When Can Babies Have Peanut Butter?

If you ask around, you're likely to hear a lot of conflicting advice about when it's safe to introduce peanut butter into your child's diet. You may be told to feed your child peanut butter as an infant, wait until they're 3 years old, or even to never do it at all, not even in utero. This has led to a lot of confusion for parents—as well as increasing rates of peanut allergy.

The good news is that the newest guidelines, which were released in 2017, clear up the issue significantly. We now know that exposing babies to peanut butter before age 1 will reduce the risk of peanut allergies. Unfortunately, the previous guidelines, which recommended waiting longer, seems to have backfired by causing an uptick in food allergies.

Higher Rates of Peanut Allergies

Allergies are a hypersensitive immune system response to a foreign substance (such as peanuts), which can result in a range of symptoms from hives to anaphylaxis, a severe and potentially life-threatening condition. Peanuts, which are actually a legume rather than a nut, are one of eight major foods known to cause allergies. The others are milk, eggs, tree nuts, wheat, soy, fish, and shellfish.

For years, parents were told that babies and peanut butter just don't mix. In fact, it was common practice to hold off on introducing any nuts, including peanut butter, until kids were 3 years old. It is now believed that this policy, which was intended to reduce the risk of serious allergic reactions, has done just the opposite, contributing to an increasing prevalence in peanut allergy.

In fact, according to the American Academy of Allergy, Asthma, and Immunology (AAAAI), under the delayed introduction policy, rates of allergy more than quadrupled between 1999 and 2010—increasing from approximately 0.4% of children to 2% in that period.

The LEAP Studies

The link between delayed introduction and increasing allergy prevalence was documented in a 2008 study lead by a pediatric allergist and researcher, Dr. Gideon Lack. He noticed that Jewish children in Great Britain had 10 times the rate of allergy compared to Jewish children in Israel.

The biggest difference between the groups was that in Israel, babies were frequently fed peanut butter while those in Great Britain were not. This lead to the Learning About Peanut Allergy (LEAP) studies, which have shown conclusively that exposure to peanut butter before age 1 significantly reduces the likelihood of developing an allergy, including for babies with higher allergy risk.

The National Institute of Allergy and Infectious Diseases (NIAID) then conducted a review of 64 studies that also backed up these results, which showed an 81% reduction in developing peanut allergy for children regularly exposed to peanut butter as babies.

New NIH Guidelines for Peanut Consumption

In 2017, following an extensive review of evidence from the LEAP trials and numerous other studies, the National Institutes of Health (NIH), in conjunction with multiple other health agencies, officially released a new set of guidelines regarding the timing of introducing peanuts to children.

• Guideline 1: Infants who are at high risk of developing a peanut allergy (those with egg allergy and/or severe eczema) can be introduced to peanut-containing food between 4 and 6 months of age. It's recommended to check with your pediatrician first because they may want to do controlled allergy tests beforehand.
• 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 for guidelines specific to your child.
• Guideline 3: All other infants can have peanuts integrated into their diets freely when they begin solid foods, which is recommended at 6 months.

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.

Your Baby and 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. One thing to remember is to never give a child under 3 years of age whole peanuts because they pose a choking hazard.

Start with a small spoonful of peanut butter thinned with water to make it easier to swallow. Wait 10 minutes after the first taste to rule out an acute allergic reaction. Then, continue feeding the rest of the portion.

Initially, don't mix it with other first foods like fruits, veggies, cereals, or meats so that you can be sure any reaction is coming from the peanut butter. Be sure to do this at home when you can watch closely for any allergic reactions over the next couple of hours.

Signs of a Peanut Allergy

Be aware that peanut allergy can be severe, lifelong, and potentially deadly. While most likely your child will do just fine, occasionally babies will exhibit an allergic reaction, which can trigger a life-threatening reaction called anaphylaxis. If you notice anything suspicious, call your pediatrician right away. If your infant is having difficulty breathing, dial 911.

These symptoms can appear in just minutes or they may take hours, so be watchful during this time. If you have any concerns, don't wait to call emergency services or your healthcare provider. Learn the symptoms to watch out for.

Breathing Issues

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

Circulation Issues

• Pale skin
• Light-headedness
• Loss of consciousness

Skin Issues

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

Stomach Issues

• Diarrhea
• Nausea
• Stomach cramps
• Vomiting

A Word From Verywell

If you have any concerns about peanut allergies or the best peanut exposure strategy for your child, talk to your pediatrician. While it can be scary to test your baby for peanut allergies, it's important to find out in a controlled environment rather than by accident later in life.

Remember, it's most likely your child won't have any adverse effects. Plus, introducing peanut butter before age 1, as well as eating it regularly, is the best way to prevent peanut allergy in the first place.