The National Institute of Allergy and Infectious Diseases (NIAID) just released new guidelines for introducing infants to peanuts, and the news may surprise you. Now, the recommendation is that once your child hits the 6-month mark, you should begin introducing peanut-containing foods into their diet in order to reduce the chance of a peanut allergy later in life. Whole peanuts, of course, remain a choking hazard, but you can try foods like peanut butter or peanut flour. Always consult your pediatrician about which foods are appropriate for your child.
If this sounds like a complete reversal of conventional wisdom, it’s because it is. Previously, babies were supposed to avoid peanuts until age 3 or older, based on guidelines from the American Academy of Pediatrics released in 2000. It was thought that introducing peanuts too early in life might increase the risk an allergic reaction.
Now, based on new scientific research, the NAIAD, which is part of the National Institutes of Health, has published a set of guidelines on how to introduce peanut products to your baby. Of course you shouldn’t go crazy and just hand them a spoon and the jar of peanut butter (although if you want to do that as an adult, no judgement from us!).
Children are split into three categories: high risk, medium risk and low risk for allergies. Those at highest risk for a peanut allergy are babies with severe eczema, an egg allergy or both. Those who have mild to moderate eczema are at moderate risk, and those in the lowest-risk group have no eczema or food allergies.
According to Matthew Greenhawt, a physician at Children’s Hospital Colorado, the new guidelines are closely tied to eczema for a reason. Greenhawt, who is chair of the food allergy committee of the American College of Allergy, Asthma and Immunology, explained to the Washington Post that eczema is “an obvious external measure that has been linked to food allergies” for over a century. There’s no solid research that explains exactly why eczema and food allergies often go hand in hand, but children with the skin condition also have high levels of immunoglobulin E antibodies, which contribute to food allergies, hay fever and asthma.
Children at the highest risk for peanut allergies should be exposed at around 4 to 6 months, which is even earlier than the NIH recommendation for lower-risk infants. The NIH also suggests involving a specialist who can perform a blood or skin test before the initial exposure to peanuts. This will help determine whether the child should ingest them at home or in a doctor’s office. Infants in the middle-risk group can start trying peanuts at home at around the age of 6 months, as can low-risk babies.
“Living with peanut allergy requires constant vigilance. Preventing the development of peanut allergy will improve and save lives and lower health care costs,” NIAID Director Anthony S. Fauci, M.D. said in a statement. “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.”
You can read the full guidelines from the NIH here.