It seems like there are more and more children these days struggling with peanut allergies. Many classrooms are now peanut-free zones to help prevent a possible allergic reaction. Peanut allergy is a serious health threat, estimated to affect 0.4% of children and 0.7% of adults in the United States. Recent research now suggests there may be evidence to prevent peanut allergy from a young age.
A clinical trial called Learning Early About Peanut Allergy (LEAP) enrolled more than 600 infants at high risk of developing a peanut allergy. Participants had severe eczema, egg allergy or both, and the group was divided into two groups: one was asked to avoid peanut-containing foods, and the other was asked to eat peanut foods regularly. They followed the infants until they were 5 years old and what they saw was a reduction of peanut allergy by 81 percent in the group that consumed peanuts starting from 4-6 months of age! That's significant!
The current guidelines can be viewed on the National Institute of Allergy and Infectious Diseases website, and I have summarized the guidelines below:
- If your infant has severe eczema, egg allergy or both, they should be introduced to peanut-containing foods as early as 4-6 months of age. Check with your healthcare provider before feeding your infant peanut-containing foods. You may want to have a blood test or a skin prick test to determine if and how to introduce peanuts to your child’s diet. The provider may suggest testing peanut-containing foods at home or in their office. However, the testing could suggest that your child may already be allergic to peanut, and therefore should avoid it.
- If your infant has mild to moderate eczema, they should be introduced to peanut-containing foods as early as 4-6 months of age. Check with your healthcare provider to determine the safest way to introduce peanut-containing foods in their diet. The study suggests that introducing peanut around 6-months of age may reduce risk of developing an allergy. Your provider may suggest testing peanut-containing foods at home or in their office.
- If your infant has no eczema or any food allergy, you can freely introduce peanut-containing foods into their diet. This can be done at home with age-appropriate foods.
So what are these age-appropriate peanut-containing foods? Well, definitely not whole nuts! Giving infants whole or even chopped peanuts can cause possible choking or even inhalation of food pieces. This can lead to an emergency department visit and infections. And peanut butter is sticky and can cause choking if it gets stuck in the throat or palate.
Instead, you can offer your baby a small amount of peanut butter or powdered peanut butter mixed into plain yogurt, or add some to pancake batter and give your baby soft pieces to chew. You can also blend peanut butter into a thinned-out smoothie with banana and milk. One of my favorite snacks, Bamba, is a popular infant snack in Israel, and is like a cheese puff but with peanut butter instead of cheese – basically the snack of dreams.
Don’t forget to talk with your pediatrician if you have any questions about introducing peanuts to your infant, especially if they already have eczema or egg allergy.
 Togias A, Cooper SF, Acebal ML, et al. Addendum guidelines for the prevention of peanut allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases – sponsored expert panel. Ann Allergy Asthma Immunol. 2017; 118 (2):166-173.