Frequently Asked Questions
Who Are We?
America’s peanut farmers – through the National Peanut Board – have contributed more than $25.3 million for food allergy research, education and outreach since 2001. The American College of Allergy, Asthma and Immunology is a professional medical organization of more than 6,000 allergists-immunologists and allied health professionals. ACAAI allergists are board-certified physicians trained to diagnose allergies and asthma, administer immunotherapy, and provide patients with the best treatment outcomes. The Food Allergy and Anaphylaxis Connection Team educates, advocates, and raises awareness for all individuals and families affected by food allergies and life-threatening anaphylaxis.
What are the new guidelines?
New guidelines encourage parents to introduce baby-friendly peanut foods depending on each child’s risk for allergies. Peanut foods should be introduced according to these guidelines after they’ve already started other solid foods.
- If your infant has severe eczema, egg allergy, or both, the new guidelines recommend talking with your doctor before giving them any peanut foods. Your healthcare provider might want to do an allergy test or introduce baby-friendly peanut foods under medical supervision. Once cleared, infants in this category should start eating peanut foods around 4–6 months of age and should continue to consume them regularly – 2g of peanut protein, three times per week.
- If your infant has mild to moderate eczema, the new guidelines recommend feeding them small amounts of baby-friendly peanut foods, like peanut powder or thinned peanut butter, around three times a week starting when they are around 6 months old.
- If your infant has no eczema or any food allergy, the new guidelines recommend introducing foods that contain peanuts together with other solid foods as often as you would like and in accordance with family preferences and cultural practices after 6 months of age. Most children will fall into the low risk category.
What research are these recommendations based on?
The recommendations to introduce peanut foods early are largely based on a recent study called Learning Early about Peanut Allergy (LEAP), released in early 2015. This study found that eating peanut foods early could prevent peanut allergy in high risk infants.
A second study, LEAP-On, found that if high-risk children ate peanut foods regularly until 5 years of age, there was no increased risk of developing peanut allergy during their 6th year of life even if they avoided peanuts for one year.
Why did the guidelines for introducing peanut foods change?
A groundbreaking study found that parents of children at risk for peanut allergy could reduce their baby’s chance of developing a peanut allergy by up to 86 percent by feeding them small amounts of peanut foods as early as 4-6 months of age. The LEAP study was released in January 2015 and was so significant that it led to new guidelines by the National Institutes of Allergies and Infectious Disease (NIAID). Now, the American Academy of Pediatrics (AAP) has updated their guidelines, and the American College of Allergy, Asthma and Immunology, American Academy of Pediatrics and other medical groups have endorsed those guidelines. Read more about this, here.
Will these recommendations prevent all babies from developing peanut allergy?
No, these recommendations will not prevent all babies from developing peanut allergy. However, according to the LEAP study, parents of children at risk for peanut allergy could reduce their baby’s chance of developing a peanut allergy by up to 86 percent by feeding them small amounts of peanut foods as early as 4-6 months of age.
Do the recommendations apply to other allergens than peanut?
No, the current recommendations apply specifically to peanut, as peanut was the only allergen studied in the LEAP study.
Should I speak to a pediatrician or family doctor before introducing peanut foods?
If your child is in the high risk group, you should talk to your pediatrician before introducing peanut foods. However, if your child is not in the high risk category, it is not necessary to speak to your pediatrician before introducing peanut foods.
If my baby is older than the recommended age to introduce peanut, what should I do?
If your baby does not have severe eczema or egg allergy, peanut can be introduced into their diet when you introduce other solid foods, as long as it’s in an age-appropriate way (to avoid choking risk). If you have concerns about introducing peanut foods into your baby’s diet, consult your pediatrician. Finally, if your child has egg allergy or severe eczema, they should be seen by a physician before peanut foods are introduced into their diet.
How much and how often should peanut foods be fed to the infant?
Once peanut foods are introduced into the diet and tolerated, they should be kept in the diet on a regular basis – 2g of peanut protein, three times per week – in order to maintain a tolerance to peanut protein. See our “How to Introduce” page for easy ways to introduce.
What do I do if my baby has a reaction? What do I look for?
Allergy symptoms usually develop within minutes of eating a food, but can occur up to 2 hours after ingestion. Allergy signs and symptoms can be mild, such as a new rash or a few hives around the mouth. More severe symptoms can include swelling of the lip, eyes, or face, vomiting, widespread hives on the body, breathing symptoms such as repetitive cough, wheeze, or any difficulty breathing, a change in skin color (pale, blue), or sudden tiredness/lethargy/seeming limp. If there are any concerns for more severe allergy symptoms, seek immediate medical attention/call 911.