A study has shown that giving products made from peanuts to babies could help prevent peanut allergy. Many food allergies improve as the children grow older but peanut allergy is one allergy that usually lasts through life and I very serious, at times even life threatening.
The American Academy of Paediatrics has come out with a guideline that gives specific guidance to paediatricians on how to implement the findings of the study.
Three separate guidelines for infants at various risk levels for development of peanut allergy are included and are intended for use by a wide variety of healthcare providers. The guideline divides babies into three groups:
babies with severe eczema (persistent or recurrent eczema with a frequent need for prescription creams) and/or egg allergy
babies with mild to moderate eczema
Babies without eczema or food allergy.
First guideline: evaluating for peanut allergy is recommended for the first group with Skin prick test or a blood test for IgE. If the testing shows allergy, the baby should see a specialist to discuss giving peanut products. Most babies can get them, but it needs to be done carefully and in small amounts. The first time should be in a doctor’s office, in case a severe allergic reaction occurs. It’s important to do this testing early, as the recommendation is that these babies should get peanut products between 4 and 6 months, once they have tried some solid foods and shown that they are ready.
Second guideline: those with mild to moderate eczema don’t need to get tested. Those babies should get peanut products at around 6 months of age, once (like the babies in the first group) they can handle solid foods.
Third guideline: As for babies without eczema or food allergy, it is recommended that parents should introduce peanut products “freely” into the diet along with other foods, based on their own family preferences and cultural practices. For these babies, it’s less important that peanut products be in the diet early, although it’s fine if they are.
It is very important to use peanut products and not peanuts. Whole peanuts, or chunks of peanuts, should never be given to babies because they can choke on them. Children can even choke on a teaspoon of peanut butter. A little bit of peanut butter is a bit more manageable and the American Academy of Paediatrics suggests mixing it into purees. Families can also give snacks or foods made with peanut butter.
While attending the clinic for 2- or 4-month check-up, parents should talk to their doctor about what group their baby falls into, and about any other factors — like a family history of peanut or other food allergy — that might be important. This will give them enough time to do perform any tests if required and also to start incorporating the recommended diet.