Babies and Peanut Butter: What Parents Need to Know

Early introduction to peanuts may prevent an allergy

Baby eating with a spoon
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Over the years, there have been many conflicting recommendations about when it is safe to start feeding babies peanut butter. This has led to a lot of confusion for parents. The good news is that the newest guidelines (released in 2017) clear the issue up significantly.

It turns out that you may be able to reduce the risk of peanut allergies in your children if you introduce peanut butter or paste to your baby as early as 4 to 6 months.

The Rise in Peanut Allergies

For years, parents were told that babies and peanut butter just don't mix. In fact, it was common practice to hold off introducing any nuts, including peanut butter, until kids were 3 years old. This may have had a negative effect and led to a rise in peanut allergies among children.

According to Food Allergy Research & Education (FARE), peanuts are one of eight major foods known to cause allergies. The others are milk, eggs, tree nuts, wheat, soy, fish, and shellfish. The practice of delaying introduction to these foods to young children has not reduced the development of allergies. In fact, the number of peanut and tree nut allergies actually tripled between 1997 and 2008.

Instead, FARE states that "feeding peanut foods early and often to babies with egg allergy or eczema dramatically reduces their risks of developing peanut allergy." This recommendation applies to most babies.

Guidelines for Introducing Peanuts

In 2017, the U.S. National Institutes of Health (NIH) released a set of three new guidelines regarding the timing of introducing peanuts to children. It is based specifically on evidence from a clinical trial supported by the National Institute of Allergy and Infectious Diseases (NIAID) and has been backed up by numerous other studies in recent years.

The study found an 81 percent reduction in peanut allergies among 600 high-risk infants. The children started eating peanuts as infants and monitored until they turned 5 years old. This led to the following NIH guidelines:

  • Guideline 1: Infants who are at high-risk of developing a peanut allergy can be introduced to peanut-containing food between 4 and 6 months of age. It's recommended to check with your pediatrician first because he may want to do controlled allergy tests first.
  • Guideline 2: For infants with mild or moderate eczema, peanut foods can be introduced at 6 months. Again, it's best to consult your doctor.
  • Guideline 3: All other infants can have peanuts integrated into their diet freely.

Some studies have also found that in non-allergic expecting mothers, eating peanuts while pregnant may reduce the risk of a peanut allergy for children.

Feeding Your Baby Peanut Butter

Peanut butter can be a healthy addition to your baby's diet. The NIH recommends that you begin with other solid foods before introducing any with peanuts. It's important to never give a child under 3 years of age whole peanuts because these pose a choking hazard.

Start with a small spoonful of peanut butter and don't mix it with other first foods like fruits, veggies, cereals, or meats. Instead, create a paste by mixing two teaspoons for peanut butter with hot water. Be sure to do this at home when you can watch closely for any allergic reactions over the next couple of hours. These include hives, a rash, problems breathing, or a change in behavior.

If you spot any signs of a peanut allergy, call your pediatrician right away. If your infant is having difficulty breathing, dial 911.

Signs of a Peanut Allergy

Be aware that a peanut allergy can be severe, lifelong, and potentially deadly. It may trigger a life-threatening allergic reaction called anaphylaxis in some children. These symptoms can appear in just minutes or they may take hours, so be watchful during this time and don't wait to call emergency services or your healthcare provider.

The American Academy of Allergy Asthma & Immunology (AAAAI) states that food allergies can trigger the following symptoms:

Skin Problems

  • Hives (red spots that resemble mosquito bites)
  • Skin rashes (eczema, also called atopic dermatitis)
  • Itching or tingling (in or around the mouth and throat)
  • Swelling

Breathing Problems

  • Runny nose
  • Sneezing
  • Shortness of breath (wheezing)
  • Throat tightness

Stomach Problems

  • Nausea
  • Vomiting
  • Diarrhea
  • Stomach cramps

Circulation Problems

  • Pale skin
  • Light-headedness
  • Loss of consciousness

A Word From Verywell

If you're concerned about your child having a peanut allergy, talk to your pediatrician. While it can be scary to test your baby for peanut allergies, it's best to find out in a controlled environment rather than by accident later in life at a friend's house or school event.

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