New Guidelines for When and How to Introduce Peanut-Containing Foods to Infants

Updated on Friday, January 6, 2017

Atlanta Allergy & Asthma News
If you asked parents when and how they should introduce peanut-containing foods to their babies, you would most certainly get a number of different answers. Another point of confusion tends to be how to determine whether their infant might be at high-risk for developing a peanut allergy.

To help clarify all of these questions, some newly published information should help to simplify matters for parents.

On Jan. 5, updated guidelines from the National Institute of Allergy and Infectious Diseases (NIAID) defined high-, moderate- and low-risk infants for developing peanut allergy, and how to proceed with the introduction of peanut-containing foods based on risk.

“These guidelines are important since the report is under the auspices of the NIAID,” said Atlanta Allergy & Asthma’s Dr. Stanley Fineman, a past president of the American College of Allergy, Asthma & Immunology. “The conclusions are basically that early introduction with potentially allergenic foods such as egg and peanut can be beneficial in preventing food allergy. However, infants deemed high risk for food allergy should consult with an allergist before introducing these foods.”

According to the new guidelines, an infant at high-risk of developing peanut allergy is one with severe eczema and/or egg allergy. In this case the guidelines recommend introduction of peanut as early as 4 to 6 months for infants who have already started eating solid foods. The new guidelines also recommend that parents take their child who is in the high-risk category for an evaluation by an allergy specialist. That evaluation might involve peanut allergy testing, followed by trying a peanut-containing food for the first time while the parent and child are in the safety of the doctor’s office.

“Patients with food allergy should be reassured that there is ongoing high-quality, evidence-based research helping us understand the mechanism and potential therapies for our patients,” Dr. Fineman added. “As these studies progress, our knowledge and available treatments will advance.”

Here are the new/updated guidelines:
  • A recommendation that infants with severe eczema, egg allergy, or both have introduction of age-appropriate peanut-containing food as early as 4 to 6 months of age to reduce the risk of peanut allergy.
  • The suggestion that infants with mild-to-moderate eczema should have introduction of age-appropriate peanut-containing food around 6 months of age to reduce the risk of peanut allergy.
  • The suggestion that foods with peanuts can be freely introduced to infants who do not have eczema or any food allergy.

  • An expert panel of 25 leading physicians from the National Institute of Allergy and Infectious Diseases (NIAID), a branch of the National Institutes of Health, issued the new guidelines. One of the studies on which this expert panel based its work is the 2015 landmark Learning Early About Peanut Allergy (LEAP) study. The LEAP study’s authors found that that the early introduction of peanut to the diet of children in infancy (until they were five years old) led to an 81 percent reduction in peanut allergy for children considered to be at high risk.

    Atlanta Allergy & Asthma’s board-certified allergists can help you determine if your infant is at high risk for food allergy and the proper time and technique for introduction of allergenic foods. Schedule an appointment here.