Parents who are wondering when exactly they should start feeding peanut-containing foods to their infants to reduce the children’s risk of peanut allergies can now turn to new guidelines.
The guidelines, which are sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), outline when and how parents should introduce peanut-containing foods to their children, depending on the child’s risk of developing a peanut allergy.
“We expect that widespread implementation of these guidelines by health care providers will prevent the development of peanut allergy in many susceptible children and ultimately reduce the prevalence of peanut allergy in the United States,” Dr. Anthony Fauci, director of NIAID, said in a statement.
The guidelines are based on recent studies that have found that feeding children peanut-containing foods early in life actually reduces the kids’ risk of developing allergies to this food.
For the guidelines, infants are divided into three groups: those at high, moderate and low risk for developing a peanut allergy. The recommendations for these groups are as follows:
High-risk infants: These infants already have severe eczema, a severe egg allergy or both, putting them at high risk for developing a peanut allergy. Infants in this group should be fed peanut-containing foods as early as 4 to 6 months, if they have already started eating solid foods, the guidelines state. However, parents whose children fall into this group should first check with their doctors before starting their infants on peanut-containing foods.
A doctor may recommend that the infant undergo an allergy test, or have peanut-containing foods fed to him or her for the first time at a doctor’s office, to determine whether it’s safe for the infant to start eating peanut. If it seems likely that the child is already allergic to peanuts, because of a very large reaction to a skin test for peanut allergies, then the doctor may suggest that the child avoid peanuts altogether, said allergist Dr. Matthew Greenhawt, of Children’s Hospital Colorado in Aurora, who was a co-author of the guidelines.
Moderate-risk infants: These infants have mild to moderate eczema. For these children, parents should introduce peanut-containing foods around 6 months of age, and parents do not need to seek evaluation from a doctor beforehand, the guidelines said. But parents can always consult with their doctors if they have questions.
Low-risk infants: These infants do not have eczema or an egg allergy. They can have peanut-containing foods freely introduced into their diets along with other solid foods, the guidelines said.
In the past, doctors recommended that children who were at high risk for food allergies should avoid potentially risky foods, such as eggs and peanuts, until they were 2 to 3 years old. But in recent years, experts have changed their views on this issue. One particularly influential study found that, among children at high risk for developing a peanut allergy, those who were fed peanut-containing food early in life were about 80 percent less likely to develop a peanut allergy, compared to those who avoided the food.
The new guidelines are the first to formally recommend early peanut introduction for kids with a high risk of developing allergies to peanuts.
It’s important to note that whole peanuts pose a choking risk to young children, and so parents should not feed whole peanuts to infants. Instead, parents could use age-appropriate foods, such as smooth peanut butter, the guidelines said.
The guidelines were published today (Jan. 5) in the Journal of Allergy and Clinical Immunology.