New Guidelines for Introducing Peanut-Containing Foods to Infants

January 27, 2017
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Approximately 2 percent of American children have some form of peanut allergy. The fact that some peanut allergies are so severe that they can lead to a life-threatening reaction known as anaphylaxis has led many parents to avoid giving peanut products to their children. Despite the over-abundance of caution, the incidence of peanut allergies appears to be growing. New guidelines published in the Journal of Allergy and Clinical Immunology challenges the idea that avoiding peanut products during infancy is the best policy.

Large-Scale Study Regarding Peanut Allergy Prevention:

The study was developed by researchers from the Immune Tolerance Network after observing that infants in Israel had a much lower incidence of peanut allergies than infants in other parts of the world. The researchers wanted to determine if there was a correlation between the lower incidence of peanut allergies and the common practice in Israel of feeding infants a peanut-containing snack during infancy.

The study followed more than 600 children who were at high risk of developing peanut allergies. One group was given a small amount of a food containing peanuts three times a week starting in infancy and continuing until the age of 5. The second group did not receive any peanut products before the age of 5. At the end of the study, each group of children was given peanuts. Approximately 18 percent of the children who had abstained from peanuts had an allergic reaction compared to only 1 percent of those who had been introduced to peanuts early in life. The peanut challenge was repeated the following year, and the children who did not have a peanut allergy initially were still free of peanut allergies. The researchers concluded that introducing peanut products while the immune system is still developing can prevent up to 80 percent of peanut allergies.

Guidelines for Introducing Peanut-Containing Foods to Infants:

• High-Risk Children

Infants with egg allergies, asthma, or a family history of peanut allergies are the most likely to develop peanut allergies. The new guidelines for high-risk infants recommend that parents either introduce a small amount of a peanut-containing food at 4 to 6 months of age or consult an allergist for a skin or blood test to determine if their child is allergic.

• Moderate-Risk Children

Children who have mild to moderate eczema are considered to have a moderate risk of developing peanut allergies. Parents are encouraged to give these children peanut-containing foods starting at 6 months of age.

• Low-Risk Children

Children without food allergies, eczema, or a family history of peanut allergies can be given peanut-containing foods at any age.

Of course, you should never give whole peanuts to infants since they pose a significant choking hazard.

What This Means for Other Food Allergies:

It is unclear if a similar approach can be used for other common food allergies. Researchers advise that more evidence-based studies are needed before they can issue guidelines regarding other allergies; however, determining if the approach is applicable for other allergies is a logical next step.

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Dr. Chacko and Dr. Sanjay Gupta on CNN. See the video here.