New guidelines recommend giving babies puréed food or finger food containing peanut powder or extract before they are 6 months old, and even earlier if a child is prone to allergies and doctors say it is safe to do so.
In a significant reversal from past advice, new national health guidelines in the United States are calling for parents to give their children foods containing peanuts early and often, starting when they’re infants, as a way to help avoid life-threatening peanut allergies.
Peanut allergies are responsible for more deaths from anaphylaxis, or constriction of the airways, than any other food allergy. Though deaths are extremely rare, children who develop a peanut allergy generally do not outgrow it and must be vigilant to avoid peanuts for the rest of their lives.
To do this researchers recruited hundreds of infants aged 4 to 11 months, all of whom were deemed at high risk of developing a peanut allergy because they had eczema or an allergy to eggs. After running skin-prick tests on the babies and excluding those who were already allergic to peanuts, they randomly assigned some babies to be regularly fed peanut products, and others to be denied all peanut-containing foods.
By the time they turned 5, only 1.9 percent of 530 allergy-prone children who had been fed peanuts had developed an allergy, compared with 13.7 percent of the children who were denied peanuts.
“You have the potential to stop something in its tracks before it develops,” said Dr. Matthew Greenhawt, chairman of the American College of Allergy, Asthma and Immunology’s food allergy committee, and one of the authors of the new guidelines. It appears there “is a window of time in which the body is more likely to tolerate a food than react to it, and if you can educate the body during that window, you’re at much lower likelihood of developing an allergy to that food,” Dr. Greenhawt said.
The document, which was published in six medical journals, includes three separate sets of recommendations based on the level of risk an infant has for developing a peanut allergy. The kids at the highest risk are defined as babies with severe eczema and should be exposed to peanuts earlier on than other children, at 4 to 6 months old. All other kids should start consuming peanut products at around six months old.
Dr. Greenhawt acknowledged the new recommendations may face resistance. “The nuts and bolts of getting everyone to buy in to this and trust the recommendation and the data is a big unknown.” But the potential, he says, is enormous.