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To prevent a peanut allergy, feed kids peanut products early

Gregory Owens, MD

Peanut allergies can be disruptive and scary. Kids and adults who live with them have to be vigilant about what’s in every bite. And while people may outgrow other food allergies, most peanut allergies are lifelong, making it particularly important to prevent them.

For many years, parents were told not to feed peanut products to children under three if those children were at risk of an allergy. That advice coincided with a sharp increase in allergies: Between 1997 and 2008, peanut allergies more than tripled in the U.S. and U.K.

One particular U.K. allergist, Dr. Gideon Lack, noticed that compared with the children in his country, Israeli children were far less likely to be allergic. In fact, the rate of peanut allergies in Israeli children was about one-tenth that of Jewish children in the U.K. He and his team hypothesized that the difference was due to the fact that Israeli children eat lots of Bamba—a snack made of corn and peanut protein—early in life.

Lack went on to lead a study published in The New England Journal of Medicine that concluded that early, regular introduction of peanut snacks can decrease the risk of developing a peanut allergy by as much as 86 percent. While the study focused specifically on kids who were already at increased risk for food allergies, it was enough to prompt additional research and, in 2017, new advice for doctors and parents. Peanut protein should be given to infants sooner rather than later—with some important safeguards.

According to the American Academy of Pediatrics:

  • In high-risk infants (those with an egg allergy or severe eczema) allergy testing is strongly advised. Depending on the results, peanuts may be introduced either at home, in a supervised office setting, or in a special facility, as early as 4 to 6 months old.
  • In infants with increased risk (those with mild to moderate eczema), peanuts should be introduced around 6 months of age in order to reduce the risk of a peanut allergy.
  • In infants without eczema or food allergies, peanuts may be introduced freely into the diet.

Parents of babies and children who are at an elevated risk should work closely with their pediatrician or allergist to develop a plan that’s appropriate for their child.

It’s important to remember that peanuts and peanut butter are a choking hazard in small children. Bamba is available in grocery stores and is a good option for kids who are able to handle solid foods. For infants and others, peanut butter should be watered down and turned into a warm puree. No matter what, it’s important to monitor babies closely. If you have questions about introducing peanuts, talk to your child’s pediatrician or allergist.

Dr. Gregory Owens is an allergist and immunologist at Vancouver Clinic. He treats asthma, food allergies, seasonal allergies, and other conditions in adults and children.