Peanut allergies are a big problem for many kids and their families, but new guidelines published could help protect high-risk tots and other youngsters, too, from developing the dangerous food allergy.
Feeding infants peanut butter when they are as young as four to six months old might prevent them from developing peanut allergies, according to research released from the National Institute of Allergy and Infectious Diseases.
The new guidelines from the National Institutes of Health mark a change from past recommendations, which urged parents to delay giving children foods containing peanuts in their first few years. Peanut allergies can cause hives, rashes, breathing problems, and in the most severe cases, can even be fatal.
"It's old news, wrong old news, to wait," said Dr. Scott Sicherer, who represented the American Academy of Pediatrics on the guidelines panel.
Thursday's guidelines make that clear, urging parents and doctors to proactively introduce peanut-based foods early.
"Just because your uncle, aunt and sibling have an allergy, that's even more reason to give your baby the food now" — even if they're already older than 6 months, added Sicherer, a pediatric allergist at Mount Sinai Hospital in New York.
One key here is knowing your child’s risk for developing a peanut allergy, as children with the highest risk have eczema and/or an egg allergy.
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A doctor or an allergist can test your child for peanut sensitivity. The number of American children allergic to peanuts has risen dramatically in recent decade, but the new guidelines may give new hope that allergy can be avoided.
Parents are advised not to give toddlers actual peanuts, which present a potential choking hazard.
In Columbus, Ohio, one doctor told Carrie Stevenson to avoid peanuts after her daughter was diagnosed with egg allergy. Then Stevenson found an allergy specialist who insisted that was the wrong advice — and offered baby Estelle a taste test of peanut butter in his office when she was 7 months old.
"I was really nervous," Stevenson recalled, unsure which doctor to believe. But, "we didn't want her to have any more allergies."
Now 18 months old, Estelle has eaten peanut butter or peanut-flavored puffs at least three times a week since then and so far seems healthy. Stevenson, pregnant again, plans early exposure for her next child, too.
The guidelines recommend:
- All babies should try other solid foods before peanut-containing ones, to be sure they're developmentally ready.
- High-risk babies should have peanut-containing foods introduced as early as 4 to 6 months after a check-up to tell if they should have the first taste in the doctor's office, or if it's OK to try at home with a parent watching for any reactions.
- Moderate risk babies have milder eczema, typically treated with over-the-counter creams. They should start peanut-based foods around 6 months, at home.
- Most babies are low risk, and parents can introduce peanut-based foods along with other solids, usually around 6 months.
- Building tolerance requires making peanut-based foods part of the regular diet, about three times a week.
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What's the evidence? First, researchers noticed a 10-fold higher rate of peanut allergy among Jewish children in Britain, who aren't fed peanut products during infancy, compared to those in Israel where peanut-based foods are common starting around age 7 months.
Then in 2015, an NIH-funded study of 600 babies put that theory to the test, assigning them either to avoid or regularly eat age-appropriate peanut products. By age 5, only 2 percent of peanut eaters — and 11 percent of those at highest risk — had become allergic. Among peanut avoiders, 14 percent had become allergic, and 35 percent of those at highest risk.
Whether the dietary change will spur a drop in U.S. peanut allergies depends on how many parents heed the new advice — and if a parent seems skeptical, the guidelines urge doctors to follow up.