cupboard.

It made sense at the time. A baby is brand new and easily upset. You keep the risky thing away until they're big enough for it.

Then a doctor in London noticed something strange.

His name is Gideon Lack. He was giving a talk to about 200 children's doctors in Israel, and he asked them one question. How many of you have seen a peanut allergy in the last year?

Two or three hands went up. Back home in London, that same question got nearly every hand in the room.

So he went looking for the difference, and it wasn't hard to find. Israeli babies eat a puffed peanut snack called Bamba almost as soon as they can hold one.

Then he ran a real test. He found 640 babies who were already likely to have trouble, because they had bad eczema or an egg allergy. He split them in two. One group ate peanut early. The other kept avoiding it, the way the advice said.

Then he checked them all at five years old. In the avoiding group, about 14 out of every 100 had a peanut allergy. In the group that ate peanut, it was 2 out of every 100.

The advice flipped in 2017. Now it says to get peanut in early.

This one is settled.

Just don't do it on your own. A baby with bad eczema or a known egg allergy gets seen by a doctor first. And never a whole nut, at any age, because a small child can choke on one.

So what do you do if there's a baby in your life?

Peanut goes in early now, around the time other solid food starts. Peanut butter thinned with warm water, or that puffed snack.

And if you had your babies in those years, and did what the pediatrician told you, here is the part worth hearing.

You followed the advice. The advice was wrong. That isn't the same as you being wrong.

Where this came from: American Academy of Pediatrics guidance from 2000, withdrawn in 2008. Du Toit and colleagues, Journal of Allergy and Clinical Immunology, 2008, for the Britain and Israel counts. The LEAP trial, New England Journal of Medicine, 2015. The American guidelines that replaced the old advice, 2017.

The Correction

The rules we write by

Nothing runs unless the correction is on the public record.

A guideline that was rewritten. A label the regulator changed. A trial that turned the advice around. Every letter ends with where it came from, so you can go and look.

No theories, no crusade, and no fight with anybody's doctor. When the honest answer is that experts still disagree, the letter says so and stops there.

Tomorrow morning, one thing you can stop doing.

Most days it's small — the water, the ice, the pills you felt guilty about. Some days it's bigger than that.

The Correction is journalism about how health guidance has changed. It is not medical advice, and it isn't a substitute for your doctor, who knows things about you that a newsletter never will. Never start, stop or change a medicine because of something you read here.