Forget what you thought you knew about infants and peanuts.
On Jan. 5, experts at the National Institute of Allergy and Infectious Diseases (NIAID) issued new guidelines that recommend introducing infants to peanut-containing foods early to prevent the development of peanut allergy.
The revised recommendations are based on findings from the Learning Early About Peanut Allergy (LEAP) clinical trial, which showed regular peanut consumption begun in infancy and continued until 5 years of age led to an 81 percent reduction in development of peanut allergy in infants deemed at high risk. The new guidance separates infants into three risk categories:
- High-risk. Infants considered at high risk of developing peanut allergy because they have severe eczema, egg allergy or both should have peanut-containing foods introduced into their diets as early as four to six months. Parents should check with their health care provider before feeding the infant peanut-containing foods as they may choose to perform an allergy blood test or send the infant to a specialist for additional tests to help them determine if and how peanut should be safely introduced into the infant’s diet.
- Moderate risk. Infants with mild or moderate eczema should have peanut-containing foods introduced into their diets around six months.
- Low risk. Infants without eczema or any food allergy should have peanut-containing foods freely introduced into their diets.
Dr. John LaCount, a pediatrician with St. Elizabeth Physicians’ Florence office, emphasizes that the new guidelines pertain to peanuts – not tree nuts. Parents should start by introducing a small amount of peanut-containing food and gradually increase the amount over time depending upon the child’s tolerance and response.
“Families with low risk often can start this introduction just like any other food, observing for reaction,” he says, but parents of high-risk infants should talk to their health care provider as, “there may be children who would be better with the introduction at a pediatrician’s office or in the presence of an allergist in case a reaction develops.
“Our hope is that we can decrease the need for severe dietary restrictions, which are difficult to adhere to for most families,” LaCount says. “This will also improve their ability to integrate children into regular schools, camps and programs without restrictions required for these children.”
