Cutting Peanut Allergy Risk

Growing incidence of peanut allergies

It’s not your imagination. More kids today have peanut allergies. One study shows three times more kids have a peanut allergy than they did 20 years ago, and statistics are on the rise. It’s why I get a lot of questions in my Methodist Physicians Clinic Hawthorne Court office from parents worried about how and when to introduce their child to peanuts. There’s a very real concern of your child having a life-threatening reaction.

New recommendations mean prevention

In previous years, it was thought that delaying the introduction of peanuts helped to decrease the risk of peanut allergies. However in the past couple of years, the National Institute of Allergy and Infectious Diseases (NIAID) published new recommendations based on an important study. This study performed in 2015 showed that early introduction of peanuts in infants at “high risk” of peanut allergy actually prevented peanut allergy. 

Although this is good news, it can still be quite difficult as a parent to know exactly how and when to introduce peanuts. An addendum published earlier this year gave more specific guidelines regarding when to introduce peanuts and how exactly to do that. It’s important to note while these are guidelines, you should always talk to your pediatrician about the appropriate time and way to introduce solids to your infant.

Guidelines for peanut introduction

The guidelines from the NIAID put infants into three different categories based on their risk level for developing peanut allergy. In all three categories, age-appropriate solid food should be introduced before peanut-containing food to ensure the child is developmentally ready.

High Risk Infants: Infants who are at high risk for peanut allergy have a history of severe eczema, egg allergy or both. After these infants have started to tolerate age-appropriate solid food, it is strongly recommended they be evaluated in their pediatrician’s or a specialist’s office for their risk of peanut allergy before introducing peanut-containing foods. Testing for the risk of peanut allergy consists of either a blood test or skin-prick test. Based on those results, your pediatrician or allergy specialist will give you recommendations regarding if and when it is safe to introduce peanuts to your child. 

Moderate Risk Infants: Infants at moderate risk of peanut allergy are those with mild to moderate eczema. In these infants, it is okay to introduce a small amount of peanut containing food at home around six months of age. Again, it is important to talk with your pediatrician regarding the difference between mild to moderate eczema and severe eczema to ensure you are keeping your child as safe as possible. 

Low Risk Infants: These are infants who have no history of egg allergy or eczema. Foods  containing peanuts can be safely introduced based on family preferences and developmental readiness, but most experts recommend around six months of age. 

How to introduce peanut

Whole peanuts are a choking hazard and can’t be introduced to young children. So how are you supposed to give your infant peanuts? One easy way I tell my parents to give peanuts to their child is to thin out a small amount of peanut butter in infant cereal or yogurt. You can also dissolve peanut puff cereal with breast milk or formula and spoon feed it to your infant. 

There are specific instructions and recipes that were published in the 2017 guidelines for introduction of peanut-containing foods that can be provided by your pediatrician. 

Some other helpful tips

• Your child should be healthy when you first decide to introduce the peanut-containing food. (No vomiting or other illness.)
• Make sure it is done at home and not at a restaurant, and there will be an adult available who will be free from distraction to monitor your infant.
• Give yourself at least two hours of time with your infant after introduction of the food to ensure there are no signs of allergic reaction.
• Signs of an allergic reaction include hives, lip or face swelling, color change, vomiting, trouble breathing, coughing or wheezing.
• If you have concerns regarding an allergic reaction, seek immediate care or call 911.

Again, any introduction of peanuts should be done with the guidance of your pediatrician, or contact my office at Methodist Physicians Clinic Gretna for more assistance.