The early introduction of peanut-containing foods to infants may help prevent the development of peanut allergy, according to guidelines issued today by the National Institute of Allergy and Infectious Diseases (NIAID).

Recent oral food challenge (OFC) studies have indicated that introducing peanut-containing foods in infancy results in a much higher rate of tolerance in later years. The new guidelines are an addendum to the Institute’s 2010 guidelines; the implications of the changes could potentially reduce the prevalence of peanut allergies in the U.S.

“The LEAP study clearly showed that introduction of peanut early in life significantly lowered the risk of developing peanut allergy by age 5. The magnitude of the benefit and the scientific strength of the study raised the need to operationalize these findings by developing clinical recommendations focused on peanut allergy prevention,” said Daniel Rotrosen, M.D., director of NIAID’s Division of Allergy, Immunology and Transplantation. 

The new NIAID guidelines specify the steps for infants by age and eczema and egg allergy status (both at higher risk for peanut allergies):

Infants with severe eczema, egg allergy or both:

  • Should be introduced to peanut-containing foods between 4-6 months of age. The infants should first see a board-certified allergist for peanut allergy testing, which will determine if peanut can be safely introduced, and if this needs to first be done in a specialist’s office.

Infants with mild or moderate eczema:

  • Should have peanut-containing foods introduced into their diets at 6 months of age to reduce the risk of developing peanut allergy. These children do not need to first see a specialist and can have peanut-containing foods introduced at home.

Infants without any eczema or egg allergy:

  • Can have peanut containing foods freely introduced into their diets together with other solid foods. These infants do not need to see a specialist first and can have the foods introduced at home.

Additionally, the guidelines state that peanut-containing foods should not be the first solid food introduced to an child and should not be given when the child is ill. Whole peanuts should not being given as they present a choking hazard.

“Living with peanut allergy requires constant vigilance. Preventing the development of peanut allergy will improve and save lives and lower health care costs,” said NIAID Director Anthony S. Fauci, MD. “We expect that widespread implementation of these guidelines by health care providers will prevent the development of peanut allergy in many susceptible children and ultimately reduce the prevalence of peanut allergy in the United States.”

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