Reduce allergy risk by introducing peanuts early in babies’ diets, panel says

January 6, 2017

Giving creamy peanut butter or pureed foods containing nut powder to infants between four to six months old will help lower the risk of life-threatening allergies, according to new US guidelines released by an expert panel.

New guidelines from the National Institute of Allergy and Infectious Diseases (NIAID) – one of the 27 centers and institutes that make up the National Institute of Health (NIH) in the US – recommend the introduction of foods containing peanuts as soon as babies are able to tolerate other solid foods. This recommendation applies to babies without severe eczema or egg allergies that make peanut allergies more likely.

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, said introduction can be done at home for most babies. However, he warns against giving whole peanuts to any child under the age of 4, as they are a choking hazard.

The new guidelines are a radical departure from the 2000 recommendations that advised against giving babies peanuts before the age of 3. Revised recommendations in 2008 had suggested no food be delayed past 4 to 6 months but failed to offer specific guidance on when to feed babies peanuts.

Peanut allergies are a leading cause of death from food allergies in the US 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 help.

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.

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% reduction in development of peanut allergy in infants deemed at high risk because they already had severe eczema, egg allergy or both.

The guidelines are being published simultaneously in several journals including the Annals of Allergy, Asthma and Immunology.

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Category: Education, Features

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