By Lisa Rapaport
(Reuters Health) - Parents should feed babies creamy peanut butter
or puréed food with nut powder when infants are 4 to 6 months old to
help lower the risk of life-threatening allergies, new U.S.
For most babies -- kids without severe eczema or egg allergies that
make peanut allergies more likely -- new guidelines from the
National Institute of Allergy and Infectious Diseases recommend
introducing foods containing peanuts as soon as babies are able to
tolerate other solid foods.
"For most infants, introduction can be done at home," said allergist
Dr. Matthew Greenhawt, chair of the food allergy committee for the
American College of Allergy, Asthma and Immunology and a co-author
of the guidelines.
"Whole peanuts should never be given to any child under the age of
4, as it they are a choking hazard," Greenhawt added by email.
The new guidelines are a radical departure from recommendations in
2000 that advised against giving babies peanuts before age 3.
Revised recommendations in 2008 had suggested no food be delayed
past 4 to 6 months but failed offer specific guidance on when to
feed babies peanuts.
Peanut allergies are a leading cause of death from food allergies in
the U.S. and the new guidelines aim to alter this statistic by
helping babies get an early taste that will make severe allergic
reactions less likely.
Some allergic reactions can be mild with symptoms like hives or
nausea, but more serious reactions can lead to anaphylaxis, when the
airways tighten to the point where it's impossible to breathe.
People with anaphylaxis can die if they don’t get immediate medical
As doctors and parents change their approach to peanuts to follow
the new guidelines, early exposure should help dramatically curb the
number of children who develop severe allergies, doctors say.
Under the new guidelines, most babies can have peanuts introduced at
home by parents or caregivers, but infants with severe eczema or egg
allergies should see an allergist first. A specialist can test for
peanut allergies and if necessary, give babies their first taste of
peanuts during a doctor visit.
These precautions are for infants with severe eczema that doesn't
respond to treatment with moisturizer or corticosteroid creams or
ointments, not babies with temporary rashes.
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"Infants without severe eczema or egg allergy are unlikely to have
peanut allergy by 4-6 months, although they still have a risk for
developing peanut allergy later, especially if they are not fed
peanut in early infancy," Dr. Robert Boyle, a researcher at Imperial
College London who wasn't involved in the guidelines, said by email.
In infants without eczema or any food allergies, parents should feel
comfortable giving babies a taste of peanuts after they are
accustomed to eating other solid foods, said Dr. Sandra Hong, an
allergy and immunology specialist at the Cleveland Clinic in Ohio
who wasn't involved in the new guidelines.
"These guidelines are different than what some doctors may be
currently recommending because, previously, the practice was to
avoid the highly allergenic foods for risk of developing an
allergy," Hong said by email.
The new advice follows trial results reported in February 2015 that
showed regular peanut consumption begun in infancy and continued
until 5 years of age led to an 81 percent reduction in development
of peanut allergy in infants deemed at high risk because they
already had severe eczema, egg allergy or both.
"Monumental trials have shown that prevention or food allergies can
occur with early introduction of peanut and egg into the diet," Hong
The guidelines are being published simultaneously in several
journals including the Annals of Allergy, Asthma and Immunology.
SOURCE: http://bit.ly/2jfX3xn Annals of Allergy, Asthma and
Immunology, online January 5, 2017.
(This version of the story corrects headline to make clear babies
should not be fed whole peanuts)
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