Updated Guidelines Call for Introduction of Peanuts During Infancy to Reduce Risk of Allergy

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January 18, 2017 | 170,098 views

Story at-a-glance

  • Research suggests exposing children to peanuts early on can help reduce their risk of developing an allergy, while strict avoidance actually heightens the risk. Early exposure to peanuts may cut the risk of allergy by 80 percent or more
  • Updated guidelines recommend introducing pureed food or finger food that contains peanut powder or peanut extract at or before the age of 6 months, depending on your child’s allergy risk
  • High-risk infants — those with severe eczema and/or other known food allergies — may receive peanut-containing foods as early as 4 months while under careful medical supervision

By Dr. Mercola

While nuts generally receive top marks for being a healthy addition to your diet, there are a few factors to consider. Peanuts — which despite the name are not actually a nut but a legume — are among the most allergenic of foods.

In 1999, less than 0.5 percent of American children had a peanut allergy. A decade later, that number had risen to 2 percent. This despite the fact that during that time, parents were warned to avoid all peanut products before the age of 3.

Clearly, the advice was not having an impact. The avoidance recommendation has been further challenged by a number of recent studies.

Research actually suggests that exposing children to peanuts early on can help reduce their risk of developing an allergy, while strict avoidance actually heightens the risk.

Moreover, giving trace amounts of peanuts to children with peanut allergy has been shown to de-sensitize their immune systems and boost their tolerance over time.

Naturally, if your child has a known peanut allergy, you would embark on this kind of de-sensitization program under the guidance of a knowledgeable doctor to avoid a potentially life threatening situation. Also, to avoid choking, never give young children whole peanuts or ground peanut bits.

That said, the broader, more general recommendation that parents should avoid feeding their children peanut products during infancy has now radically changed. In fact, research suggests early exposure to peanuts may cut the risk of allergy by 80 percent or more.

New Guidelines Call for Introduction of Peanut Products During Infancy

The new guidelines,1,2,3,4 issued by the National Institute of Allergy and Infectious Diseases (NIAID), recommend introducing pureed food or finger food that contains peanut powder or peanut extract at or before the age of 6 months. According to The New York Times:5

“If broadly implemented, the new guidelines have the potential to dramatically lower the number of children who develop one of the most common and lethal food allergies, said Dr. Anthony Fauci, the institute’s director, who called the new approach ‘game changing’ …

It appears there ‘is a window of time in which the body is more likely to tolerate a food than react to it, and if you can educate the body during that window, you’re at much lower likelihood of developing an allergy to that food,’ Dr. [Matthew] Greenhawt [co-author of the new guidelines] said.”

In 2008, scientists became intrigued by anecdotal reports that Jewish children in Israel had very low rates of peanut allergy. A comparison of statistics revealed that Jewish children in the U.K. had 10 times the rate of peanut allergy as those in Israel, despite the similarities in genetic background.

A major difference between the two groups was that Israeli children were typically fed foods containing peanuts, starting in infancy. Bamba, a puffed corn and peanut butter snack, is very popular among Israeli children.

The researchers tested the hypothesis that early exposure to peanuts might lower the risk of allergy by recruiting infants between the ages of 4 and 11 months of age, all of whom were at high risk for peanut allergy.6 The children were randomly assigned to receive peanut-containing foods on a regular basis, or no peanuts at all.

By the age of 5, less than 2 percent of the children fed peanuts developed an allergy, while nearly 14 percent of those who were never given peanuts became allergic.

The difference was even more striking among a subgroup of particularly high-risk children who were already more sensitive to peanuts at the outset of the study. In this group, 10 percent of those who were fed peanut-containing foods went on to develop an allergy, compared to 35 percent of those who did not receive any peanuts.

The findings were considered revolutionary, and eventually formed the basis of the updated recommendations.

How to Implement the New Guidelines

The new guidelines divide children into categories based on perceived risk:

Low-risk infants (no eczema or other food allergy, and no family history of peanut allergy) can start receiving peanut-containing foods at any age, once other solid foods have been introduced.

