In a complete turnaround from the American Academy of Pediatrics (AAP) 2000 recommendation to not give peanut butter to children with high risk of developing an allergy until the age of 3, the AAP is now suggesting high-risk children (infants with severe eczema, egg allergy or both) receive peanut proteins as early as 4 months.
The Addendum Guidelines for the Prevention of Peanut Allergy in the United States, a supplement to the “Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the National Institute of Allergy and Infectious Diseases (NIAID)-Sponsored Expert Panel” was published in the Annals of Allergy, Asthma & Immunology, the Journal of Allergy and Clinical Immunology on Jan. 5.
A National Institute of Health-sponsored workshop was attended by representatives of many stakeholder groups to develop evidence based recommendations for introducing peanuts to young children in order to prevent peanut allergy. The evidence they relied on was from the early introduction of peanut-containing food to high risk children, in which they found they should start being introduced to peanut products around 4 to 6 months of age to reduce risk.
However, this should not happen until other solid, non-risk, foods have been introduced. In order to determine if introduction is appropriate, peanut-specific IgE measurement, skin-prick tests or both, should be considered.
Children without severe eczema or any food allergy should be introduced to peanut-containing products after parents introduce other solid foods.
