New advice: Peanuts in baby’s diet can prevent scary allergy
WASHINGTON—The National Institutes of Health (NIH) issued new guidelines Thursday saying most babies should regularly eat those foods starting around six months of age, some as early as four months. It’s a major shift in dietary advice for a country fearful of one of the most dangerous food allergies.
The recommendations are based on landmark research that found early exposure is far more likely to protect babies from developing peanut allergies than to harm them.
The guidelines, published Thursday in several medical journals, make that clear, urging parents and doctors to proactively introduce peanut-based foods early.
In Columbus, Ohio, one doctor told Carrie Stevenson to avoid peanuts after her daughter was diagnosed with egg allergy. Then Stevenson found an allergy specialist who insisted that was the wrong advice—and offered baby Estelle a taste test of peanut butter in his office when she was seven months old.
“I was really nervous,” Stevenson recalled, unsure which doctor to believe. But “we didn’t want her to have any more allergies.”
Now 18 months old, Estelle has eaten peanut butter or peanut-flavored puffs at least three times a week since then and so far seems healthy.
The guidelines recommend:
-All babies should try other solid foods before peanut-containing ones, to be sure they’re developmentally ready. -High-risk babies should have peanut-containing foods introduced at age four to six months after a check-up to tell if they should have the first taste in the doctor’s office, or if it’s OK to try at home with a parent watching for any reactions.
-Moderate-risk babies have milder eczema, typically treated with overthe-counter creams. They should start peanut-based foods around six months, at home.
-Most babies are low-risk, and parents can introduce peanut-based foods along with other solids, usually around six months.
-Building tolerance requires making peanut-based foods part of the regular diet, about three times a week.
What’s the evidence? First, researchers noticed a tenfold higher rate of peanut allergy among Jewish children in Britain, who aren’t fed peanut products during infancy, compared to those in Israel where peanut-based foods are common starting around age seven months.
Then in 2015, an NIH-funded study of 600 babies put that theory to the test, assigning them either to avoid or regularly eat age-appropriate peanut products. By age five, only two percent of peanut eaters—and 11 percent of those at highest risk—had become allergic. Among peanut avoiders, 14 percent had become allergic, and 35 percent of those at highest risk.
Whether the dietary change really will cut U.S. peanut allergies depends on how many parents heed the new advice, and the guidelines urge doctors to follow up, even offer lower-risk tots an in-office taste, to reassure them.
“I was really nervous,” Stevenson recalled, unsure which doctor to believe. But “we didn’t want her to have any more allergies.”