The National Institute of Allergy and Infectious Diseases just published new recommendations providing guidance on how and when to introduce young children to peanuts, and it’s blowing the minds of food allergy parents everywhere as it contradicts everything we were previously taught on the prevention of peanut allergies in children. Now, instead of waiting until after a child’s first birthday to introduce peanuts to an infant, the new peanut allergy guidelines recommend introducing peanuts as young as 4 to 6 months old for most children.
New Peanut Allergy Guidelines
Medical experts are shifting gears on dietary recommendations for infants and avoiding peanuts. In the addendum released in January of 2017, the NIAI provides 3 separate peanut allergy guidelines for infants at various risk levels for the development of peanut allergy and is intended for use by a wide variety of health care providers. Topics addressed in the addendum include the definition of risk categories, appropriate use of testing (specific IgE measurement, skin prick tests, and oral food challenges), and the timing and approaches for the introduction of peanut-containing foods in the health care provider’s office or at home.
“Recommendations in the past have included delaying the introduction of peanut and other nuts into the diet of children until late toddlerhood and preschool age,” said Dr. Laura Dziadzio, a pediatric allergist at Carilion Children’s Hospital and an assistant professor of pediatrics at the Virginia Tech Carilion School of Medicine. “However, recent studies have suggested this recommendation may be associated with the development, not the prevention, of peanut allergy.”
The new peanut allergy guidelines break down the definition of the risks into three categories.
- Risk group #1: It is recommended that infants with egg allergy and/or severe eczema undergo either blood or skin testing to peanut by age 4-6 months. If negative, peanut should be introduced into their diet at that time. If positive, it would be up to the family and the physician based on the test results how to proceed.
- Risk group #2: It is recommended that infants with mild to moderate eczema begin to eat peanut around six months of age.
- Risk group #3: Finally, the third group includes infants with no eczema or food allergies. The recommendation for these infants is to introduce peanut into their diet when age appropriate and in accordance with family preferences.
Once the risk category has been determined, the NIAI further breaks down how much dietary peanut protein to introduce, the rationale of introducing peanut proteins at a younger age, and the balance of benefits and harm of introducing peanut proteins during infancy.
If you choose to follow the NIAI’s new peanut allergy guidelines recommendations and introduce peanuts to your infant, please follow the guidelines for dosing and be prepared in case of a severe reaction.
You can read the full text of the NIAI’s new peanut allergy guidelines here.