You may have heard recently that introducing peanuts into an infant’s diet early on can reduce his or her risk for developing a peanut allergy. Le Bonheur Allergist and Immunologist Jay Lieberman, MD, weighs in on this topic below.
We discussed this topic on the blog a few years ago -- when to introduce allergenic foods (e.g. peanut, egg, fish, shellfish) into your child’s diet. In that post we discussed introducing foods early (4-6 months of age) in average or low-risk children. In children who already had eczema or evidence of food allergy at that age, we recommended discussion with your pediatrician. New research has gives us additional guidance.
First, if your child does not have eczema or known food allergies by 4-6 months of age, not much has changed from the prior post.
Feel free to add age-appropriate foods starting at 4-6 months of age. This means foods that are not a choking hazard and are in an age-appropriate style. However, if your child already has eczema or a food allergy by 4-6 months of age, we now have new information that suggests early introduction of peanut may be a good thing. Based on recent studies, if your child has eczema and/or a known egg allergy by 4-10 months of age, then adding peanut to his diet early can reduce the risk of developing a peanut allergy.
So, what should you do?
- If your child has no eczema or food allergy, feed away. His or her risk for peanut allergy is low. I would still recommend milk only (breastmilk or formula) for 4 months. After that point, if you would like, feel free to add peanut-containing foods into his or her diet. There is no reason to delay. Make sure the foods are not a choking hazard -- for peanut, this can be done by thinning out smooth peanut butter with water. This goes for other foods as well.
- If your child has mild eczema (the kind of eczema that pretty easily controlled with lots of moisturizers and the occasional steroid cream), current recommendations are to introduce peanut-containing foods around 6 months of age. It is not likely necessary that he or she gets tested first.
- If your child has severe eczema and/or a food allergy already by 4-10 months of age, current recommendations are to have them evaluated for peanut allergy early. This can be done by a blood test by the pediatrician or a skin test by an allergist.
If the testing is negative, introducing peanut early -- between 4-6 months of age is recommended. This can decrease their chance of having peanut allergy as they grow.
If the testing is positive, recommendations are to see an allergist. Depending on how large their skin test is, the allergist may recommend a formal feeding challenge in the office. If they pass this, then they should continue eating peanut at home.
While we don’t know for sure if this concept extends to other foods, it is possible. Also, if you already have a kiddo at home that is allergic to peanut, discuss with your doctor if it is worth testing future infants early.