The New Peanut Allergy Prevention Guidelines Are Out – And It’s Not What You Expected

For many years, the guidelines from the American Academy of Pediatrics recommended introducing peanuts later in life (not within the first 2-3 years, at least). In the United States, we have seen an increase in peanut allergy despite (or maybe because of) these recommendations.

Other nations, such as Israel, have lower rates of peanut allergy. Israeli parents often feed their babies Bamba (peanut puffs) early in infancy.

New studies (EAT and LEAP) have now confirmed that early peanut exposure is beneficial. It should not be the first solid food given, particularly not whole peanuts. Breastfeeding (or infant formula feeding) is still recommended as best nutrition until at least 4 months of age.

Here is  a summary of the consensus statement on early food introduction:

Healthy babies (low risk for allergy):

Babies without any signs of allergy (no eczema or egg allergy) should start peanut containing foods around 6 months of life after other solids foods have been tolerated. No specialist visit is necessary.

The best time to introduce peanut is when the baby is in good health – not when (s)he is suffering from a cold or infection. It’s better to give the first peanut feeding earlier in the day so the baby can be observed for any symptoms during the waking hours.

Peanut butter or peanut puffs such as Bamba or Peanut Butter Panda Puffs are some of the best tolerated peanut products. Peanut butter can be diluted with milk or water, if preferred. Alternatives includes soup with ground peanut. Whole peanuts are not a good choice, as they can be a choking hazard in your infants.

High-risk babies

Infants with severe eczema or egg allergy should ideally start peanut in their diet at age 4-6 months. They should see an allergy specialist who can determine if peanut can be introduced safely. In order to find out, skin testing may be necessary. For some infants, the safest first exposure is in the allergist’s office, so if there is an allergic reaction, treatment is available.

Moderate-risk babies

Children with with mild or moderate eczema do not necessarily have to see a specialist. They should start peanut consumption around 6 months of age. Peanut can be introduced at home.

Maintenance

Once peanut is introduced, consumption should be regular: a small dab (2 grams) 3 times per week. Regular exposure is particularly important for the children at risk for allergies. As mentioned before, risk factors include eczema and egg allergy.

Author

Dr. Corina Bowser