AAP: Early Introduction of Peanuts Cuts Risk for Allergy

Staff Writer
Baystateparent Magazine

Introducing peanuts early may help some babies avoid allergies, according to new guidance from the American Academy of Pediatrics (AAP).

The AAP, which endorsed a policy on early peanut introduction in high-risk infants in 2015, bolsters the recommendation with research cited within a clinical report published in the April issue of Pediatrics. For years, doctors thought that delaying the age at which kids first eat common allergens like peanuts, eggs and milk could help them avoid allergies later in life. But the new report says there is more evidence than ever to suggest that purposefully introducing some foods to children early in life may help prevent them from developing food allergies, which affect about 8 percent of American kids.

“We know that some children are predisposed to allergies because of their family history,” said Dr. Frank Greer, co-author of the clinical report. “It’s clear that sometimes nutrition can play a key role in preventing or minimizing allergies that can be concerning – or even deadly – for some children.”

An expert panel convened by the National Institute of Allergy and Infectious Diseases (NIAID) developed guidelines for early peanut introduction endorsed by the AAP. This includes adding infant-safe forms of peanut to the diet for most babies, as early as around 6 months, after other solid foods are tolerated.

For high-risk infants, like those who have severe eczema or have an egg allergy, testing for peanut allergy and introduction of peanut-containing foods under supervision of a health care provider is a consideration. These high-risk infants may have peanut products introduced as early as 4-6 month of age.

Eight groups of foods account for about 90 percent of all food allergies and must be declared on U.S. product labels. These include cow milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat and soybeans. More than 170 additional foods are reported to cause allergic reactions, and some, including sesame, are included in labeling laws in other countries.

The AAP says there is no reason to delay giving your baby foods that are thought of as allergens like peanut products, eggs or fish. These foods can be added to the diet early, just like foods that are not common allergens, like rice, fruits or vegetables.

The AAP also finds:

-Exclusive breastfeeding for the first 3 to 4 months helps protect against eczema during a child’s first two years of life. Any amount of breastfeeding (even if it is not exclusive) beyond 3 to 4 months also protects against wheezing for the first two years and offers even longer benefits in reducing asthma.

-Evidence does not support restricting a mother’s diet during pregnancy or breastfeeding as methods to prevent allergies.

-Hydrolyzed formula does not prevent allergies in infants and children, even in those at high risk for allergic disease, according to research. This finding marks a change from the 2008 clinical report, which concluded there was modest evidence that supported the use of hydrolyzed formula to prevent dermatitis in high-risk infants.

-Recommendations on the prevention of peanut allergy are based primarily on the Learning Early About Peanut Allergy (LEAP) trial. Ground peanuts and other specialized formulations are advised, as whole peanuts are a choking hazard to children under 4.