Experts say babies should be fed peanut protein early to reduce allergy risk. But a new survey says most parents aren't so sure. Here's what you need to know.
Instead of avoiding all peanut products for fear of allergies, the current advice is to introduce peanut foods to babies as young as 4-6 months to help reduce the risk. But although groups like the American Academy of Pediatrics endorse this new feeding guidance, many parents still aren't aware of the switch—and most aren't convinced they should put it into practice, according to a new survey.
Though the old feeding wisdom was to avoid any foods containing peanut until preschool-age and beyond, guidelines changed after a study found that giving peanuts early actually helped reduce the risk of developing allergies, especially for kids at high risk. The AAP, along with other health organizations, endorses this plan saying, "There is now scientific evidence that health care providers should recommend introducing peanut-containing products into the diets of 'high-risk' infants early on in life (between 4 and 11 months of age) in countries where peanut allergy is prevalent because delaying the introduction of peanut can be associated with an increased risk of peanut allergy."
But in a recent survey of pregnant women and new mothers published in Annals of Allergy, Asthma, and Immunology, almost a third said they hadn't heard about the new guidelines, and more than half said they didn't consider following the new guidelines to be important. Only 31 percent said they would be willing to introduce peanut to their baby around six months of age.
With rates of food allergy increasing—and allergies to peanut among the most common and potentially life threatening—it makes sense to do everything you can to help prevent them. So here's a breakdown of the current guidelines:
If your child has a high-risk of allergy due a history of egg allergy or severe eczema: Talk to your child's pediatrician about seeing a specialist for allergy testing and advice on introducing peanut. If the allergy test is negative for peanut, talk with the specialist about introducing it between 4-6 months of age--and whether the first feeding should take place in a healthcare provider's office.
If your child is at mild to moderate risk of allergy because of mild or moderate eczema: Introduce peanut-containing foods starting around six months when beginning solids.
If your child is not at increased risk: Introduce peanut foods at any time after starting solids (but aim to include them the first year).
When you're ready to start giving peanut, do the first feeding when your child is healthy, and free from colds and other bugs. Do the initial feeding at home, not at daycare or at a restaurant, and be sure there's an adult supervising at all times. Avoid whole nuts and globs of nut butter, which are choking hazards for children under the age of four. Instead, try one of these suggestions from the National Institutes of Health:
- Thin two teaspoons of smooth peanut butter with two teaspoons of hot water and stir until dissolved. Allow it to cool, then thin it more if needed before feeding.
- Combine two teaspoons of smooth peanut butter (or two teaspoons of peanut butter powder) with 2-3 tablespoons of a tolerated fruit or vegetable puree and stir until smooth.
- Offer your baby peanut-containing puffs such as Bamba. Though they're soft enough to melt in the mouth, soften them even more with water for babies younger than seven months.
When giving that first peanut feeding, wait 10 minutes after the initial taste to watch for signs of allergy. If things look good, continue with the feeding. Signs of a mild allergy include a new rash or hives around the mouth or on the face. Red flags of a severe reaction (which requires immediate medical help) include swollen lips or tongue, vomiting, and trouble breathing.
If your baby tolerates peanut just fine, continue to serve it regularly. The NIH guidelines suggest three times a week to continue to expose babies to peanut protein.
And keep in mind that while peanut allergies are on the rise (and scary for sure!), the vast majority of kids--98 percent--won't develop a peanut allergy.
Get more information about introducing nuts to babies, as well as nut recipes here.
Sally Kuzemchak, MS, RD, is a registered dietitian, educator, and mom of two who blogs at Real Mom Nutrition. She is the author of The Snacktivist's Handbook: How to Change the Junk Food Snack Culture at School, in Sports, and at Camp—and Raise Healthier Snackers at Home. She also collaborated with Cooking Light on Dinnertime Survival Guide, a cookbook for busy families. You can follow her on Facebook and Instagram. In her spare time, she loads and unloads the dishwasher. Then loads it again.