A young relative of mine has a 4-month-old baby. She asked me about peanut allergies and the best way to introduce her infant to peanuts. She had already talked to her pediatrician, but wanted more reassurance that she was doing the right thing.
Her anxiety is shared by lots of new parents who are terrified of peanut allergies.
Who can blame them? Peanut allergies among children have been on the rise over the last 20 years. And the news media love to pick up those tragic stories of death by peanut, which just frightens new parents and makes them more determined to avoid peanuts altogether.
Unfortunately, avoiding peanuts is the root of the problem!
What causes peanut allergies?
Twenty years ago the American Academy of Pediatrics (AAP) set up peanut guidelines, following the theory that peanut allergies were caused by early exposure.
The AAP recommended pregnant and breast-feeding women avoid peanuts, and kids not be given peanut-containing foods until after age 3.
Parents jumped on these recommendations because the theory made sense.
And then peanut allergies began to skyrocket.
In 2008 the AAP put out new peanut guidelines. Now mothers were told it was okay to eat peanuts when pregnant or breast feeding. And they could introduce their kids to peanuts (in an infant-safe form, of course) as early as 6 months.
Despite the flip-flop, parents weren’t convinced. A study as recent as 2018 showed many parents were either unaware of the new guidelines, or unwilling to introduce peanuts before their child’s first birthday.
A remarkable study published in 2015—the LEAP study—highlighted how wrong the AAP’s original guidelines were. Rather than cause allergies, early exposure to peanuts significantly decreased the risk of developing an allergy.
Although experts aren’t exactly sure how a peanut allergy develops, they now know the best way to prevent a peanut allergy is to start early. Infants as young as 4 months should be introduced to foods containing peanuts, and given these foods regularly until about age 5.
Recommended guidelines to prevent peanut allergies
So what are the most current guidelines if you have a new baby and want your best shot at avoiding a peanut allergy in your future?
First, infants are divided into three categories:
- High-risk: infants with severe eczema, an egg allergy, or have tested positive for peanut sensitivity.
- Moderate-risk: infants with mild eczema.
- Low-risk: none of the above.
Even though it sounds counter-intuitive, high-risk infants actually benefit the most from early exposure to peanuts. In the LEAP study, high-risk infants who were regularly exposed to peanuts from a young age were much less likely to develop a peanut allergy than those who weren’t.
Just follow the recommendations from your child’s pediatrician.
Moderate- and low-risk infants can be started on peanut products (again, infant-safe foods, not whole peanuts or big globs of chunky peanut butter!) between 4 and 11 months.
Here are some tips from Parents magazine:
- If your child is at mild to moderate risk of allergy because of mild or moderate eczema: Introduce peanut-containing foods starting around six months when beginning solids.
- If your child is not at increased risk: Introduce peanut foods at any time after starting solids (but aim to include them the first year).
- When you’re ready to start giving peanut, do the first feeding when your child is healthy, and free from colds and other bugs. Do the initial feeding at home, not at daycare or at a restaurant.
- Thin two teaspoons of smooth peanut butter with two teaspoons of hot water and stir until dissolved. Allow it to cool, then thin it more if needed before feeding.
- Combine two teaspoons of smooth peanut butter (or two teaspoons of peanut butter powder) with 2-3 tablespoons of a tolerated fruit or vegetable puree and stir until smooth.
- Offer your baby peanut-containing puffs such as Bamba. Though they’re soft enough to melt in the mouth, soften them even more with water for babies younger than seven months.
Introducing kids to peanuts shouldn’t be a terrifying ordeal! The vast majority of infants will have no problem, and will only benefit by being less likely to develop a peanut allergy later in life.