Early exposure to peanuts can prevent peanut allergies in babies, AAP says

I say this as a sufferer: Peanut allergies are the worst. I learned I was allergic to peanuts when I was 13 years old, and although my allergy isn’t severe, I choose not to bring peanuts or peanut products into my house. As a result, I was unable to expose my son to peanuts earlier in his life.

But after a landmark 2019 guideline change from the The American Academy of Pediatrics (AAP), the organization recommends parents introduce peanut-based purees to some babies before the age of 6 months as a way to potentially avoid life-threatening peanut allergies.

Strong evidence shows that early exposure to peanuts, along with other allergenic foods like eggs and fish, shouldn’t be avoided—and in fact, for children who are at higher risk of developing an allergy, exposure should start earlier than 6 months of age, the generally recommended time to start solid foods.

Related: Starting solids? Here’s everything you need

“We know that some children are predisposed to allergies because of their family history,” said Frank Greer, MD, FAAP, co-author of the clinical report, in a statement. “It’s clear that sometimes nutrition can play a key role in preventing or minimizing allergies that can be concerning—or even deadly—for some children.”

It makes sense that for some parents, the thought of serving up a potential allergen to their infant could be scary. A 2018 study published in Annals of Allergy, Asthma and Immunology found that a majority of new moms and moms-to-be surveyed were still hesitant to serve up peanuts, despite established recommendations from National Institute of Allergy and Infectious Diseases (NIAID), which the AAP has endorsed.

To be exact, 53% of respondents said they were wary of recommendations to try early peanut introduction, according to the survey results. Researchers also discovered that, overall, 61% of women surveyed said they weren’t that concerned with their child developing a food allergy. Only 31% of participants said they would be willing to try early introduction, the survey found.

About 6.1 million people in the US have an allergy to peanuts or tree nuts. In fact, a peanut allergy is the most common allergy among food-allergic children, according to Food Allergy Research & Education. The NIAID and the AAP say early exposure to peanuts could significantly decrease the chances of your baby developing a nut allergy.

When to introduce peanuts to baby

According to the guidelines, parents of babies who are at low risk of developing peanut allergies are encouraged to try peanuts at home, while babies at moderate or high risk should have peanut skin testing first, and depending on the results they can try peanuts as an oral food challenge at their specialist’s office.

Low risk: If there’s no known reason to be concerned that your child may have a food allergy, after your child turns 6 months old and has tolerated a few first foods, you can start to incorporate more commonly allergenic foods (like peanut powder mixed into a puree, a small amount of Greek yogurt and eggs, etc.).

Moderate risk: If your child has mild to moderate eczema, they are at an increased risk of developing peanut allergy. Introduce peanut-containing products around 6 months, and keep them as a consistent part of their diet to prevent a potential peanut allergy from developing. Your pediatrician may recommend allergy testing.

High risk: If your child has severe eczema or an immediate allergic reaction to any food, they are considered high risk of developing a future peanut allergy. Meet with your child’s pediatrician to discuss the best way to introduce highly allergenic foods such as peanut and eggs, though most experts recommend exposure should begin between 4 and 6 months of age. Allergy testing is recommended, and you may want to try an oral challenge test in the doctor’s office under supervision.

How to feed peanut butter to babies

Because peanut butter can be a choking hazard, it’s best to thin it first with warm water before offering to baby, or mix it in with another already-safe food. Another option is the corn- and peanut-based Bamba Peanut Snacks. Wait 10 minutes between the first and second tastes, and watch for a reaction in the two hours after eating.

Related: Does my baby have an allergy?

A note on introducing peanuts to baby

As someone with a peanut allergy, I totally understand why parents would hold off on introducing peanuts at such an early age. But there’s strong evidence to show that early introduction can have tremendous benefits in the long-term.

A version of this post was originally published March 22, 2018. It has been updated.