If someone in your family suffers from a peanut allergy, you know how difficult it can be. From preschool snacks to the weekend birthday party, it can feel as though danger lurks around every corner. While the old guidelines recommended that parents kept children away from peanuts and peanut products until they were three years old and parents could be sure to know if their child was allergic or not, new data suggests that a peanut allergy can be prevented through the introduction of peanut-containing foods beginning in infancy.
The National Institute of Allergy and Infectious Diseases, along with 25 other professional organizations, federal agencies, and patient advocacy groups including the American Academy of Pediatrics (AAP), American Society for Nutrition (ASN), and the World Allergy Organization (WAO) collaborated to release an addendum to the previous guidelines in the Annual of Allergy, Asthma and Immunology. (You can read the document in its entirety here.)
Here’s the gist: Experts now believe that by exposing infants to peanut products early, peanut allergies can be prevented. Dr. Matthew Greenhawt, chairman of the American College of Allergy, Asthma and Immunology’s food allergy committee explained that there is “a window of time in which the body is more likely to tolerate a food than react to it, and if you can educate the body during that window, you’re at much lower likelihood of developing an allergy to that food.”
Who does this apply to? According to the study, nearly all kids should get a taste of peanut protein by the time they are 6 months old, and they should get regular doses after that if they don’t have an allergic reaction. The study specifically discusses three categories of infants.
- High-risk infants are those babies with an egg allergy, severe eczema or both. These infants are at higher risk for developing a peanut allergy. High-risk infants should be tested for a peanut allergy at a specialist’s office when they’re 4 to 6 months old and have started taking solid food. Depending on the results of the test, the guidelines recommend either introducing peanuts at home or in a doctor’s office with supervision. (Scroll down to Addendum Guideline 1 for more information)
- Moderate-risk infants may have mild to moderate eczema. They can be fed a little peanut-containing food at home without a doctor’s help, according to the guidelines. Parents should be on the lookout for signs of an allergic reaction such as rash, hives, swelling, vomiting, or wheezing.
- Low-risk children have no egg allergy or history of eczema. These infants can consume peanut-containing foods after they start solid foods ideally by 6 months of age.
How much? According to the new addendum, experts recommend 6 to 7 grams of peanut protein over 3 or more feedings per week.
What peanut products should I use? According to the guidelines, children under the age of 5 should not be given whole peanuts and kids under 4 shouldn’t be given straight peanut butter. Instead, the guidelines recommend these four preparations methods for introducing peanut products:
- Option 1: Smooth peanut butter mixed with either a previously tolerated pureed fruit or vegetable.
- Option 2: Smooth peanut butter dissolved carefully with hot water and cooled.
- Option 3: Peanut flour mixed with either a previously tolerated pureed fruit or vegetable. Peanut butter powder can be used instead of the peanut flour.
- Option 4: Bamba peanut snack or other similar peanut puff products dissolved in hot water and cooled or even as a solid (ie, as a stick).
Why the change? New research has shown that those individauls more prone to a peanut allergy who consumed small amounts from early infancy showed a 70-80% risk reduction in the prevalence of peanut allergy. That being said, this isn’t a magic bullet. “This won’t outright prevent every single case of peanut allergy,” explains Dr. Greenhawt in a New York Times article. “There will still be some cases – but the number could be significantly reduced by tens of thousands.”
Please check all health concerns with your pediatrician, but keep these important notes in mind:
- While the new guidelines recommend introducing peanut butter as early as 4-6 months, your baby should already have started some solid food before you introduce it.
- Not all babies are ready for solid food at 4-6 months. Please check with your doctor to make sure your infant is ready.
- Do NOT give your infant whole peanuts. Whole nuts should not be given to kids under 5.
- Peanut butter directly from a spoon or in lumps/dollops should not be given to kids under 4.
- While these guidelines may decrease the number of peanut allergies if widely implemented, there are still many children and adults who DO have a peanut allergy. Therefore it’s important to still be cautious about peanut products in the general public.
What do you think about the new peanut guidelines?
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