Giving Babies Peanut-Containing Food Early Can Prevent Peanut Allergy
Question: I grew up in a family full of allergies. Both of my parents have hayfever; I have eczema and asthma. My younger brother had severe eczema when he was small. Our parents were told to avoid giving him peanuts and eggs until he was older. When he went to a birthday party at three, he ate a cookie with peanut, and developed severe allergic reaction. Since then, he had several similar episodes; once he developed anaphylaxis and had to go to emergency room. Our family was always on edge; we carried an Epi-Pen all the time. I am now pregnant with our first child. I wonder whether there is anything that I can do to prevent her from developing peanut allergy.
Peanut is one of the most common causes of serious food allergy in North America. About one to two percent of the population are allergic to peanut; some have anaphylaxis and can die unless epinephrine and other medications are available quickly to counteract the allergy.
In the last few decades, because of the concern about peanut allergy, specialists (including allergists and paediatricians) recommended delaying introduction of foods containing peanut until 3 years of age. The reasoning is that if we delay giving children peanut, may be they will be less likely to develop allergy. Unfortunately, subsequent research showed that peanut allergy in children actually increased three times between 1997 and 2008. Clearly, avoiding peanut early in life didn’t prevent peanut allergy.
Then, something remarkable happened. Researchers found that Jewish children in England were ten times more likely to develop peanut allergy compared with those growing up in Israel. It turned out that Israeli children were given Bamba, a snack food for infants, when they showed interest in solid food, usually before six months of age. Bamba was made with puffed corn and coated with peanut butter. When exposed to peanut at an early age, these children rarely developed peanut allergy.
This observation sparked a number of international research programs evaluating early versus late introduction of peanut. They showed that early introduction of food containing peanut can significantly reduce development of peanut allergy in children. It looks like that there is a window of opportunity, probably from 5 to ten months of age, when children can develop tolerance to food like peanut without becoming allergic to it. If peanut is introduced later, the chance of developing allergy is much greater.
This is very humbling for doctors who try to do their best to provide good guidance to parents and children. The advice given in the last few decades to delay introduction of foods like peanut, egg, and fish were wrong; they were not based on scientific evidence.
The Canadian Paediatrics Society (CPS), and American Academy of Pediatrics (AAP), two organizations that represent most of the paediatricians in North America, now recommend parents to give peanut-containing food as soon as babies show interest in taking solid food, usually from 4-6 months of age. They can mix smooth peanut butter with water, expressed breastmilk, or pureed fruits and vegetables, and give it daily.
Research also showed that other food allergies can be prevented the same way; there is no need to delay introduction of any kind of solid food. The best common-sense approach came from the Australian Society of Clinical Immunology and Allergy, which states that: “when your infant is ready, introduce foods according to what the family eats, regardless of whether the food is considered to be a common food allergen.”
Other research also showed that pregnant women and breastfeeding mothers don’t have to avoid any food to prevent food allergy in their children. Therefore, relax and eat all the normal food that you enjoy. I would also encourage you to breastfeed your baby for as long as you want; enjoy the bonding and motherhood!