Prevent peanut allergy with . . . peanut butter?

Peanut allergy affects nearly 3 million people in the U.S. It’s usually lifelong, and the number of children affected by it has increased dramatically over the past 15 years. But several recent and large-scale studies have shown that this upward trend could be reversed if parents introduce peanut foods when their at-risk infant is old enough to begin eating other solid foods, usually around age 6 months. 

Sound nutty? This counterintuitive revelation originated from doctors noticing that Jewish children raised in the United Kingdom were 10 times more likely to have peanut allergies than Jewish children raised in Israel. The doctors theorized the significant difference might be attributable to early exposure to “Bamba,” a peanut puff snack food given to young children in Israel.

Further studies comparing early introduction of peanutty foods with avoidance of them confirmed this suspicion, and in January 2017 the National Institute of Allergy and Infectious Diseases (NIAID) issued new guidelines, acknowledging that the old strategy of withholding peanuts from kids until they’re 3 years old hadn’t worked.

UT Southwestern food allergy specialist J. Andrew Bird, M.D., says the data from the studies are compelling and that there’s reason to hope the new guidelines will dramatically reduce the prevalence of peanut allergy. He notes that an important part of the guidelines is to first consult with the baby’s health care provider who may suggest allergy testing before proceeding with the peanuts. 

“I would not recommend giving peanut products to a child who has already had a reaction to peanuts,” says Dr. Bird, who is also the Director of the Food Allergy Center at Children’s Medical Center. “But for infants who are at high risk for peanut allergy – those who have severe eczema or who have had an allergic reaction to eggs – it is now advisable to give them at least 6 grams of peanut protein per week, divided over three or more servings.”

Options for infants include serving two teaspoons of smooth peanut butter mixed with warm water, a fruit puree, or breast milk to achieve a soupy, Stage I puree consistency. NIAID guidelines note that infants should not be fed actual peanuts, however, because they are choking hazards.