Easing Fear about the Early Introduction of Peanut Foods

Introducing peanut foods to your infant can feel like a frightening step to take, but also an exciting and important part of your infant’s early eating experiences, as research states it could have the potential to reduce the risk of developing peanut allergies by up to 86%. 

In this Q&A, Dr. Jay Lieberman, an allergist and immunologist at the Le Bonheur Children’s Hospital, and associate professor at the University of Tennessee, shares his perspective on what parents should know about early introduction of peanut foods and how to overcome the fear.

NPB: What would you tell a parent who is hesitant about implementing early introduction of peanut foods? How do you recommend overcoming the fear?

Dr. Lieberman: For years we (doctors and society) have been telling parents not to feed peanut before 1 year of age. So overcoming that dogma and fear is difficult. I tell parents that it is natural to be fearful or wary of this.  I recommend that they first try a very small (pea sized) amount of peanut butter in a puree that the child is already eating and then to slowly increase the amount according to the current recommendations. In rare cases, I will have them eat the first dose in the clinic.

NPB: Why is early introduction of peanut foods critical for kids with egg allergy and severe eczema?

Dr. Lieberman: Current research suggests that in high-risk infants (those with egg allergy and/or severe eczema) the addition of peanut foods into the diet early on can drastically reduce that child’s chance of having peanut allergy.

NPB: Does having a sibling with a peanut allergy affect an infant’s risk of developing a peanut allergy?

Dr. Lieberman: Current guidelines suggest that younger siblings of peanut allergic children can be treated like any other child. However, given that their situation is slightly different, it is recommended that parents discuss early introduction of peanut, in this case with their pediatrician or allergist.  Many parents who have an older child with a peanut allergy may be fearful when it comes to introducing peanut into a younger infant’s diet. In this case, it may be reasonable to have the younger child tested first, even if they are low risk.

NPB: What is the main takeaway parents should know about early introduction of peanut foods?

Dr. Lieberman: For the vast majority of children, early introduction of peanut-containing foods is safe and easy to do.  For infants who are at high-risk for developing peanut allergy (those who already have an allergy to egg or who have severe eczema) parents should talk to their pediatrician or discuss with an allergist about testing prior to introducing the peanut containing foods.

For more information, visit preventpeanutallergies.org.

The American College of Asthma, Allergy, and Immunology has partnered with the National Peanut Board to spread awareness of the NIAID guidelines for the early introduction of peanut foods to help prevent peanut allergy.

About Dr. Lieberman

Dr. Lieberman works at the University of Tennessee, and Le Bonheur Children’s Hospital, where he is an associate professor, concentrating his efforts on food allergies and has built a collaborative program for primary immune deficiencies with St. Jude Children’s Research Hospital. He was recently awarded the American College of Allergy Asthma & Immunology (ACAAI) Young Investigators award, and he serves as Vice-chair for the ACAAI Food Allergy Committee, and as an associate editor for Annals of Allergy Asthma and Immunology. He currently lives in Memphis with his wife and two daughters.

Source: https://www.niaid.nih.gov/sites/default/files/peanut-allergy-prevention-guidelines-clinician-summary.pdf

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