Parents should expose infants to peanut-based foods to prevent allergy
WASHINGTON, D.C. — Most babies should start eating foods that contain peanuts well before their first birthday. This is new advice. It's different from what parents have been told before. These new guidelines aim to protect children from developing a dangerous allergy to peanuts.
The guidelines from the National Institutes of Health (NIH) are based on new, important research that found that trying peanuts early dramatically lowers a baby's chances of becoming allergic. The NIH is a government group that does health research.
NIH's New Advice
The group's advice spells out exactly how to introduce infants to peanut-based foods and at what age. For some babies, it could be as early as 4 to 6 months old. It depends on whether they're at high, moderate or low risk of developing one of the most troublesome food allergies.
"We're on the cusp of hopefully being able to prevent a large number of cases of peanut allergy," said Dr. Matthew Greenhawt. He studies allergies and is a member of the NIH-appointed panel that wrote the guidelines.
Some babies are at high risk because they have a severe form of the skin rash eczema or egg allergies. They need a check-up before any peanut exposure. It might be best for them to get their first taste of a peanut-containing food in the doctor's office just in case they have a bad reaction.
For other tots, most parents can start adding peanut-containing foods to the diet, much like how they introduced oatmeal or mushed peas.
Babies should not be given whole peanuts or a big glob of peanut butter because they could choke. Instead, the guidelines include options like watered-down peanut butter or peanut-flavored puff snacks.
Getting Used To Peanuts Early
"It's an important step forward," said Dr. Anthony Fauci. He works with the NIH, which found experts to turn the research findings into user-friendly guidelines. "When you do desensitize them from an early age, you have a very positive effect."
Peanut allergy is a growing problem. About 2 percent of U.S. children must avoid the many types of peanut-containing foods. Otherwise, they risk severe or even life-threatening reactions.
For years, pediatricians advised avoiding peanuts until age 3 for children thought to be at risk. But the delay didn't help. So that guideline was dropped in 2008. However, parents still have been nervous about giving peanut-containing foods to their children.
"It's old news, wrong old news, to wait," said Dr. Scott Sicherer. He represented the American Academy of Pediatrics on the guidelines panel. He is a pediatric allergist at Mount Sinai Hospital in New York.
The new guidelines urge parents and doctors to introduce peanut-based foods early.
"Just because your uncle, aunt and sibling have an allergy, that's even more reason to give your baby the food now," even if the baby is already older than 6 months, Sicherer said.
Taste Test At Doctor's Office
In Columbus, Ohio, one doctor told Carrie Stevenson to avoid peanuts after her daughter was diagnosed with an egg allergy. Then Stevenson saw another doctor who offered baby Estelle a taste test of peanut butter in his office when she was 7 months old.
"I was really nervous," Stevenson recalled. But, "we didn't want her to have any more allergies."
Now 18 months old, Estelle has eaten peanut butter or peanut-flavored puffs at least three times a week since then. She seems healthy so far. Stevenson plans to give her next child peanut-containing food early, too.
The guidelines recommend that all babies should try other solid foods before peanuts. This will ensure they're ready for solid foods.
High-risk babies should have peanut-containing foods introduced as early as 4 to 6 months. This should happen after a check-up to tell if the babies should have the first taste in the doctor's office or at home.
Most babies are low-risk. This means parents can introduce peanut-based foods along with other solids around 6 months old. Building up the tolerance to avoid a peanut allergy requires making peanut-based foods part of the regular diet, which means consuming peanut foods about three times a week.
What's the evidence? First, researchers noticed a much higher rate of peanut allergy among Jewish children in Britain, who aren't fed peanut products during infancy, compared to those in Israel with similar genes. In Israel, peanut-based foods are common starting around age 7 months.
Then in 2015, an NIH-funded study put that theory to the test. Six hundred babies were assigned to either avoid or regularly eat peanut products. By age 5, only 2 percent of peanut eaters — and 11 percent of those at highest risk — had become allergic. Among peanut avoiders, 14 percent had become allergic and 35 percent of those at highest risk had become allergic.
Whether a change in diet will cause a drop in U.S. peanut allergies depends on how many parents heed the new advice. If a parent seems unsure, the guidelines urge doctors to follow up.