As a new parent, introducing peanuts to your baby can be a confusing and stressful time. You’re not alone! But don’t worry – I break it all down in this post: the why, when, what and how!
Introducing new foods to babies can be an exciting, yet sometimes stressful time for parents. With all the options out there of which foods to introduce first it’s hard to know what to choose. If you have food allergies in your family, it can be even more stressful to introduce new foods to your baby.
With the latest research now suggesting to introduce peanuts to infants earlier, rather than later, some parents have questioned how to do this.
Why did the recommendations for introducing peanuts to your baby change?
If you’ve heard the old recommendation that you should wait until after 1 (or later) before introducing peanuts to your baby to help reduce risk of allergy – it’s time to throw it out the window. New research has actually shown introducing peanuts at an earlier age is more likely to reduce the risk of developing an allergy, rather than waiting, especially in those at high-risk for developing an allergy.
The updated guidelines are based primarily on the “Learning Early About Peanut (LEAP)” trial study. The study randomized 640 infants from 4-11 months of age with severe eczema and/or egg allergy to consume or avoid peanuts until 60 months (5 years) of age. The study excluded infants who tested highly positive to peanuts on skin prick tests, assuming they already had a peanut allergy. The remaining infants were categorized into 2 groups: infants who had no reaction to peanuts (negative) on the skin prick tests and those who had a mild reaction (positive).
The results showed that in the negative reaction group, the prevalence of peanut allergy at age 5 was 13.7% in the avoidance group vs. 1.9% in those who consumed peanuts. Among those in the positive group, the prevalence of peanut allergy was 35.3% in the avoidance group and 10.6% in the consumption group.
With the results showing a big difference in developing a peanut allergy in those who consumed peanuts vs. those who avoided peanuts, the recommendation of waiting to introduce peanuts changed.
What are the new guidelines?
The table below summarizes the American Academy of Pediatrics guidelines into three risk categories and introduction recommendations for each.
Group 1 (high risk): If your baby has severe eczema, defined as persistent or frequently recurring eczema assessed as severe by a health care provider and requiring frequent need for prescription-strength medication(s) and/or an egg allergy, you should talk with your pediatrician or other health care provider about possible food allergy testing before introducing peanuts. This would be a good topic of conversation at your baby’s 4 month well baby does that all mean?
After talking with the doctor and discussing any results of the food allergy testing, you can decide how and when to introduce peanuts to your baby. This might be supervised in the doctor’s office as an oral food challenge, or could be done at home.
According to these new guidelines, it’s recommended to introduce peanut-containing foods to infants at high-risk of allergy between 4-6 months of age.
Group 2 (medium risk): If your baby has mild to moderate eczema, they are also at an increased risk of peanut allergy. After other solid foods have been successfully introduced at home, it is recommended to introduce peanut-containing foods around 6 months of age. You can introduce peanuts at home when and how it works for your family.
If you are worried, you can always ask your baby’s health care provider for an in-office evaluation before introducing peanut-containing foods.
Group 3 (low risk): This group includes everyone else: infants without eczema or egg allergies who are not at increased risk for peanut allergy. Parents can “freely” introduce peanuts to their baby with other solid foods when and how it works for your family.