Giving babies peanut products at earlier age may help prevent allergies

This week the American Academy of Pediatrics (AAP) released a report updating its guidance on the roles of maternal and infant diets in preventing food allergies.

“There is no reason to delay giving your baby foods that are thought of as allergens like peanut products, eggs or fish,” said Dr. Scott Sicherer, MD, FAAP, a coauthor of the report. “These foods can be added to the diet early, just like foods that are not common allergens, like rice, fruits or vegetables.”

The AAP examined the latest research on how to prevent allergies in children and confirmed that a growing body of evidence supports the early introduction of peanut-based foods to infants to prevent peanut allergies.

An expert panel convened by the National Institute of Allergy and Infectious Diseases (NIAID) developed guidelines for early peanut introduction endorsed by the AAP.  This includes adding infant-safe forms of peanut to the diet for most babies, as early as around 6 months, after other solid foods are tolerated. 

For high-risk infants who have severe eczema requiring prescription treatments or have an egg allergy, testing for peanut allergy and introduction of peanut-containing foods under supervision of a health care provider is a consideration. These high-risk infants may have peanut products introduced as early as 4-6 month of age. More information is available in the NIAID Guidelines.

Eight groups of foods account for about 90 percent of all food allergies and must be declared on U.S. product labels. These include cow milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat and soybean. More than 170 additional foods are reported to cause allergic reactions, and some, including sesame, are included in labeling laws in other countries.

The AAP also stated that:

• Exclusive breastfeeding for the first 3 to 4 months helps protect against eczema during a child’s first two years of life. Any amount of breastfeeding (even if it is not exclusive) beyond 3 to 4 months also protects against wheezing for the first two years and offers even longer benefits in reducing asthma.
• Evidence does not support restricting a mother’s diet during pregnancy or breastfeeding as methods to prevent allergies.
• Hydrolyzed formula does not prevent allergies in infants and children, even in those at high risk for allergic disease, according to research. This finding marks a change from the 2008 clinical report, which concluded there was modest evidence that supported the use of hydrolyzed formula to prevent dermatitis in high-risk infants.
• Recommendations on the prevention of peanut allergy are based primarily on the Learning Early About Peanut Allergy (LEAP) trial. Ground peanuts and other specialized formulations are advised, as whole peanuts are a choking hazard to children under 4.

Parents are advised to talk with their pediatrician or allergist about the symptoms of allergies and whether their child should be tested.