When Should I Introduce Peanuts to My Baby?
For most new parents, introducing new foods to your baby is stressful. One of the biggest concerns parents have is that their baby will have an allergic reaction to a new food. Peanuts have a notorious reputation for allergies, and for good reason. According to the National Institute for Allergy and Infectious Diseases (NIAID), peanut allergy prevalence in US children rose from an estimated 0.4% in 1999 to approximately 2% in 2010. Although peanut allergy is still rare, a prevalence of even 2% can seem like a lot. And for many, peanut allergies start early and persist into adulthood.
So, with all that concern, is it safe to give peanut foods to babies? When is the best time to introduce peanuts to babies?
Research says that early introduction of peanuts may help prevent a peanut allergy.
In 2015, the New England Journal of Medicine published a study examining the effect of early introduction of peanuts on the prevalence of peanut allergy. This study was inspired by prior observations that babies in Israel tended to have lower rates of peanut allergy. In Israel, it is common practice to introduce babies to peanuts around 7 months of age, often with the baby-friendly snack food Bamba (which is delicious, by the way!).
The study, called Learning Early about Peanut Allergy (LEAP) looked at babies 4-11 months old who were at risk for developing food allergies due to severe eczema and/or egg allergy. The researchers instructed one group of babies to avoid peanut foods, and the other group to introduce peanut foods. At 5 years old, the children were tested for peanut allergy. Researchers found that the children who consumed peanut foods early were much less likely to have developed a peanut allergy than the children who avoided peanut foods.
These positive results led the scientific community to continue to study early introduction of allergens, including peanuts, as a way to help prevent development of allergies. In 2017, the National Institute for Allergy and Infectious Diseases (NIAID) released guidelines on the early introduction of peanut foods as a way to prevent peanut allergies. You can read the full guidelines here.
For babies with history of severe eczema and/or egg allergy, consider seeing an allergist before introducing peanut foods.
While having a history of eczema or egg allergy does not mean that your baby will definitely have a peanut allergy, there does appear to be an increased chance that they will. Talk to your pediatrician or allergist before introducing peanuts. Your doctor may want to do a Skin Prick Test or IgE Blood Test for peanuts to see just how high that risk is.
Depending on your baby’s history and results of testing (if testing is done), your pediatrician may advise you to hold off on giving your baby peanut foods. For many babies, the risk of peanut allergy is still low, and your pediatrician will recommend to begin introducing peanuts to your baby as early as 4-6 months, provided they are developmentally ready for solid foods. Read more Tips for Starting Solid Foods here. Starting to introduce peanut foods early, around 4-6 months, may help prevent your baby from developing a peanut allergy.
For babies with history of mild-to-moderate eczema, introduce babies to peanut foods around 6 months old.
It’s important to talk to your pediatrician before starting any solid foods. If your baby is developmentally ready for solids, and your pediatrician gives the green light, it is recommended to introduce your baby to peanuts around 6 months old to help protect against peanut allergy. Read more Tips for Starting Solid Foods here.
For babies with no history of eczema or egg allergy, introduce peanut foods according to your family’s lifestyle.
Even if your baby is at low risk for developing a peanut allergy, it still makes sense to introduce peanuts early and often. Simply introduce your baby to peanuts in a way that works with your family. Introduction does not have to take place at 6 months, but if peanuts are a part of your family’s diet, you can give your baby peanut foods according to your family’s preferences and lifestyle. There is no evidence that giving peanut foods at this young age will cause your baby to develop a peanut allergy.
How to give babies peanut foods.
When introducing any new food to your baby, you want to introduce one new food at a time and monitor your baby carefully for any signs of allergic reaction. Take a look at my article Does My Child Have a Food Allergy? to learn the signs of a food allergy and what to do if you suspect your child is allergic to a food.
Follow this process for introducing peanut foods for your baby. You can download these steps from NIAID here.
Feed your baby only when they are healthy, and not if they have a cold, vomiting, diarrhea, or other illness.
Unless your doctor instructs you otherwise, give your baby peanut foods for the first time at home, not at daycare or a restaurant. If your baby is at higher risk for peanut allergy, your doctor may instruct you to give peanuts for the first time in the doctor’s office.
Make sure that you or another adult can have your full attention on your baby for at least 2 hours after eating, to monitor for signs of an allergic reaction. Feed peanut foods for the first time in the morning or afternoon, not in the evening, so you can watch your baby for 2 hours after eating.
Do not make peanuts the first solid food for your baby. Before giving peanuts, make sure your baby is developmentally ready for solid foods and has been able to tolerate foods. If peanuts are the first food given to your baby and there is a reaction, you won’t know if it was due to the peanuts or your baby not being ready for solid foods.
How to feed:
Prepare a full portion of peanut foods (see below). Remember, do not give babies whole peanuts, chunky peanut butter, and do not give peanut butter directly from a spoon without thinning it out. These are all choking hazards for your baby.
Offer your baby a small part of the peanut food on the tip of a spoon.
Wait 10 minutes, watch for signs of allergic reaction.
If no reaction, then slowly offer your baby the rest of the portion.
Peanut food recipes:
Bamba snacks (or similar puffed peanut snacks) - For babies 7 months old or younger, soften 21 Bamba in 4-6 teaspoons of water until they break down. For babies older than 7 months that can manage this crunchy dissolvable texture, Bamba can be given without soaking in water.
Peanut butter in water - Measure 2 teaspoons of creamy peanut butter, add 2-3 teaspoons of hot water. Mix until the peanut butter dissolves and is thin. Let cool. You can then add more water or infant cereal to make it a better texture for your baby.
Peanut butter in puree - Measure 2 teaspoons of creamy peanut butter, add 2-3 teaspoons of a fruit or veggie puree that your baby has had before and tolerated well. Mix well. You can add more puree to make it a better texture for your baby.
Peanut flour or powder - Measure 2 teaspoons of peanut flour or peanut powder. Add 2 Tablespoons of a fruit or veggie puree that your baby has had before and tolerated well. You can add more or less puree to make it a better texture for your baby.