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Introducing infants to peanut products can help decrease their risk of developing a food allergy. Getty Images
  • Experts want parents to know how to safely introduce peanut products to infants and toddlers.
  • Some children, including those with severe eczema and egg allergy, are more at risk for developing an allergy to nuts.
  • Even children at increased risk for a peanut allergy should be introduced to the food in a safe environment.

Introducing peanut products to infants is becoming more common as studies have shown the positive effects of early introduction to reduce the risk of developing a peanut allergy. Thinking of giving your baby peanuts? There are a few things you should keep in mind.

A report in the Canadian Medical Association Journal outlined what parents should know about introducing infants to peanuts in order to reduce their risk of developing a peanut allergy. The report joins other recent peanut introduction guidelines published by the National Institute of Allergy and Infectious Diseases (NIAID)

Studies have shown that babies with severe eczema are more likely to develop a peanut allergy. Babies with severe eczema, egg allergy, or both should see a specialist to discuss testing and determine how to safely expose the child to peanut products.

A 2015 study found that children at high risk for peanut allergy who had peanut introduced earlier were at a decreased risk for developing the allergy. The study is what changed the landscape of when and how peanuts are introduced.

The NIAID guidelines are aimed at introducing peanut products more purposefully, explained Dr. Scott H. Sicherer, a professor of pediatrics and director of the Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai in New York.

The report describes three risk groups:

  • infants with known egg allergy or severe eczema — or both
  • infants with mild or moderate eczema
  • infants with no known egg allergy or any eczema

Infants at high risk for developing peanut allergy are those with a known egg allergy or severe eczema. An allergist can conduct a skin test or a pediatrician can send in bloodwork to check for evidence of a peanut allergy. In children with severe eczema, egg allergy or both that has been diagnosed based on testing, parents should introduce peanut products under supervision at their doctor’s office, Sicherer noted. Once it is introduced to the infants at the highest risk, there is a recommendation to maintain peanut in the diet for about 6 to 7 grams per week given over three or more feedings per week.

Babies with mild or moderate eczema can begin having peanut products around 6 months.

In those with low or no risk, peanut butter or peanut puff products can be introduced at home in most babies between 4 and 6 months.

The NIAID report details specifics on portions and feeding recommendations of different peanut products such as smooth peanut butter puree, thinned peanut butter, and peanut flour/peanut butter powder.

Giving a child a lick of peanut butter isn’t the only option when introducing peanut products. (Though you won’t ever want to give an infant a whole peanut.)

“In order to keep babies safe from choking, mix creamy (not crunchy) peanut butter with some water or into other puréed foods,” noted Dr. Jaime Friedman, a pediatrician based in San Diego. “Once they are eating finger foods, try peanut-containing baby snacks like Bamba.”

Peanut butter or peanut flour can be smoothed out in water or fruit or vegetable purees, Sicherer added.

Some parents dilute peanut butter in water to avoid the risk of choking due to the thick nature of peanut butter, noted Dr. Aikaterini Anagnostou, an associate professor of pediatric allergy at Baylor College of Medicine. She also heads up the food immunotherapy program at Texas Children’s Hospital. Anagnostou also recommends peanut puffs or Bamba, as well as peanut flour or peanut butter powder mixed in a fruit or vegetable puree.

If your child is at a low risk or has no risk and you introduce peanut at home, just be mindful. You should supervise the child for two hours after eating to look for any symptoms of an allergy. Symptoms include runny nose; redness or swelling in the eyes, mouth, or face; and irritation in the throat area.

Also, make sure the infant does not have a cold or illness when you introduce peanut products, Anagnostou added.

Try not to let the peanut introduction experience cause you anxiety, Sicherer added. “It should not be so anxiety producing if there is no reason to be worried,” he said.

“It is always okay and reasonable to start with a smaller amount, like some from the tip of a spoon, and wait a few minutes and then go slowly forward,” he added.