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There are new guidelines on when to introduce your baby to peanuts

Jan 9, 2017

The number of kids with peanut allergy tripled between 1997 and 2008, according to Food Allergy Research and Education (FARE).

The idea that your child could be exposed to nuts and have a reaction that is damaging, or even fatal, can be pretty scary. In the past, caregivers were told to avoid exposing kids in danger of developing an allergy to peanut products for the first few years of their lives.

But there are new federal guidelines for introducing kids to peanuts with the goal of decreasing the prevalence of this life-threatening allergy.

According to the National Institute of Allergy and Infectious Diseases, introducing babies at increased risk of developing peanut allergy to peanut-containing foods as early as 4 to 6 months drastically reduces the risk of them developing an allergy. Low-risk infants can start these foods at 6 months or older. Patti Neighmond reported for NPR:

The guidelines are largely based on dramatic findings from a large study published in the New England Journal of Medicine in 2015. Researchers found that babies at high risk of developing a peanut allergy who were fed the equivalent of about 4 heaping teaspoons of peanut butter each week, starting at the age of 4 to 11 months, were about 80 percent less likely to develop an allergy to the legume by age 5 than similar kids who avoided peanuts. The benefit held up even after the children stopped getting the puree, a follow-up study found.

So how can you tell if your baby is at increased risk of developing peanut allergy? Two telltale signs are moderate to severe eczema, egg allergy or both. But these infants should be evaluated by an allergy specialist before their parents or caregivers introduce them to peanuts, according to the guidelines:

Check with your infant’s healthcare provider before feeding your infant peanut-containing foods. He or she may choose to perform an allergy blood test or send your infant to a specialist for other tests, such as a skin prick test. The results of these tests will help to determine if peanut should be introduced into your infant’s diet and, if so, the safest way to introduce it. If your infant’s test results indicate that it is safe to introduce peanut-containing foods, the healthcare provider may recommend that you introduce peanut-containing foods to your infant at home. Or, if you prefer, the first feeding may be done in the healthcare provider’s office under supervision. On the other hand, testing may indicate that peanut should be carefully introduced at a specialist’s facility or not introduced at all because your child may already have developed an allergy to peanut.

Drew Bird is director of the Food Allergy Center at Children's Health in Dallas. He told Parents.com that once parents get the okay from their baby's doctor to give them peanuts, he recommends stirring a small amount of peanut powder into a puree, spreading a thin layer of peanut butter on toast or diluting a small amount of peanut butter with water - but never whole peanuts.

It's also important that once babies are given peanut products they continue to consume them on a regular basis. According to Bird:

Foods that are in the diet more frequently are less likely to cause problems down the road. The new guidelines recommend babies get two teaspoons, three times a week.

Researchers stress that the new guidelines are only for kids who are not already allergic. Kids who have been diagnosed with a peanut allergy should use the same caution around peanut products as always.

Dr. Matthew Greenhawt is chairman of the American College of Allergy, Asthma and Immunology’s food allergy committee, and one of the authors of the new guidelines. He told The New York Times:

This won’t outright prevent every single case of peanut allergy – there will still be some cases – but the number could be significantly reduced by tens of thousands. In the best case scenario, every allergist across the U.S. could be seeing fewer cases of peanut allergy — and that’s a good problem to have.

Symptoms of an allergic reaction include hives, swelling, itching, vomiting and shortness of breath or wheezing. If your child shows any of these signs, call your doctor immediately.

Check out the video below from the American College of Allergy, Asthma and Immunology to learn more about how to safely introduce peanut-containing foods to prevent peanut allergy:

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