The New Rules of Introducing Peanuts: What Concerned Parents Need to Know

Experts weigh in on the new guidelines that encourage us to introduce peanuts to all kids much earlier.
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Everything you think you know about peanut allergies might be about to change. The National Institute of Allergy and Infectious Diseases has released a new set of rules for introducing kids to peanuts in the hopes of decreasing the prevalence of this widespread allergy.

At first glance, the guidelines may seem counterintuitive: Babies with a higher chance of developing a peanut allergy should actually be given foods containing peanuts earlier than those with less of a risk of allergic reaction.

The guidelines, released earlier this week, suggest parents should introduce peanuts to high-risk babies when they are between 4 to 6 months old. Infants with less of a risk can start these foods at 6 months or older, following the pattern of the family’s normal diet.

Previously, kids in danger of developing an allergy were supposed to avoid any contact with peanuts for the first three years of their lives, according to Hugh Sampson, M.D., director of the Elliot and Roslyn Jaffe Food Allergy Institute at Mount Sinai and a Parents advisor.

But the new guidelines mean children at high risk should have peanuts in their diet much sooner. “It's not only saying it's okay, it's saying you need to do it,” Dr. Sampson says.

So how can a parent know if their baby might be at high risk of developing a peanut allergy?

Two main signs your little one could be ready for a peanut intervention are egg allergies or severe eczema, according to the NIAID guidelines. Talk to your pediatrician if your child has either or both conditions; your doctor can do an allergy test to find out the best timing for introducing peanuts.

Whole peanuts are a choking hazard for infants and small children, says Drew Bird, M.D., director of the Food Allergy Center at Children's Health in Dallas and father of a baby starting to eat foods with peanuts. For your baby's first bites, you can stir a small amount of peanut powder into a puree or spread a thin layer of peanut butter on toast.

The sticky consistency of thick peanut butter can also be hard for little mouths to handle, so Dr. Bird recommends two teaspoons of smooth peanut butter mixed with two teaspoons of warm water for babies just starting solids.

It's also important to keep serving your child peanuts once they've been introduced. "Foods that are in the diet more frequently are less likely to cause problems down the road," Dr. Bird explains. The new guidelines recommend babies get two teaspoons, three times a week.

Dr. Bird also stresses that these guidelines are only for kids who are not already allergic. Children who have already been diagnosed with a peanut allergy should continue to use the same caution around peanut products as always.

If your child does have an allergic reaction, symptoms may include swelling lips, coughing, vomiting, or rashes that look like mosquito bites around the mouth or other parts of the body, and they would begin almost immediately after eating. If your child has a reaction, call your doctor immediately.

Libby Ryan is Editorial Assistant for Parents.com.

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