Feeding peanuts to babies to avoid later allergies

Updated US guidelines now recommend introducing food containing peanuts to an infant’s diet as early as four to six months of age to avoid developing an allergic reaction later in life. The guidelines reflect the findings of a 2015 allergy study, Learning Early About Peanut (LEAP), published in The New England Journal of Medicine.

In the LEAP allergy study that surveyed over 600 children between the ages four and 11 months who were prone to developing peanut allergies, researchers found that infants deemed at higher risk were more than 80 percent less likely to develop an allergy by the time they reached five years of age when exposed to peanuts early. “This is an amazing opportunity to help potentially reduce the number of cases of peanut allergy, but this can only be done with the cooperation of parents and healthcare providers,” said Dr Matthew Greenhawt, a pediatrician and co-director of the Food Challenge and Research Unit at Children’s Hospital Colorado and coauthor of the updated guidelines, to Reuters Health.

The study also outlined three approaches for introducing peanuts to infants based on their risk factors for developing the allergy. The first approach introduces peanuts as early as four to six months of age for infants deemed at higher risk of developing nut allergies. In the second approach, peanuts are fed to infants around six months of age with mild to moderate risks, while the third approach introduces peanuts freely into the diet for infants at lower risks.

“Infants with severe eczema, breathing issues, or any adverse reactions after consuming a certain type of food are deemed to be at high risk of developing allergies,” said Dr Iris Rengganis, an internist, and allergy and immunology consultant at Pondok Indah Hospital in Jakarta, Indonesia, to Global Health & Travel (GHT). She explained that since about 80 percent of allergy cases are genetic, high risk parents should consult an allergist who will administer a skin prick or blood test to determine if the child is hypersensitive to food with high allergens, such as peanuts, eggs, milk, wheat and seafood, before adding them to the diet. She also recommends low risk parents to feed their infants food with high allergens in smaller portions first in order to avoid possible allergic reactions and/or treat it swiftly if it occurs.

Another important factor is the form in which peanuts are introduced. “Several appropriate peanutcontaining foods include creamy peanut butter that can be made softer or more liquefied by adding warm water and left to cool. For older infants, peanut butter can be added to fruit purees,” said Dr Amal Assa’ad, another coauthor of the updated guidelines and director of the FARE Food Allergy Center of Excellence at the Cincinnati Children’s Hospital Medical Center in Ohio, to Reuters Health.

According to a study funded by the National Institutes of Health, the prevalence of peanut allergies among children in Western countries more than tripled from 0.4 percent in 1997 to 1.4 percent in 2010 and is the leading cause of anaphylaxis and food allergy deaths. In Asia, however, the new guideline may be unsuitable because an allergic reaction to peanuts is not as evident in this part of the world due to differences in primary diet, acknowledged Dr Iris.

This story was originally published in the Global Health and Travel issue of October 2017