Most parents know that peanuts can cause a life-threatening allergic reaction in some people. Many schools, daycares and summer camps don’t let children bring peanut products for lunch or snack. Even Southwest Airlines won’t pass out peanuts if a passenger has a peanut allergy.
In the past 15 years, the number of U.S. children affected by peanut allergy has tripled, to an estimated 1 in 50 elementary school children.
In Austin, the number of children with food allergies—particularly peanut allergy—is increasing every year, says Dr. Scott Oberhoff, an Austin physician who is board certified in allergy, pediatrics and internal medicine. “I see children with these problems on a daily basis. It is often incredibly disruptive for the child and the family.”
The medical community has struggled to find a solution. Because peanut allergy develops early in life, recommendations focus on babies and young children.
In 2000, the American Academy of Pediatrics (AAP) recommended not to give peanuts to babies and young children at higher risk of peanut allergy. Mothers were advised to avoid peanuts during pregnancy and while nursing. Parents were told not to let the child to have peanuts until after age 3.
But then in 2008, the AAP withdrew these recommendations because they didn’t seem to help.
Earlier this year came a shocking reversal by the AAP and 10 other medical organizations from all over the world. Instead of waiting longer to introduce peanut products, the best thing is to give peanuts sooner. The reason behind this big change was new scientific research.
Researchers noticed that a group of children in the U.K. had 10 times the risk of peanut allergy as a similar group in Israel. Turns out in the U.K., most babies don’t eat peanut-based foods until after age 1. But in Israel, a peanut corn puff snack called Bamba is often introduced at around 7 months.
This observation led to new research published in the New England Journal of Medicine earlier this year. The important message to parents? Giving babies food that contains peanuts helps protect them from developing peanut allergy.
“This research is the best guide to date for a method to prevent peanut allergy in children,” Dr. Oberhoff says. “It actually shows a big difference between kids who ate peanut products early and those who avoided it.”
When to Introduce
The ideal window for introducing peanut products is between 6 and 11 months of age, says Dr. Oberhoff. “If peanut is introduced before or after this window, protection may not occur.”
“The child’s history of reactions or lack of reaction with eating peanuts remains the most important tool in assessing risk,” Dr. Oberhoff says. “This is more important than any blood testing or skin testing that has been performed.”
How to Introduce
Dr. Oberhoff agrees that introducing peanut products can be scary for parents. “One of the concerns I hear is ‘Will giving peanuts cause a reaction?’ Reactions are possible, but in the research, none of the children had a severe reaction. This is interesting because the children were selected because they were at higher risk for food allergy. This is reassuring for children who are not at higher risk.”
Brenda Schoolfield is a freelance medical writer in Austin.
How to Introduce Peanut Products to Your Baby
When. Introduce products made with peanuts during the time you start giving solid foods. The AAP recommends solid foods be introduced around 6 months of age. As with any new food, introduce one food at a time.
How. Mix a little peanut butter in cereal or applesauce for a baby. For a young child, thin the peanut butter in a sandwich with jelly, banana or something else.
How much. To limit the risk of a reaction, start slowly. Give a very small amount each time. If there are hives, vomiting, coughing or other reactions, stop immediately and consult an allergist. If there are no reactions, gradually increase the amount. In the research, babies were given a total of about one tablespoon of peanut butter each month.
Where. Some experts recommend giving the first bite at home, instead of at daycare or a restaurant.
Don’ts. Don’t give whole peanuts to a baby or child under 4 years old. Even if a child has teeth and can chew, whole peanuts are a serious choking hazard. Also, don’t give your child a plain spoonful of peanut butter. Peanut butter is thick and can get stuck in the throat and cause choking.
If your child is at higher risk for food allergy problems, see an allergist to discuss when and how to introduce foods containing peanuts.
“Higher risk” means:
- The child’s parent or sibling has a documented allergic condition, such as an allergy to eggs.
- The child has asthma, allergic rhinitis or eczema.
- The child has had a reaction to peanut products, such as rash, cough or vomiting.