Peanut Allergy Prevention: Introduce Infants Early and Often

Peanut allergies strike fear into the hearts of many parents, my patients included.

It's an understandable concern, as peanut allergy is one of the most common food allergies in the United States, affecting up to 3 percent of all children, and rates have risen steadily over the past 15 years.

Fortunately, new research published earlier this year may provide an answer to preventing the development of peanut allergies in children. Although it may sound terrifying to some parents, it starts with introducing infants to the legumes early and often.

The British study published in the New England Journal of Medicine showed that early introduction of peanuts -- between 4 and 11 months of age -- in infants at high risk for the development of this allergy actually helps to prevent it.

Until recently, pediatricians were taught to tell parents to hold off on the introduction of certain foods if their child is at high risk for an allergy. So the findings from this randomized trial truly represent a dogmatic shift in prevention of peanut allergies for doctors and parents.

In this study, of the children who were given peanuts from an early age, only 3 percent developed an allergy as compared to a whopping 17 percent of those who avoided peanuts for five years. According to this data, you would only have to give peanuts to approximately seven children at an early age in order to prevent one child from developing a peanut allergy!

This clinical trial provides excellent evidence that it's safe and effective to change our recommendations and support the early introduction of peanuts. The next practical question for parents: When is my child ready to eat peanuts?

Before feeding your child peanuts, it's imperative to make sure he or she is ready to eat solid foods. Here are signs of food readiness:

-- A child is at least 4 months of age.

-- She sits with support.

-- He holds his head up well.

-- She shows interest in eating -- often parents say children get fussy and want to grab their food.

-- He opens his mouth for food.

Additionally, when it comes to purchasing peanuts for your child, remember to choose wisely. Some helpful tips:

-- Purchase a pure peanut butter -- preferably with nothing else but peanuts on the label. Avoid added sugars, fats, salt and chocolate.

-- Try out powdered peanuts, which are lower in fat but easy to mix with foods.

-- For older children who are ready for textures, grind or finely chop the peanuts.

-- Never introduce whole peanuts until after the age of 4 due to the choking risks.

The aforementioned study gave the equivalent of three teaspoons of peanut butter per week. While it's not yet known if you need to give this much or if it can be less, 3 teaspoons per week serves as a good rule of thumb to follow.

Now the next order of business -- the fun part -- is figuring out how to feed peanuts to your child. Below are some delicious, and successful, recipe ideas I've tried with my own kids:

First Foods With Peanut Butter

-- Peanut butter baby cereal or oatmeal: Add a spoonful of peanut butter or powdered peanuts as you're mixing up the cereal.

-- Peanut butter banana: Mix peanut butter with a mashed banana.

-- Mix it up: Add a dollop to applesauce, yogurt or fruit purees. You may want to try powdered peanuts to achieve a good consistency, or warm the peanut butter up so it's easier to mix in.

Fun Finger Foods

-- Grate or slice apples into matchsticks and spread with peanut butter.

-- Spread peanut butter onto whole-wheat bread, and cut into small bites.

-- Use powdered peanuts as a dip or topping.

The bottom line: Don't be afraid to give your child peanuts, and get creative with your recipes.

Since this is a big step for many parents, it's normal to feel fearful at first. But if you have questions or concerns about how to introduce allergenic food to your child, don't hesitate to visit your pediatrician. We're always there to help!