What is early peanut introduction? Why are we recommending early introduction of a food that my child might be allergic to? How can I make sure that my child is safe and not at risk of anaphylactic shock? These are some of the questions that likely come to mind as you decide to give your child peanuts or any other highly allergenic food.

Discover what early peanut introduction is and how to assess what it right for your food allergic child.

What is early peanut introduction?
Prevention is key when it comes to peanut allergy. With nearly 2% of children being diagnosed with peanut allergy, finding a way to reduce this number is important.

Early introduction means trying or introducing a peanut product as early as four to six months of age.

Why are we recommending early introduction to a food that your child might be allergic to?
The Learning Early About Peanut Allergy (LEAP) study, published in early 2015, looked at different groups of infants and tried to determine if early introduction of peanut products would reduce the risk of a peanut allergy. What they found was remarkable: the study showed that early introduction of peanut foods to infants at high risk (those with severe eczema, an egg allergy or both) reduced peanut allergy by 86% in this group!

How can you make sure your child is safe?
After these results were published, new guidelines were released to help the medical community put these results into action. These guidelines will help keep your food allergic child safe by dividing infants into three groups: high risk, some risk and no risk.

GROUP 1
The first group, which I briefly mentioned above, is the “high risk” group. These are infants who have severe eczema, an egg allergy or both of these conditions, and are considered to be at high risk of developing a peanut allergy, based on the study.

What we need to know:
1. These infants need to be evaluated early on by a doctor to determine whether they can be introduced to peanuts early;
2. There is a strong recommendation that these infants be sent for either serum testing or skin prick testing to see if they are allergic to peanuts;
3. Depending on the results, oral introduction may be done at home, in the doctor’s office or not at all;
4. If it is determined that peanuts are safe for the infant, then it should be introduced into the infant’s diet at four to six months of age;
5. The infant should receive age-appropriate peanut foods, in the amount of 2g of peanut protein three times per week. See more below on how to get this amount of peanut in your infants’ diet.

GROUP 2
This second group of infants are at some risk and have a history of mild to moderate eczema only and do not have a known history of other food allergens at baseline.
1. If infants are at moderate risk, the guidelines recommend introducing peanuts at home, but caregivers or health professionals may choose to introduce peanut foods in their office;
2. The recommendation is to introduce peanut-containing foods around six months of age;
3. The infant should receive age-appropriate peanut foods, in the amount of 2g of peanut protein three times per week.

GROUP 3
These infants do not have any eczema or any food allergy by history and are not considered at risk. According to the guidelines, these infants can be fed peanut foods in whatever way is preferred by the family (according to cultural and family preferences) at the age of six months old.

How should you feed your child peanut products?
Parents should feed infants other solid foods before peanut-containing foods in all cases, according to the guidelines. The introduction should generally be with diluted peanut butter. Peanuts can be dangerous, as they can be aspirated, and peanut butter can be dangerous because of how sticky it is.
The study was done with a product called Bamba, a snack made in Israel. There are other products available on the market for infant feeding – like Ready, Set, Food!, Lil Mixins, etc. – and this link provides several other recipes that can be made at home with peanut butter, peanut flour or peanut powder.

References
https://www.leapstudy.co.uk/
https://www.aappublications.org/news/2017/01/05/PeanutAllergy010517
https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF Documents/Practice and Parameters/Addendum-guidelines-for-the-prevention-of-peanut-allergy-in-the-United-States.pdf