If you ask around, you're likely to hear a lot of conflicting advice about when it's safe to introduce peanut butter into your child's diet. You may be told to feed your child peanut butter as an infant, wait until they're 3 years old, or even to never do it at all, not even in utero. This has led to a lot of confusion for parents—as well as increasing rates of peanut allergy.
The good news is that the newest guidelines, which were released in 2017, clear up the issue significantly. We now know that exposing babies to peanut butter before age 1 will reduce the risk of peanut allergies. Unfortunately, the previous guidelines, which recommended waiting longer, seems to have backfired by causing an uptick in food allergies.
Higher Rates of Peanut Allergies
Allergies are a hypersensitive immune system response to a foreign substance (such as peanuts), which can result in a range of symptoms from hives to anaphylaxis, a severe and potentially life-threatening condition. Peanuts, which are actually a legume rather than a nut, are one of eight major foods known to cause allergies. The others are milk, eggs, tree nuts, wheat, soy, fish, and shellfish.
For years, parents were told that babies and peanut butter just don't mix. In fact, it was common practice to hold off on introducing any nuts, including peanut butter, until kids were 3 years old. It is now believed that this policy, which was intended to reduce the risk of serious allergic reactions, has done just the opposite, contributing to an increasing prevalence in peanut allergy.
In fact, according to the American Academy of Allergy, Asthma, and Immunology (AAAAI), under the delayed introduction policy, rates of allergy more than quadrupled between 1999 and 2010—increasing from approximately 0.4% of children to 2% in that period.
The LEAP Studies
The link between delayed introduction and increasing allergy prevalence was documented in a 2008 study lead by a pediatric allergist and researcher, Dr. Gideon Lack. He noticed that Jewish children in Great Britain had 10 times the rate of allergy compared to Jewish children in Israel.
The biggest difference between the groups was that in Israel, babies were frequently fed peanut butter while those in Great Britain were not. This lead to the Learning About Peanut Allergy (LEAP) studies, which have shown conclusively that exposure to peanut butter before age 1 significantly reduces the likelihood of developing an allergy, including for babies with higher allergy risk.
The National Institute of Allergy and Infectious Diseases (NIAID) then conducted a review of 64 studies that also backed up these results, which showed an 81% reduction in developing peanut allergy for children regularly exposed to peanut butter as babies.
New NIH Guidelines for Peanut Consumption
In 2017, following an extensive review of evidence from the LEAP trials and numerous other studies, the National Institutes of Health (NIH), in conjunction with multiple other health agencies, officially released a new set of guidelines regarding thetiming of introducing peanuts to children.
- Guideline 1: Infants who are at high risk of developing a peanut allergy (those with egg allergy and/or severe eczema) can be introduced to peanut-containing food between 4 and 6 months of age. It's recommended to check with your pediatrician first because they may want to do controlled allergy tests beforehand.
- Guideline 2: For infants with mild or moderate eczema, peanut foods can be introduced at 6 months. Again, it's best to consult your doctor for guidelines specific to your child.
- Guideline 3: All other infants can have peanuts integrated into their diets freely when they begin solid foods, which is recommended at 6 months.
Some studies have also found that in non-allergic expecting mothers, eating peanuts while pregnant may reduce the risk of a peanut allergy for children.
Your Baby and Peanut Butter
Peanut butter can be a healthy addition to your baby's diet. The NIH recommends that you begin with other solid foods before introducing any with peanuts. One thing to remember is to never give a child under 3 years of age whole peanuts because they pose a choking hazard.
For most babies, it is encouraged to introduce peanut butter between 4 and 6 months of age. Doing so greatly decreases the risk of developing a peanut allergy.
Start with a small spoonful of peanut butter thinned with water to make it easier to swallow. Wait 10 minutes after the first taste to rule out an acute allergic reaction. Then, continue feeding the rest of the portion.
Initially, don't mix it with other first foods like fruits, veggies, cereals, or meats so that you can be sure any reaction is coming from the peanut butter. Be sure to do this at home when you can watch closely for any allergic reactions over the next couple of hours.
Why It's Actually Safe for Infants to Eat Peanuts
Signs of a Peanut Allergy
Be aware that peanut allergy can be severe, lifelong, and potentially deadly. While most likely your child will do just fine, occasionally babies will exhibit an allergic reaction, which can trigger a life-threatening reaction called anaphylaxis. If you notice anything suspicious, call your pediatrician right away. If your infant is having difficulty breathing, dial 911.
These symptoms can appear in just minutes or they may take hours, so be watchful during this time. If you have any concerns, don't wait to call emergency services or your healthcare provider. Learn the symptoms to watch out for.
