Exposing Kids to Peanuts Early May Prevent Allergy Later

Exposing Kids to Peanuts Early May Prevent Allergy Later

When I was growing up, PB & J was a lunch box staple, but due to the increase in peanut allergies (which has quadrupled over the past 13 years), many schools don’t allow children to take peanut products to school anymore for fear of anaphylaxis -- a severe, potentially life-threatening allergic reaction.

But the results from a new study found that exposure to peanut products may actually help decrease future peanut allergies -- and bring PB & J sandwiches back as a lunchtime staple.

The LEAP study (Learning About Peanut Allergy) released its groundbreaking data showing without a doubt that early introduction of peanuts to babies who were at least 4 months but less than 11 months of age decreased their chance of developing a peanut allergy. In the study, researchers found that kids who avoided peanuts until they were age five were up to seven times more likely to wind up with a peanut allergy than kids who ate peanuts at least three times a week.

This helps shed light on the question: When should we introduce peanut butter and peanut products to children?

Previously it was recommended that parents hold off on giving kids peanuts and peanut products until they reached 1 to 3 years of age. But as the number of cases of peanut allergies in children continued to grow, we doctors began to wonder if we were creating food allergies by holding off on potentially allergic foods. One striking example: the prevalence of peanut allergies in Israel, a country where babies and young children eat a peanut snack called Bamba, was low.

The LEAP study included just over 600 infants at high risk for peanut allergy, determined by whether they were already allergic to eggs or had eczema. The researchers randomly assigned the children to either receive a peanut protein powder mixed with water three times a week, or to avoid peanut protein completely. They also tested the infants to see if their skin prick test to peanut was negative (not allergic) or mild.

The results were shocking. In the group of children who were initially negative (did not have a peanut allergy), 13.7% of those who avoided peanut protein developed a peanut allergy.  But only 1.9% of those given peanut protein three times a week developed a peanut allergy. In the group who initially had a mild allergy, 35% in the avoidance group developed a peanut allergy, compared to 10.6 % in a mildly allergic group who ate a peanut protein. Wow! 

While this study clearly shows that early introduction of peanut dramatically decreases the risk of developing a peanut allergy, we don’t yet have recommendations. So what I tell my patients is this: Introducing your infant to peanut products starting at around age 6 months is a good idea, but you must be extremely careful. Do not give any child under age 3 whole peanuts, as they can be a choking hazard. In terms of peanut butter, it may be difficult (and dangerous) for an infant or toddler to move a glob of peanut butter around his mouth and swallow.  

But older infants, around 8 or 9 months of age, may be able to handle a thin smear of creamy peanut butter to lick off of a parent’s finger or on a thin piece of soft bread. Alternatively, you could mix peanut butter into a pureed food (such as oatmeal) that you are already feeding your infant, or mix a small amount into muffins. Be sure to ask your pediatrician or pediatric allergist when it’s okay to introduce your child to peanut products.

While it’s difficult to know exactly how much you’re giving your child (to replicate the amounts in the study), giving your child a taste is a good idea since peanuts are a healthy food. 

You may be wondering if you can cause your child to become allergic by introducing peanuts at a young age. The answer is no -- the study results show that it can actually decrease the possibility. If your child should develop an allergy after this exposure, it would likely have happened anyway.

And one final note: Allergic reactions can vary from mild, such as dry, itchy skin, to hives, facial or lip swelling or trouble breathing. If there is swelling or trouble breathing seek medical help immediately.

Meanwhile, I’m mixing some peanut butter into my 6-month-old’s oatmeal. Yum! 

Medically reviewed in June 2019.

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