Moderate-risk infants (mild eczema) may receive peanut-containing foods around 6 months of age.

High-risk infants (severe eczema and/or other known food allergies) should receive peanut-containing foods as early as 4 months under medical supervision.

An evaluation by an allergy specialist is strongly advised, and peanut-containing foods may be administered in the doctor’s office for safety. If a skin test reveals your child is already allergic, complete avoidance may be recommended.

For low- and moderate-risk infants, you may use a 50/50 mix of smooth peanut butter and warm water. Stir to blend into a purée-like consistency. However, do not make peanut butter the first or only solid food your baby eats.

Once introduced, continue giving your child peanut-containing foods at least three times a week throughout the childhood years. If you’re at all unsure about whether your child might be allergic to peanuts, ask your pediatrician to perform an allergy test.

Allergic Children May Also Be Desensitized Through Early Exposure

As mentioned, even those with diagnosed peanut allergy may benefit from early exposure, provided it’s done under careful medical supervision. In one study,7 allergic children between the ages of 7 and 16 were given very small doses of peanut protein powder, beginning with a dose equivalent to about 1/70th of one peanut.

After six months of gradually increasing the dose, more than 90 percent of the children could tolerate the equivalent of five peanuts in one sitting with no reaction.

Other research8,9 also suggests the allergy protection a child gets from being exposed to nuts during infancy can be sustained even if nuts are later avoided for up to a year. As reported by BBC News:10

“The New England Journal of Medicine study11 looked at 550 children deemed prone to developing a peanut allergy …

The new study suggests that if a child has consumed peanut snacks within the first 11 months of life, then at the age of 5 they can afford to stop eating the food entirely for a year, and maintain no allergy.

Lead author Prof. [Dr.] Gideon Lack said: ‘[The research] clearly demonstrates that the majority of infants did in fact remain protected and that the protection was long-lasting.’ 

He said that part of the problem was that people lived in a 'culture of food fear.' ‘I believe that this fear of food allergy has become a self-fulfilling prophecy, because the food is excluded from the diet and, as a result, the child fails to develop tolerance,’ he told the BBC News …”

Pros and Cons of Peanuts

Peanuts do contain a number of valuable nutrients, including trace minerals such as copper, manganese and molybdenum, along with vitamins B1, B3 and E, folate, biotin and phosphorous. They also contain a number of highly beneficial antioxidants, including resveratrol and p-coumaric acid.12,13

Unfortunately, peanuts tend to be heavily sprayed with pesticides14 and are frequently contaminated with aflatoxin15 — toxic metabolites produced by certain molds that grow in soil and moist environments.

To avoid pesticides, I recommend buying only organically grown peanuts and peanut butter. Just beware that organic peanuts are not a guarantee they’ll be free of aflatoxin.

Contamination can occur anytime during pre-harvest, storage and/or processing, and is therefore difficult to avoid. Unbeknownst to many, gut problems such as leaky gut can be related to the presence of mycotoxins such as aflatoxin.

(To rid your body of aflatoxin, you need to use bentonite clay. Activated charcoal will absorb other mycotoxins, but not aflatoxin.)

In terms of nutrition, peanuts also have the drawback of being relatively high in omega-6, so they may further skew your omega-3-to-omega-6 ratio — a problem you may struggle with if you’re eating a lot of processed foods and shy away from omega-3-rich fish such as wild-caught Alaskan salmon, sardines, herring and anchovies (and do not take an animal-based omega-3 supplement). So, while introducing small amounts of peanuts may help reduce your child’s risk of peanut allergy, avoid overdoing it.

Gut Health and Food Allergies

No discussion about food allergies is complete without addressing general gut health. Without a well-functioning gastrointestinal (GI) tract, your baby will be more vulnerable to pathogens, allergens and a number of immune-related diseases, so getting your baby’s gut up and running efficiently is crucial.