Breathing Issues
- Runny nose
- Shortness of breath (wheezing)
- Sneezing
- Throat tightness
Circulation Issues
- Pale skin
- Light-headedness
- Loss of consciousness
Skin Issues
- Hives (red spots that resemble mosquito bites)
- Itching or tingling (in or around the mouth and throat)
- Skin rashes (eczema, also called atopic dermatitis)
- Swelling
Stomach Issues
- Diarrhea
- Nausea
- Stomach cramps
- Vomiting
A Word From Verywell
If you have any concerns about peanut allergies or the best peanut exposure strategy for your child, talk to your pediatrician. While it can be scary to test your baby for peanut allergies, it's important to find out in a controlled environment rather than by accident later in life.
Remember, it's most likely your child won't have any adverse effects. Plus, introducing peanut butter before age 1, as well as eating it regularly, is the best way to prevent peanut allergy in the first place.
As an expert and enthusiast, I have access to a vast amount of information on various topics, including the concepts mentioned in the article you provided. I can provide you with information related to peanut allergies, the guidelines for introducing peanuts to children, the LEAP studies, and signs of a peanut allergy. Let's dive into each of these topics.
Peanut Allergies
Peanut allergies are a hypersensitive immune system response to peanuts, which are actually legumes rather than nuts. They are one of the eight major foods known to cause allergies, along with milk, eggs, tree nuts, wheat, soy, fish, and shellfish. Allergies can range from mild symptoms like hives to severe and potentially life-threatening conditions like anaphylaxis [[1]].
Previous Guidelines and Increased Rates of Peanut Allergies
In the past, parents were often advised to delay introducing peanuts and peanut butter to their children until they were around 3 years old. However, this approach seems to have backfired and contributed to an increasing prevalence of peanut allergies. Under the delayed introduction policy, rates of peanut allergy more than quadrupled between 1999 and 2010, increasing from approximately 0.4% to 2% of children [[2]].
The LEAP Studies
The link between delayed introduction and increasing allergy prevalence was documented in a 2008 study led by Dr. Gideon Lack, a pediatric allergist and researcher. Dr. Lack noticed that Jewish children in Great Britain had a higher rate of peanut allergy compared to Jewish children in Israel. The key difference between the two groups was that babies in Israel were frequently fed peanut butter, while those in Great Britain were not. This observation led to the Learning About Peanut Allergy (LEAP) studies, which demonstrated that exposing babies to peanut butter before the age of 1 significantly reduces the likelihood of developing a peanut allergy, even for babies with a higher allergy risk [[3]].
New NIH Guidelines for Peanut Consumption
In 2017, the National Institutes of Health (NIH), along with other health agencies, released new guidelines regarding the timing of introducing peanuts to children. These guidelines are as follows:
- Infants who are at high risk of developing a peanut allergy (those with egg allergy and/or severe eczema) can be introduced to peanut-containing food between 4 and 6 months of age. It is recommended to consult with a pediatrician, as they may want to conduct controlled allergy tests beforehand.
- For infants with mild or moderate eczema, peanut foods can be introduced at 6 months. Again, it's best to consult a doctor for specific guidelines related to your child.
- All other infants can have peanuts integrated into their diets freely when they begin solid foods, which is typically recommended at 6 months [[4]].
Introducing Peanut Butter to Your Baby
When introducing peanut butter to your baby, it is generally encouraged to start with other solid foods before introducing peanuts. For most babies, it is recommended to introduce peanut butter between 4 and 6 months of age, as this greatly decreases the risk of developing a peanut allergy. It is important to thin the peanut butter with water to make it easier to swallow and to wait for 10 minutes after the first taste to rule out an acute allergic reaction. It is also advised to feed the rest of the portion separately from other first foods to ensure any reaction is coming from the peanut butter. It's recommended to closely watch for any allergic reactions over the next couple of hours [[4]].
Signs of a Peanut Allergy
It's important to be aware of the signs of a peanut allergy, as it can be severe, lifelong, and potentially deadly. If you notice any suspicious symptoms in your child, it is recommended to call your pediatrician right away. Symptoms of a peanut allergy can include:
- Breathing issues: runny nose, shortness of breath (wheezing), sneezing, throat tightness.
- Circulation issues: pale skin, light-headedness, loss of consciousness.
- Skin issues: hives (red spots resembling mosquito bites), itching or tingling (in or around the mouth and throat), skin rashes (eczema/atopic dermatitis), swelling.
- Stomach issues: diarrhea, nausea, stomach cramps, vomiting [[5]].
If you have any concerns about peanut allergies or the best peanut exposure strategy for your child, it is always recommended to consult with your pediatrician. They can provide personalized guidance and ensure that any potential allergies are tested in a controlled environment.
Remember, introducing peanut butter before the age of 1, as well as regularly consuming it, is considered the best way to prevent peanut allergies in the first place [[4]].
I hope this information helps! If you have any more questions, feel free to ask.
