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Head’s Up! There Are New Guidelines for Peanut Allergies in Infants!

Written by Carolyn Carlson, M.D. on Mar 15, 2017, 7:56:00 AM

After years of guidelines that instructed parents to hold off on giving young children peanut-related products, new guidelines endorsed by the American Academy of Pediatrics and other medical professionals say parents should introduce foods containing peanuts to children early and often, starting when they’re infants, as a way to avoid life-long peanut allergies. 

Sooner Rather Than Later 

Several recent studies have shown that feeding food that contains peanuts to infants can potentially reduce the risk of peanut allergies later in life. In response to these studies, the National Institute of Allergy and Infectious Diseases (part of the National Institutes of Health) issued the new guidelines which recommend giving babies pureed food or finger food that contains peanut powder or extract before they reach 6 months. But take note: Never give a baby whole peanuts or peanut bits because they are a choking hazard

Study Found Decreased Risk

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Peanut allergy affects about 2 percent of children in the United States and the number is growing. A serious peanut allergy can lead to anaphylaxis (acute, allergic reaction) and, rarely, even death. As a result, parents were advised to hold off on introducing peanuts until the toddler years, especially if there was a family history of allergies. 

But the recent Learning Early About Peanut Allergy (LEAP) Study and other scientific research has provoked a major change in the Guidelines for the Diagnosis and Management of Food Allergy in the United States used by pediatricians and other healthcare providers. The results of that study seem to indicate that introducing peanuts early in life significantly lowered the risk of developing peanut allergy by age 5.

Three Sets of Recommendations

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The new guidelines contain three separate sets of recommendations based on the level of risk an infant has for developing a peanut allergy: 

  • Those at highest risk are babies with severe eczema (a skin condition where patches of skin become inflamed, itchy, red and cracked) or egg allergy or both.
  • Those in the middle group have mild-to-moderate eczema.
  • And those in the lowest-risk group have no eczema or food allergies. 

Those children at highest risk should be exposed to peanuts earliest – at 4 to 6 months – and be referred to a specialist who might perform a blood or skin test before deciding how to handle their first exposure to peanuts. In some cases, it may be best for a child to be given peanuts for the first time in a doctor’s office, in other cases it can be done at home. 

Children who fall into the middle risk group should be fed peanuts when they are about 6 months old. This can be done at home. 

Those at lowest risk can have them at any time, also at home, and can typically start when about 6 months old, as well.

The guidelines also remind parents that all infants should first progress to solid foods such as pureed vegetables and cracker puffs before being exposed to peanuts. 

Consult Your Physician

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Before you introduce anything that could potentially be harmful to your child’s diet, be sure your child is examined by a pediatrician, and possibly an allergist, before that food is administered – especially if there is a preexisting condition that could signify an increased risk. 

If your physician does recommend giving your child food with peanut products in it, remember that peanut butter might be too thick, and peanuts themselves will definitely be too large. If your child is not old enough to chew on the peanut butter, some physicians recommend adding warm water to peanut butter to thin it down.

Here’s a link to a video showing a good way to thin peanut butter for easier feeding to babies.


Dr. Carlson is a board-certified pediatrician at Kelsey-Seybold’s Summer Creek Clinic. Her clinical interests include infectious diseases (both viral and bacterial), dermatologic diseases, development and Adolescent Medicine. 


Topics: new guidellines for peanut allergies in infants, when to introduce peanut products to babies

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