A recent study (N Engl J Med. 2015 Feb 26;372(9):803-13) questions the current guidelines on early childhood nutrition. The study supports the introduction of peanuts at the age of 4 to 11 months since early introduction of peanuts dramatically decreased the risk of developing peanut allergy in the future. The old guidelines from the American Academy of Pediatrics recommended that peanut products should not be introduced to children at risk for allergies until the age of 3 years.
This is not the first and only study showing increased risk for allergy development with delayed food introduction. As allergists we recommend breastfeeding for the first 4-6 months (if possible). There is no conclusive evidence for use of formula over breast-feeding to prevent allergies.
Solids should be introduced one at a time between 4-6 months of age (first time exposure to a new food preferably at home)
Children with a family history of allergies in a first degree relative or early signs of allergy such as eczema are at increased risk of allergies; they should be tested for food allergies as early as 2-3 months of age by skin or blood testing (this may need to be followed by a food challenge). If the child is not positive to food allergen, eliminating the food from the diet could actually increase risk of food allergy.
During pregnancy, maternal avoidance of essential foods such as milk and egg is not recommended at this time. Data are currently inconclusive on whether peanut ingestion during pregnancy can lead to peanut allergy in the child; thus, no recommendation on maternal avoidance can be made at this time.
Maternal diet while breastfeeding: avoidance of highly allergenic foods is not recommended, unless an allergy is identified in the infant.
We would like to be your partner in helping you figure out the best way to feed your children without the fear of causing allergies. We can help you make decisions if tests are positive, possibly by performing a challenge. If you are hesitant to try new foods in your child’s diet (while breastfeeding) or to introduce new foods to your children, we are happy to consult and evaluate.