Peanut allergies can be severe, even life threatening, and require life-long vigilance to avoid exposure. However, new recommendations for new parents may greatly reduce the number of children who develop an allergy to begin with.

“Parents are now encouraged to introduce babies to peanuts by the time they’re six month olds,” says Aaron Pinion, DO. “This is a big change – previously the recommendation was at least 1 year old, or for children most at risk, age 3.”

“A large study completed in 2015 found there’s a window of opportunity where the immune system isn’t going to recognize peanut as dangerous,” says Hiba Bashir, MD. “That means introducing peanut proteins to a baby can actually help train their immune system to not overreact and cause a dangerous reaction.”

The Learning Early about Peanut Allergy (LEAP) study involved more than 600 infants. Researchers followed them for five years and found an 81 percent reduction in development of peanut allergy in infants.

The National Institute of Allergy and Infectious Diseases released new guidelines this past January based off the study to introduce peanut to babies. The guidelines divide children by risk:
• High risk: babies with severe eczema and/or egg allergy
• Moderate risk: babies with mild to moderate eczema
• Low risk: babies without eczema or food allergy

Those at low or moderate risk can be introduced to peanut protein about 6 months of age at home. Those at high risk should be introduced to peanut protein as early as 4 to 6 months, but only after consulting with the child’s doctor first.

How to introduce peanuts

Do not give a baby a plain peanut butter, peanut or bits of peanuts due to risk of choking. Fairview allergists recommend thinning out two teaspoons of peanut butter with warm water to make the consistency similar to their usual baby food. Alternatively, the peanut butter can be mixed with a fruit puree they’ve already been eating, for example apple, peaches or pears.

“It is important to only introduce one new food at a time so you can watch for signs of food allergy or sensitivity,” advises Dr. Pinion. “Give your infant a small taste, then wait 10 minutes. If no reaction – go ahead and feed as normal.”

What to look for

Allergist Yuriy Zgherea, MD, says the most common signs of an allergic reaction is hives, or the child appears to be itchy. More severe reaction can involve vomiting, diarrhea, choking, persistent cough, shortness of breath, wheezing and/or altered mental status.

“Allergic reactions to food tend to happen within minutes,” says Dr. Zgherea. “You should introduce peanuts at home so you can monitor them for a bit. If there’s going to be a reaction, it’ll happen right away or within the first two hours.”

For a mild reaction, symptoms may resolve on their own. “It’s always a good idea to keep an antihistamine in the house like Zyrtec,” says Bashir. “Talk your child’s doctor to determine the correct dose if needed.”

Severe reactions are rare, but if your child is wheezing, has difficulty breathing or a sudden drop in blood pressure, seek emergency care.

Early introduction of peanut protein to children won’t prevent 100% of peanut allergies in children, but the numbers are expected to decline.

When to see an allergy specialist

Parents should talk to their child’s primary care provider about their child’s allergies, then see a specialist if needed. Fairview’s allergy specialists treat infants, children and adults. In addition to food allergies, they provide treatment for seasonal and environmental allergies as well as eczema, chronic sinusitis and asthma.

To learn more visit fairview.org/allergy or call 855-FAIRVIEW for an appointment.