Women who are pregnant or planning to become pregnant would be wise to address their own gut health as early as possible to give their child the best start possible in this regard. According to an analysis of clinical trials,16 women who take probiotics during pregnancy do reduce their child’s risk of developing allergies. That said, it’s never too late to address your, or your child’s gut, and most people would likely benefit from doing so.

The bacteria located in your GI tract play a crucial role in the development and operation of the mucosal immune system in your digestive tract. They also aid in the production of antibodies to pathogens. Beneficial bacteria even train your immune system to distinguish between pathogens and non-harmful antigens, and to respond appropriately.

This important function prevents your immune system from overreacting to non-harmful antigens, which is the genesis of allergies, be it peanuts, eggs or any other food allergy.

Your baby gets his or her first “inoculation” of gut flora from your birth canal during childbirth. If your flora is abnormal, your baby’s flora will also be abnormal; whatever organisms live in your vagina end up coating your baby’s body and lining his or her intestinal tract. Breastfeeding also helps protect and normalize your baby’s gut flora, which is why breastfeeding is so crucial to your child’s health. No infant formulas can do this.

Consider Introducing Fermented Foods Early

A condition known as “leaky gut” can be a contributing factor to allergies, which can help explain why children with healthier gut flora have a reduced risk of developing allergies. Even more significantly, pathogenic microbes in your baby’s digestive tract can damage the integrity of his or her gut wall, allowing all sorts of toxins and microbes to flood his or her bloodstream, which can then enter his or her brain and disrupt proper brain development.

Providing abundant probiotics in the form of fermented foods is one of the most powerful ways to optimize your baby’s gut microbiome. Oftentimes, a commercial probiotic supplement won’t even be needed.

Raw organic grass-fed yogurt is well tolerated by most infants and children. It’s best to make your own yogurt at home from raw organic milk, and start with a very tiny amount. Once yogurt is well tolerated by your baby you can introduce kefir. If you have any problems with dairy, you can substitute vegetables fermented with yogurt culture or kefir culture.

Avoid commercial yogurt from the grocery store, as these typically contain high amounts of sugar, and sugar tends to feed pathogenic bacteria — the exact opposite of what you’re looking for.

To learn more about introducing fermented foods to your newborn, I recommend picking up a copy of Dr. Natasha Campbell-McBride’s book “Gut and Psychology Syndrome,”17 which has a large recipe section for fermenting your own foods at home and using them to benefit all members of your family. If your baby has a severe condition, then the addition of a high-quality probiotic supplement might be needed.

As for peanuts, I generally don’t recommend them due to the risk of pesticide and aflatoxin contamination. However, complete abstinence from early childhood could potentially increase your child’s risk of developing a peanut allergy, so you’ll have to weigh the various risks and benefits.

If you choose to include peanuts, opt for an organic brand of peanut butter that contains nothing but ground peanuts to avoid pesticides. Also, if you have any doubts whatsoever, be sure to perform an allergy test before introducing peanuts into your baby’s diet.

[+]Sources and References [-]Sources and References

  • 1 Report of the National Institute of Allergy and Infectious Diseases–sponsored expert panel
  • 2 BBC News January 5, 2017
  • 3 CNN January 5, 2017
  • 4 STAT News January 5, 2017
  • 5 New York Times January 5, 2017
  • 6 NEJM 2015 Feb 26;372(9):803-813
  • 7 The Lancet January 30, 2014
  • 8, 11 NEJM March 4, 2016, DOI: 10.1056/NEJMoa1514209
  • 9 Scientific American March 10, 2016
  • 10 BBC News March 5, 2016
  • 12 Epoch Times March 1, 2016
  • 13 The World’s Healthiest Foods, Peanuts
  • 14 The Street November 2, 2014
  • 15 Cornell University, Aflatoxin
  • 16 Pediatrics August 19, 2013 [Epub ahead of print]
  • 17 Natural Treatment for Autism, Dyspraxia, A.D.D., Dyslexia, A.D.H.D., Depression, Schizophrenia