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Introducing Peanuts Early May Help Prevent Food Allergy, Study Finds

Introducing peanuts to baby
Introducing peanuts to baby.

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Key Takeaways

  • Peanuts are known as an allergenic food, and studies show it’s best to introduce them as one of baby’s first foods to decrease allergy risk. 
  • A new study shows that prevalence of peanut allergy in infants has decreased by 16% since guidelines suggested introducing peanuts earlier in life.
  • Dietitians recommend introducing diluted peanut butter or peanut puffs to baby, but not whole peanuts or thick peanut butter. 

Eight major food allergens—milk, eggs, peanuts, tree nuts, wheat, soybeans, fish, and shellfish—are responsible for the majority of food allergies in America.

Of these, peanuts are the most common food allergy in children, affecting about 25% of those with a food allergy.?? Sadly, this diagnosis can affect a child's quality of life, so any steps to prevent peanut allergy are welcome.

The prevalence of peanut or tree nut allergy appears to have more than tripled in U.S. children between 1997 and 2011. There is hope that the incidence will trend downwards due to revised guidelines that now recommend introducing peanuts to babies as one of their first foods.??

In 2016, the National Institute of Allergy and Infectious Diseases released Addendum Guidelines for the Prevention of Peanut Allergy in the United States. The guidelines recommend introducing peanuts to babies as early as 4-6 months of age.

Before these guidelines were established, it was common for caregivers to wait until their children were 1-3 years old before introducing peanuts.

Similar recommendations to introduce peanuts at an early age guide baby feeding in Australia. Their guidelines recommend that all infants, including those with eczema or other food allergies, have peanuts at around 4-6 months or within the first 12 months, when developmentally ready.

A recent abstract published in Allergy and Clinical Immunology looked at whether or not these new guidelines had an effect on the prevalence of peanut allergies, and found that allergy in infants had decreased by 16%.??

What the Study Found

After the 2016 change in the infant feeding guidelines in Australia, there was an increase in people introducing peanuts to their babies by 12 months of age. The aim of the researchers was to see the change in peanut allergy prevalence following the changes to infant feeding practices.

They compared a sample of 12-month-old infants from 2018-2019 to a sample recruited 10 years earlier (2007-2011). Questionnaires collected demographic and infant feeding data, and the babies had skin prick tests and food challenges to test for allergy.

The peanut allergy prevalence in 2018-19 was 2.6%, compared to 3.1% in 2007-11. The researchers report this as a 16% decrease in peanut allergy incidence.??

They also reported that in the 2018-19 group, 77.7% of infants consumed peanut before 12 months and 2.6% were peanut allergic, compared to 4.8% of those who avoided peanut until after 12 months.

“I am very encouraged by the results of this study,” says dietitian Jamie Johnson, owner at Ingraining Nutrition in Mt. Pleasant, South Carolina, and mom to a 1-year-old. “Hopefully this means peanut allergies are on the decline and parents can be at ease if their child comes into contact with peanuts unintentionally.”

Introducing Peanuts to Baby

Babies may get their first exposure to peanut protein while mom is pregnant. Yes, pregnant women can eat peanuts, explains Johnson.

If pregnant moms-to-be aren’t allergic to peanuts, I see no reason to avoid peanuts while pregnant. In fact, they are a great source of protein and folate, two important nutrients in pregnancy, and eating peanuts in pregnancy may even reduce the risk of the child having a peanut allergy,” says Johnson. 

And for babies, the study supports the benefit of introducing peanuts to your baby between 4 and 6 months of age. But why that large age range?

Jessica Gust MS, RDN

I recommend my clients introduce peanut protein and other top allergens to their baby around 6 months when their baby shows signs of developmental readiness for solids.

— Jessica Gust MS, RDN

Most guidelines, including those of the World Health Organization, recommend introducing your baby to solid food at 6 months. Other guidelines, including data from the American College of Allergy, Asthma, and Immunology, say that the sweet spot is between 4-6 months.

The Addendum Guidelines for Prevention of Peanut Allergy say earlier introduction (4-6 months) is warranted if the baby has severe eczema or egg allergy. Other babies can be fed peanuts at 6 months.?

“I recommend my clients introduce peanut protein and other top allergens to their baby around 6 months when their baby shows signs of developmental readiness for solids,” says Jessica Gust, pediatric dietitian and founder of Element Nutrition Kids.

Essentially, the right age is when your baby’s gag reflex and digestive tract have developed enough to accept solid food, and that’s usually at 6 months. Other signs of readiness for introducing sold food include:

  • Baby can sit with support, such as in a high chair.
  • Baby tends to open their mouth when food comes near it.
  • Baby shows interest in the food other people are eating.
  • Baby is able to move food to the back of their mouth without excessive drool and dribbling.

How to Introduce Peanuts

There are a few things to know about the right way to introduce peanuts to your baby.

Gust explains that caregivers need to use proper mixing to ensure there is enough peanut protein to identify a reaction. That includes two grams of peanut protein for the exposure.

She recommends one of the following three methods for introducing peanut protein to babies:

  • Cereal: Mix two teaspoons of creamy peanut butter into 2-3 tablespoons of previously tolerated baby cereal, thin with breastmilk, formula, or water to a consistency tolerated by your baby. 
  • Fruit/vegetable puree: Mix two teaspoons of creamy peanut butter into 2-3 tablespoons of previously tolerated fruit or vegetable puree, thin with breastmilk, formula, or water to a consistency tolerated by your baby. 
  • Peanut butter puffs: Mix 21 Bamba or similar puffs with 4-6 teaspoons of breastmilk, formula, or water to soften them.

“There are lots of other ways to provide peanut protein after the initial exposures, as well, such as lightly spread on toast, mixed into baked goods, in smoothies or popsicles,” says Gust. “Once you have established tolerance, you can use a variety of other methods to offer repeat exposure to peanut protein.”

It's not enough to introduce peanuts once. Repeat exposure is key.

Per the Addendum guidelines: "the total amount of peanut protein to be regularly consumed per week should be approximately 6 to 7 grams over three or more feedings."

The Do’s and Don’ts of Introducing Peanuts

“Parents should give peanuts in an age-appropriate form to prevent choking,” says Johnson. As outlined above, these include peanut puffs or peanut butter that’s been very diluted, so it’s not sticky.

“Parents definitely want to avoid giving whole peanuts and dollops of peanut butter to baby to avoid choking,” says Johnson. Whole peanuts are too large for a baby’s windpipe, and are a choking hazard.

Jamie Johnson RDN, LDN

Parents definitely want to avoid giving whole peanuts and dollops of peanut butter to baby to avoid choking.

— Jamie Johnson RDN, LDN

It’s also important to introduce peanuts when your baby is feeling well, and doesn’t have a cold or a fever. “You don’t want to question if your baby is having a reaction to an allergenic food or if it was due to whatever they were already fighting off,” says Gust.

Gust also recommends serving new foods early in the day, not before bedtime, so you can monitor for a reaction.

While early introduction of peanuts is recommended, pediatricians and allergists still say these guidelines are not fully understood.?? Hopefully studies like this will be headline news and show parents the benefit of the early introduction of peanuts.

What This Means For You:

If you are pregnant or feeding a baby, make sure that peanuts and other common allergens are part of meals and snacks. The early introduction of peanuts into your baby’s diet may help prevent peanut allergy but should be done under the guidance of your child's pediatrician.

 

 

 

 

 

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