by Dana Crosby, MD
Why Is It Important?
- Peanuts are the number one cause of death from food induced anaphylaxis, or severe allergic reaction of the body, in the United States.
- Peanut allergy is typically a lifelong problem.
- Risk of death related to peanut allergies leads to significant stress and anxiety for the patient and their family.
- The rate of peanut allergy has been increasing. In 1999 peanut allergy affected only 0.4% of children, but by 2010 this increased to 2% of children.
Why Is There Confusion?
- In the late 1990s the recommendation from multiple medical societies was to avoid peanut containing foods in infants thought to be at risk of developing food allergies.
- As recent as 2010 medical societies guidelines still recommended avoidance of peanut containing foods until the toddler years.
- Recommendations have now changed dramatically!
Why Have The Recommendations Changed?
- A very important research study was published in 2015, called the Learning Early about Peanut Allergy (LEAP) trial.
- This study showed over an 80% decrease in risk of developing peanut allergy when peanut containing foods were given early in infants who were at high risk of food allergy.
- The LEAP trial showed that introducing peanut containing foods early was safe and protective for most infants.
- If an infant has no eczema (red, itchy skin) and no known food allergy, parents should introduce peanut containing foods early at a time that is right for the family, typically between ages 6 to 8 months.
- If an infant has mild to moderate eczema (red, itchy skin), introduce peanut containing foods around 6 months of age.
- If an infant has severe eczema (red, itchy skin) or egg allergy, discuss giving peanut containing foods to infant with pediatrician and/or allergist.
- Give other solid foods first to ensure your child is able to eat solid foods.
- All peanut butter should be avoided in children under 4 years of age.
- Do not feed whole peanuts or chunky peanut butter to children under 5 years of age as it could cause choking.
- Peanut butter can be introduced in multiple ways. Peanut butter containing recipes and food products suitable for infants are available online.
- Introduce peanut containing foods only when your child is healthy. If they are experiencing a cold, vomiting, diarrhea, or other illness wait until they have recovered.
- Give first peanut containing food at home when your child can be supervised directly for at least 2 hours to watch for signs of a reaction.
- Common signs of food allergy are rash, swollen lips or tongue, itching, vomiting, coughing, wheezing, difficulty breathing.
- If you are concerned that your child is having a reaction, seek medical attention immediately. Call 911.