Feeding infants peanut-containing foods early can help prevent the development of peanut allergies, but a recent study published in JAMA Network Open indicates that many parents are unclear about how and when to introduce peanuts to their children. The research, led by Dr. Waheeda Samady of Ann & Robert H. Lurie Children's Hospital of Chicago and Northwestern University Feinberg School of Medicine, involved interviews with 49 parents from diverse backgrounds in Chicago.
"While some parents we talked to understood correctly that starting their baby on peanut foods trains the immune system in order to prevent the development of peanut allergy, other parents mistakenly believed that the purpose is to test if their baby is allergic – a misconception that fueled fears of severe allergic reaction, leading to hesitation and delays in peanut introduction," said Dr. Samady.
Dr. Samady stressed the importance of timing and consistency for effective prevention: "For prevention of peanut allergy, timing and consistency are of the essence," she said. "We encourage peanut introduction as soon as the baby starts eating solids, before or around 6 months of age. It's also important to continue peanut exposure twice a week through the first year and into toddler years. Feeding babies peanut foods just once or twice is not enough."
Guidelines recommending early introduction were established in 2017 after research demonstrated an over 80% reduction in new cases of peanut allergy among children introduced early to peanuts. Peanut allergy affects about 2% of children in the United States and is rarely outgrown.
The study found confusion among parents regarding both the intent behind early introduction guidelines and risk factors such as eczema, which increases a child's likelihood of developing food allergies.
According to Dr. Samady, pediatricians are usually parents' main source for information about introducing peanuts: "Pediatricians are key to successful guideline implementation, but they need better resources for families to provide comprehensive information during busy well-child visits," she said. "Overall, we found that parents are accepting of early peanut introduction, but they need clearer guidance and more support."
She added that messaging should focus on explaining how regular dietary exposure prevents allergies, clarifying links between eczema and increased risk for food allergies, providing specific instructions on timing and frequency, and reassuring families about typically mild reactions in infants.
"Parents need to be reassured that if their baby is allergic to peanut, they may see hives, some swelling, or vomiting, but allergic reactions in infancy are usually mild," Dr. Samady explained. "We should empower parents with information and action plans so this does not stop them from participating in early peanut introduction."
The research was funded by the National Institute of Allergy and Infectious Diseases (NIAID K23AI159517).
