Early introduction to peanuts reduces allergies. Here’s how and why you should feed your babies peanuts
The solution to soaring food allergies? Eat peanuts early and often.
New research shows a major and significant reduction in childhood peanut allergies on the heels of guidelines that parents introduce peanuts in infancy.
The study, published Monday in the journal Pediatrics, “is one of the first reports suggesting that clinical research findings and subsequent guidelines on early allergen introduction may be translating into meaningful real-world impact,” according to the published report in the journal.
Early exposure works to prevent peanut allergies, Northeastern University professors explained, and there are steps parents can take to introduce peanut products to their babies.
A potentially life-threatening allergy
Food allergies are on the rise, affecting 8% of children in the U.S. in recent years, 2.2% of whom have peanut allergies, according to the Pediatric commentary.
The Mayo Clinic says peanut allergies are particularly scary because they are the most common cause of a life-threatening reaction to food known as anaphylaxis, when airways constrict and blood pressure drops.
This kind of reaction and other possible symptoms, including hives and diarrhea, could explain why parents initially avoided exposing their babies to peanut products as allergy rates soared.
But a decade ago, research known as the LEAP study showed that early introduction to peanuts decreased the frequency of peanut allergy development among children at high risk.
And in 2017, the National Institute of Allergy and Infectious Diseases expanded the guidelines to include early introduction of peanuts to most babies, starting at six months for those at low risk and four months for those at high risk.
It was really a sea change for parents, says Emily Zimmerman, professor and chairwoman of communications sciences and disorders at Northeastern University’s Bouvé College of Health Sciences.
“The pendulum shifted” even between when her 12-year-old and 9-year-old were born, she says.
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Zimmerman found this shift unsurprising, as her expertise in early infant feeding and understanding of early food exposure’s significance had prepared her for this change.
She highlighted how the LEAP study underscored the value of early exposure, noting Israel’s low peanut allergy rates where Bamba, a popular peanut-flavored snack, is commonly given to infants across many families.
“It’s really about early exposure,” Zimmerman says.
This week’s study in Pediatrics shows that among children ages 0-3 years, there was a 27.2% reduction in peanut allergy after guidance for high-risk children was first issued in 2015, and a decline of more than 40% after the recommendations were expanded in 2017.
The tolerance pathway
“I would say the study is really exciting,” says Jing-Ke Weng, a Northeastern professor of chemistry, chemical biology and bioengineering.
“It at least shows the potential benefit” of introducing peanuts early in a child’s life, he says.
Allergic reactions to peanuts — which are a legume, not a nut — can be considered misfired immune responses to a nutritious food, Weng says.
He says allergic symptoms occur when IgE antibodies on mast cells recognize peanut proteins, triggering the release of histamine and other inflammatory chemicals in a cascade of immune reactions.
The allergic reactions can include diarrhea, shortness of breath and even death in worst-case scenarios, Weng says.
Introducing peanuts, especially in small doses, can potentially activate what Weng calls a “tolerance pathway” by producing a protective antibody called IgG.
How to introduce your baby to peanuts
When it comes to feeding babies peanuts, Northeastern food safety policy expert Darin Detwiler advises parents to use products especially formulated for infants.
“Avoid using whole peanuts or thick peanut butter due to choking risks, and ensure strict hygiene during preparation,” he says.
FoodAllergyPrevention.org has tips for thinning peanut butter water or breast milk and mixing it with fruit.
According to the 2017 guidelines, babies at high risk of peanut allergies, who include those with severe eczema, can be given 6 to 7 grams of peanut product over three or more feedings during the course of a week.
Parents who are nervous or concerned about introducing peanuts to their infants can consult with their physician about best practices and whether their child should be tested for allergic reactions.
As with many foods, peanut consumption is not without risk even for those who do not have allergies, Detwiler says.
Salmonella infections from peanuts can cause sepsis, he says. “Less well known but equally dangerous is Cronobacter sakazakii, a bacterium that thrives in dry foods and has caused fatal infections in infants.”
The important takeaway, Detwiler says, is that “early allergen exposure may be a powerful preventive tool, but only when paired with rigorous food safety practices for our most vulnerable loved ones.”
