Peanuts and peanut butter are back on the menu for infants, according to new guidelines urging parents to introduce peanut products to their children starting around 4-6 months of age. Released January 5, the National Institute of Health’s new recommendations are based on research that found early and regular exposure to peanut products resulted in the prevention of peanut allergies in a large number of infants.
The guidelines explain how to introduce the products depending on the child’s risk level of developing an allergy:
- Low risk children: Those without eczema or food allergies can be freely introduced to peanut containing foods at home around 4-6 months.
- Medium risk children: Those with mild to moderate eczema should be introduced to peanut foods around 6 months either at home or under the supervision of a healthcare provider, depending on family and cultural preferences.
- High risk children: Those with severe eczema or egg allergy or both are considered high risk. They should first be evaluated with a blood test or skin prick test as early as 4-6 months before being introduced to peanut products under supervision by a healthcare provider.
In addition, the report noted children should first be introduced to other solid foods before trying peanut products. Whole nuts should not be given to children under 5 years of age. Peanut butter directly from a spoon or in lumps/dollops should not be given to children less than 4 years of age. Instead, parents can dilute peanut butter or peanut flour, mix it with a fruit or vegetable puree or feed their children peanut puff products.
Coverage of the new guidelines is widespread, with many experts offering their support of the guidelines:
- According to an ABC News report, the recommendations are based on landmark research that found early exposure is far more likely to protect babies from developing peanut allergies than to harm them. The guidelines spell out exactly how to introduce infants to age-appropriate peanut products depending on whether they’re at high, moderate or low risk of becoming allergic as they grow.
- “Many, many people were asking their doctors, their pediatricians, ‘We’ve heard about this wonderful information; what should we do?’” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases told CNN. “The professional societies — such as the American Academy of Pediatrics, the American Academy of Family Physicians, the American Academy of Allergy, Asthma & Immunology, etc. — all decided they needed to get together and sit down in a few meetings and put together some guidelines.”
- “This update to the peanut guidelines offers a lot of promise,” allergist Dr. Stephen Tilles, president of the American College of Allergy, Asthma and Immunology (ACAAI), said in a statement to CBS News. “Peanut allergy has literally become an epidemic in recent years, and now we have a clear roadmap to prevent many new cases moving forward.”
- For years, pediatricians advised avoiding peanuts until age 3 for children thought to be at risk. But the delay didn’t help, and that recommendation was dropped in 2008, although parent wariness of peanuts persists, according to theAssociated Press. Dr. Scott Sicherer, who represented the American Academy of Pediatrics on the guidelines panel, says “it’s old news, wrong old news, to wait.”
- The recommendations provide guidance about how to safely introduce young children to peanuts from an early age, depending on their risk level of developing an allergy. An article in TIME magazine states the hope is that by introducing peanuts early enough to children who might be allergic to them, doctors may be able to prevent them from ever developing a full-fledged allergy. While it’s not entirely clear how that happens, some kind of tolerance is likely involved.
- Allergic Living reports in the LEAP study, early consumption of peanut reduced the risk of developing peanut allergy by 86 percent for children with negative skin prick tests and by 70 percent for those who were mildly sensitized infants.
- The Washington Post reminds parents that a child’s pediatrician should go over the signs of an allergic reaction, but including things like a hivelike rash, vomiting, coughing, wheezing or a child otherwise looking lethargic or ill.
- “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,” Dr. Greenhawt, chairman of the American College of Allergy, Asthma and Immunology’s food allergy committee told The New York Times. “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.”