How to Introduce Peanuts to Your Baby

A big question many parents often ask is when to start introducing peanuts, especially now that the AAP released new guidelines at the beginning of this year.  Based on the Learning Early About Peanut Allergy (LEAP) study published in 2015, early introduction of peanut foods to infants at high risk of developing peanut allergy has been shown to reduce peanut allergy by 86%.  I recently attended a talk by Dr. Fleischer, Allergist and Director at the Children’s Hospital Research Institute in Colorado. He discussed the study and provided recommendations to healthcare providers based on the infant’s risk group.

Key Takeaways

• Early peanut introduction can reduce peanut allergy risk by up to 86%
• When to introduce peanuts depends on your baby’s allergy risk level
• High-risk infants should be evaluated by a pediatrician or allergist before starting
• Moderate and low-risk babies can usually begin peanut foods at home around 6 months
• Safe preparation methods are essential to avoid choking hazards
• Consistency matters more than perfection when introducing peanut protein
• Early and regular exposure supports long-term peanut allergy prevention in infants

The three risk groups include:

High risk infants: those who have severe eczema or/and egg allergy.

Moderate risk infants: infants with mild to moderate eczema.

Low to no risk: no allergy or eczema.

When to introduce:

High Risk:  At 4-6 months of age, allergy testing is strongly recommended for this group prior to introduction.   Refer to pediatrician’s guidelines for this introduction if it is at home or in the doctor’s office. When introduced start with 2 g of peanut protein three times per week or 7 grams per week.

Moderate Risk:  At 6 months of age, introduce age appropriate peanut foods in the amount of 2g peanut protein three times per week or 7 grams weekly.  This group can be introduced at home.

Low to no risk:  At 6 months of age or later, peanut can be feed at home in whatever way is preferred by the family.

 

What are safe ways to introduce 2 grams of peanut protein to an infant? 

• Thin 2 tsp peanut butter with hot water, formula or breast milk. Mix in with yogurt or other purees.

• Grind peanuts in a blender to a fine powder.  Mix 2 tsp with puree or sprinkle on finger foods.

• Feed baby puffed peanut snack, Bamba (which was used in study). If child is under 7 months, soften with 2-3 tsp of liquid.  Note: 21 pieces or 2/3 of the Bamba package provided 2g peanut protein.

 

Never feed baby whole peanut.  Developmental readiness should always be taken into account prior to peanut introduction and babies should be taking other solids prior to first exposure to peanut.   Always make sure baby is healthy prior to the first time feeding peanut food.   Ensure your schedule allows time to observe baby for 2 hours following first introductions of peanut, since if there is an IgE reaction, it would happen within this time.

Dr. Fleischer’s overall message was this: there isn’t a benefit delaying peanut introduction past 6 months of age. We should feed peanut frequently vs. getting too focused on the 2g provided three times each week, especially for the low to moderate at risk groups. The main goal is reduction in the continued rise of peanut allergy in children by early introduction and exposure to peanut.