How to Introduce Your Infant to Peanuts

Guidelines for introducing peanut-containing foods to infants get an update

(RxWiki News) If you do not know when or how to introduce peanut-containing foods to your infant, you are not alone.

Many parents do not know how to approach introducing peanuts to their infants' diets. Fortunately, the American College of Allergy, Asthma and Immunology (ACAAI) presented some guidance at a recent meeting.

This guidance is based on new guidelines that will soon be released. It outlines specific methods for introducing peanut-containing foods to infants.

Peanut-containing foods should not be the first solid food you give to your infant. Try to introduce new foods when your child is healthy and does not have a cold or diarrhea and is not vomiting. And it never hurts to consult with your child's pediatrician.

"The first step is determining if your child is at high risk for peanut allergy," said Dr. Amal Assa’ad, chair of the ACAAI Food Allergy Committee and a co-author of the new guidelines, in a press release. "Before introducing peanut-containing foods to a high-risk infant, the infant should be seen by their primary health care provider, who will determine if referral to an allergist for testing and/or in-office introduction is needed.”

The guidelines state that an infant is at high risk for developing a peanut allergy if he or she has an egg allergy and/or severe eczema.

The guidelines also indicate the time to introduce peanut-containing foods is as early as 4 to 6 months. This time period is indicated for high-risk infants but only after determining with a doctor that it is safe to do so. 

On the other hand, children with mild to moderate eczema and who have already been started on solid foods do not necessarily need an evaluation, according to the guidelines. In fact, these children can be introduced to peanut-containing foods by their parents at around 6 months of age, the guidelines say.

The same recommendation goes for children who do not have eczema or an egg allergy.

“If your child is determined to be at risk and then is tested and found to have peanut sensitization, meaning they have a positive allergy test to peanut, from that positive test alone we don’t yet know if they’re truly allergic,” said allergist Matthew Greenhawt, MD, MBA, MSc, an ACAAI fellow, incoming ACAAI Food Allergy Committee chair and a co-author of the guidelines, in a press release. “Peanut allergy is only diagnosed if there is both a positive test and a history of developing symptoms after eating peanut-containing foods.

"Infants sensitized to peanuts showed the most benefit from early introduction of peanut-containing foods in the Learning Early About Peanut allergy (LEAP) study. This is why it is essential that sensitized infants still undergo in-office introduction. If your child has in-office introduction and is found to have a peanut allergy, then they’ll need to avoid peanuts altogether and have an annual evaluation with an allergist.”

Another item to note: If you introduce peanut-containing foods to your infant, do not give him or her whole peanuts, as they can be a choking hazard.

Speak with your child's pediatrician if you have any questions or concerns about introducing your infant to certain foods.