Peanut Introduction to Infants

Peanut Introduction to Infants

by Rebecca Butler of Lantana Pediatrics
74 McMakin Road, Ste. 100 • Bartonville, TX 76226

The number of infants and children developing peanut allergy continues to grow. Peanut allergy in the United States has tripled over the past 10-15 years; therefore, it is very important to understand the current recommendations on how to prevent this allergy.

Despite early thinking that avoiding peanuts during infancy and at young ages would prevent peanut allergy later on, more recent thinking has focused on introduction during infancy. The success of this strategy was recently confirmed in the 2015 study Learning Early about Peanut Allergy (LEAP). Based on the findings in this study, specific recommendations for peanut allergy prevention were developed by the National Institute of Allergy and Infectious Disease (NIAID). The latest update on recommendations is based on specific risks related to presence of other chronic illnesses and/or food allergies.

Introducing Peanuts Based on Specific Risk:
1. Children with Severe Eczema and/or Egg Allergy: Introduce peanuts containing foods as early as age 4-6 months after the introduction of other solid foods AND after consideration of peanut-specific allergy testing.
2. Mild to Moderate Eczema: Introduce peanut containing foods around age 6 months.
3. No Eczema or Food Allergy: Introduce peanut containing foods together with solids foods and in accordance with family preferences and cultural practices.

Best Practice for Introducing Peanutat Home:

  • Peanuts should NOT be the first solid food introduced.
  • Only introduce peanuts to an infant that is healthy without acute illness or upper respiratory infection.
  • Introduce these peanut-containing food in the home setting (i.e not at a restaurant school or daycare)
  • Give a small portion and wait 10 minutes before gradually giving the remainder of a serving and allow time for observation after introduction.
  • Do not give peanut butter directly from a spoon or whole peanuts to children younger than 5 years of age as this poses a choking hazard.
  • Infants at high risk (#1 above)—should consume approximately 6-7 grams of peanut protein per week divided over 3 or more feedings. This recommendation is based on the actual studied amount given in the LEAP study. It is not currently known if increased or decreased amounts would have similar outcomes.
  • With regard to the other 2 risk categories above of mild to moderate eczema or no eczema or food allergies these infants may consume any amount that the family wishes without otherwise associated risks.

Results from the landmark LEAP study, published February 2015 in the New England Journal of Medicine, showed that infants with severe eczema, egg allergy, or both who regularly consumed peanut-containing foods in infancy through age 5 years were 81% less likely to develop peanut allergy than infants who avoided exposure to peanuts in their diets.

Obviously, there are more studies needed and work to be done in the field of Allergy and Immunology and the prevention of food allergies, eczema, asthma, etc.; however, the LEAP study demonstrates very promising and exciting results. It is important as a provider and caregiver to be aware of the latest studies and guidelines in advancing medicine.

For more information and summaries go to: and talk with your pediatrician.

Dr. Rebecca Butler is Board Certified in Pediatrics by the American Board of Pediatrics and is a Fellow of the American
Academy of Pediatrics. She is proud to be a resident of Lantana and the owner of Lantana Pediatrics. For more information on Lantana Pediatrics, Dr. Butler and/or Melanie Bitzer, CPNP or to schedule an appointment with one of these providers, call the
office at 940.455.7200.

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