Between 1997 and 2008, the number of American children with a reported peanut allergy tripled. That growing trend led pediatricians to recommend that children at high risk for peanut allergies avoid peanut products until after age 3.
But that all changed in 2015, when new research indicated that regular peanut consumption begun in early infancy and continued until age 5 actually reduced the rate of allergy in at-risk infants by more than 80%.
As a result, new guidelines were released by the National Institute of Allergy and Infectious Diseases. The American Academy of Pediatrics updated its guidelines as well in 2017. How should parents and caregivers who want to prevent peanut allergies process this information?
Sherry Coleman Collins, a registered dietitian with the National Peanut Board, explains that the first step is to assess an infant’s risk. “Children with severe eczema or allergies to eggs, or both, represent the small population that is considered at the highest risk for peanut allergies,” she says. “They could actually benefit most from early introduction, but they should be evaluated by a pediatrician before they are given any peanut products.”
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Infants with mild to moderate eczema can be fed small amounts of baby-friendly peanut foods, like peanut flour or peanut butter powder, three times a week after 6 months of age. All other children are considered low risk and can begin eating peanut food when they start solid foods. However, whole peanuts or peanut butter directly from a spoon should not be given to children less than 4 years of age.
Despite the change in guidance over the years, Collins says parents should feel safe in following the early introduction guidelines. “Through research conducted at King’s College in the U.K., we now know that the immune system is quite malleable and introduction is very safe in infancy.”
North Carolina Researchers Lead the Way
The Learning Early About Peanut Allergy (LEAP) study at King’s College has proven valuable to research on early introduction. But researchers in North Carolina are also doing their part in exploring ways to desensitize a child’s immune system to peanuts.
Dr. Leonard Williams, the director of the Center for Excellence in Post-Harvest Technologies at North Carolina A&T, is leading a team in this effort.
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“We are exploring how we can reduce a child’s sensitivity to the peanut allergen by mixing peanut flour with natural alternatives like blueberries or cranberries and slowly feeding it to children over time,” he says. “Our goal is to use this peanut flour in the clinical setting for skin-prick tests to demonstrate its hypoallergenic properties. Another possible use is oral immunotherapy, where the product is eaten over a period of time so the child builds up a tolerance to peanuts.”
Williams says the research requires working closely with medical professionals and shows good promise. “With the growing incidence of peanut allergies, it
is our hope that our work can potentially help mitigate the health risks to those children and the risks that persist as they become adolescents and adults.”