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“This is a very exciting development for those of us who have been treating an increasing number of kids with peanut allergies in the past 25 years,” said Amal Assa’ad, Managing Director, ACAAI Food Allergy Committee, US. “To be able to offer parents a way of reducing the risk of their children developing peanut allergies is remarkable and of real importance.”
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The authors recognised early introduction of peanut-containing foods may seem to depart from recommendations for exclusive breastfeeding through six months. Introduction of peanuts did not affect the length or frequency of breastfeeding, and did not negatively influence growth or nutrition. The first step, according to the study, is determining if your child is at high-risk for peanut allergy.
Before introducing peanut-containing foods to a high-risk infant, the infant should be seen by their primary health care provider who will determine if referral to an allergist for testing and/or in-office introduction is needed.
According to the guidelines, an infant at high risk of developing peanut allergy is one with severe eczema and/or egg allergy. The guidelines recommend introduction of peanut-containing foods as early as 4-6 months for high-risk infants, after determining that it is safe to do so.
“If your child is determined to be at risk and then is tested and found to have peanut sensitisation, meaning they have a positive allergy test to peanut, from that positive test alone we don’t yet know if they’re truly allergic,” said Matthew Greenhawt, allergist in the US and co-author of the study.
Peanut allergy is only diagnosed if there is both a positive test and a history of developing symptoms after eating peanut-containing foods. Some allergists caring for a child who has a large positive skin test may decide not to do an in-office challenge.
Instead, one might advise that the child avoid peanuts completely due to the strong chance of a pre-existing peanut allergy. Other allergists may proceed with a peanut challenge after explaining the risks to the parents.
Children with mild to moderate eczema who have already started solid foods do not need an evaluation, and can have peanut-containing foods introduced at home by their parents at around 6 months of age. Children with no eczema or egg allergy can be introduced to peanut-containing foods at home as well, according to the family’s preference.