New discoveries and scientific breakthroughs happen every day. Huge changes in the recommendations about when to introduce nuts to children have just come down the pipeline. With peanut allergies affecting 1-3% of all children, anything we could do to help prevent them would be monumental in improving quality of life.

Not that long ago, parents were instructed to delay introducing nuts (and foods that contain nuts) to infants until they were much older in an effort to reduce the number of kids who developed nut allergies. This is a hot topic because the number of kids who have developed peanut allergies have essentially doubled in the past decade. Recently, a large study: Learning Early About Peanut (LEAP), disproved that notion. In short, it took two groups of children: 4-11 months and 60 months and exposed them to nuts. The kids who were introduced at a younger age developed fewer nut allergies.

When the expert panel (allergy specialists), looked at the data, they came up with new guidelines that the American Academy of Pediatrics (the AAP) endorses.

Here’s the new guidelines in a (queue pun) nutshell:

Low Risk Kids

  1. Low risk meaning: No eczema or known food allergies.
  2. Feed your baby peanut products along with other foods when you child shows developmental readiness. For most kids, this is when they show they can tolerate other solid foods.

Higher Risk Kids

  1. Those with suspected or known peanut allergies already:
    1. They should avoid peanuts and consult with a specialist.
  2. Those who have family members with peanut allergies:
    1. Consult with your pediatrician to determine risks and benefits of peanut introduction (not all peanut allergies are anaphylactic in nature and an individualized plan is appropriate).
  3. Those with severe eczema or egg allergies:
    1. Test for peanut allergies BEFORE giving peanuts items (if testing is positive, see an allergist).
    2. Ideal test is a skin prick test (SPT), but blood tests are ok if an SPT test is unavailable.
    3. If negative SPT: Feed peanuts between 4-6 months either at home or in the doctor’s office.
  4. Those with Mild to Moderate eczema:
    1. Consult with your pediatrician about the ideal time or situation to introduce nuts.
    2. Generally, feed peanuts around 6 months.

What form of peanuts?

Due to the risk of choking, actual peanuts (either whole or pieces) should be avoided. Products like smooth peanut butter or things made with peanut butter are ideal.

How much do I give?

You may want to talk to your doctor about this. The actual study had a very specific amount, 6-7 grams a week over 3 or more feedings. For those of you who don’t usually measure in grams (few of us do), 6 grams is 1.2 teaspoons, or 0.4 tablespoons.

What does this mean in terms of other food allergies?

Absolutely nothing. The study didn’t look at any other possible food allergens, so we don’t know whether the same reasoning can be applied to other foods. As always, if you have concerns make sure and discuss them with your doctor. Good luck and enjoy those PB&Js!

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About The Author

Dr. Monica Wonnacott

I'm a pediatrician and a mom. I've been doing this doctor thing for 10 years, and love it. I'm known for giving parents the straight scoop without always sugar-coating it. And I believe in educating parents. The more you know, the better care you give your kids.

Dr. Monica Wonnacott, Pediatric Answers ™

I'm a pediatrician and a mom. Pediatric AnswersTM is where parents can get the straight scoop on their child's health, largely based on my experience in the office and at home. I don't diagnose on the site, so please don't ask. These are just my opinions. Use this site as a resource. And trust your parent gut.

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