Assessing the Effect of Infant Peanut Exposure Guidelines on Peanut Aspiration Using Google Trends Search Analysis

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.