Early introduction of peanuts in infants to reduce allergy risk

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Estimated to affect 1%-2% of children, peanut allergy often is severe and lifelong. Manifestations of peanut allergy range from mild to severe, and risk factors predisposing to severe reactions are discussed. However, even in the absence of risk factors, peanut allergic individuals may still experience life-threatening anaphylactic reactions.

In 2017, the National Institute of Allergy and Infectious Diseases (NIAID), with the help of the American Academy of Allergy, Asthma & Immunology (AAAAI) and 24 other organizations had issued an addendum to its clinical guidelines detailing when to introduce children to peanut-containing foods. The guidelines recommend that children at high risk should be introduced to peanuts early in life, instead of avoiding all peanut-containing foods.

Recently, a pratise article in Canadian Medical Association Journal highlights five things to think about early introduction of peanuts in infants to reduce the risk of peanut allergy.

  • Infants who are fed peanut protein regularly have a lower risk of peanut allergy.
  • To prevent peanut allergy, peanut protein (such as peanut butter or powdered puff) may be introduced at home for most babies between 4 and 6 months as one of the first foods.
  • Babies with severe eczema are more likely to have peanut allergy, and those with no or only mild eczema are best-suited for peanut introduction in the home.
  • Infants with risk factors for peanut allergy, such as severe eczema, egg allergy or both, should be seen by a specialist before peanut introduction.
  • To reduce the risk of peanut allergy, 8 grams of peanut protein (1 heaped teaspoon of peanut butter) should be eaten at least twice a week.

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