Peanut Allergies

Peanut is one of the leading causes of fatal and near-fatal food allergic reactions in the United States, and the prevalence of peanut allergies in children has more than tripled since 1997. While these facts are alarming, a research study published in JAMA Pediatrics suggests that pregnant women who do not have a peanut/legume allergy can reduce the risk of their child developing this allergy if they eat more peanuts during pregnancy.

Pregnant women who are allergic to nuts should not consume them during pregnancy, but non-allergenic mothers should no longer avoid eating peanuts during pregnancy and breastfeeding, as they are a good source of protein and folic acid.

Once your baby is born, when should you start introducing peanut butter and other allergenic foods into your baby’s diet? It depends on whether or not your child has had eczema and/or food allergies, but you should always discuss introducing allergenic foods into your child’s diet with your pediatrician first. Children with eczema have a higher incidence of asthma as well as environmental and food allergies. It is even possible, although, not universal, that food allergies can flare eczema, especially during infancy.

• Babies without eczema or food allergies who do not have a greater risk of developing an allergy can start having products that contain peanuts, such as peanut butter, after a few solid foods have already been introduced into their diet without any signs of an allergy.
• If your baby has or had mild to moderate eczema, he or she has a greater risk of developing a peanut allergy. Because of this, your baby should start to eat peanut-containing products around six months of age, and it should be a consistent part of their diet to prevent a peanut allergy from developing.
• Babies with severe, persistent eczema or allergic reactions to any food should not be introduced to peanut-containing products until you talk with your pediatrician about timing and how to best start this process, ideally around four to six months of age. It is highly recommended that your baby have an allergy evaluation or testing before trying any peanut-containing product. The introduction may also need to occur in a supervised setting, such as a doctor’s office.

Do not give your baby peanuts, as they are a severe choking hazard. It is recommended to introduce peanut-containing products by thinning-out out a small amount of peanut butter in yogurt or cereal, or dissolve peanut butter puffs in breast milk or formula and then feed it to your baby by spoon. Start off by giving your baby small doses, and then gradually increase the amount if there are no signs of an allergic reaction.

UPMC Children's Community Pediatrics’s Nutrition Services provides counseling and information on food allergies. Speak with your UPMC CCP pediatrician for more information.