Remember years ago when butter was the devil? And everyone switched to margarine? But then we all learned that apparently margarine is basically fake food and we should all go back to butter? And then almond milk became the new cows’ milk and then coconut milk became the new almond milk and now my head is spinning and I’m basically questioning how many other things can make milk.
It seems that this is how it goes in parenting too, doesn’t it? Rear-facing car seats until 1! No! Rear-facing until 2! Solid foods at 6 months! No, 3 months! No, a year! And the peanut thing is no different.
We introduced our first two kids to peanut butter at around a year. There was no sign or concern about an allergy, and all was well, as they have gone on to live happy, healthy, peanut-filled childhoods. However, I can recall many of my friends gasping in horror because apparently you were supposed to wait until age two.
Our third child, however, was allergic to a litany of things—milk, grass, cheese, lotions, fabrics, detergents… so out of fear of yet another allergy attack, we avoided all nuts for a while. And when we finally realized he’d never been exposed, it was too late. Today, at five years old, he is allergic to nuts, has an epi-pen, and I’m an allergy mom.
The American College of Allergy, Asthma, and Immunology reports that, in recent years, awareness about peanut allergy in children has risen, as has the number of peanut allergy cases reported. In May 2010, a study noted that the rate of peanut allergies in children, as reported in a telephone survey, had more than tripled between 1997 and 2008.
Did the widespread belief that we should all wait lead to a higher risk? Did my own hesitation have anything to do with my son’s allergies? Who knows. But there’s definitely a part of me that wishes we’d introduced a little peanut butter into his diet when he was a baby. And that’s exactly what experts are telling us is the current recommendation. The old philosophy of “wait until 2” is outdated, and allergists now say the earlier our little buggers are exposed, the better.
“Now, based on new guidelines, highly allergenic foods like peanuts and tree nuts can be introduced as early as 4-6 months of age if the baby is low or moderate risk,” says Dr. Purvi Parikh, allergist and immunologist with Allergy & Asthma Network.
Dr. Parikh does specify, however, that this recommendation is different for “high risk babies.” These children should be evaluated by a board certified allergist first.
So what does “high risk” mean? Having a history of allergies in the family? No, according to this allergy expert. “High risk is defined by any child who has severe eczema and/or egg allergy already. Moderate risk is those kids with mild to moderate eczema—they also can start eating 4-6 months and don’t need additional evaluations,” Dr. Parikh adds.
Therefore, according to these guidelines, children without any allergies and eczema can proceed straight to eating nut-based products, such as Crazy Richards’ peanut butter powder, after they’ve begun eating solid foods and can sit in a high chair.
Our son did have severe eczema as a baby, so maybe we would have waited anyway. Or maybe we would have taken Dr. Parikh’s suggestion and had him evaluated by a board-certified allergist years ago. But we didn’t, and now we’ll never know what could have been.
So how does Dr. Parikh recommend parents introduce their babies to the possible allergen? Here are a few tips:
- Introduce each nut product one at a time 3-5 days apart and at home rather than in a restaurant. (Do not feed children whole nuts until age 4.)
- To prevent a choking hazard, parents can thin creamy peanut butter with warm water or breast milk, or use powder in small quantities, depending on the child and age, as long as baby has good neck control.
- After introducing the food, look for common signs of allergic reaction such as rashes, hives, or eczema and/or coughing, wheezing, vomiting, diarrhea within an hour of eating.
Dr. Parikh says the same procedure—introducing small quantities of foods 3-5 days apart, at home, can be applied to other common allergens such as eggs and shellfish. And that if your child shows any signs of allergic reaction, to immediately contact your doctor.
In the end, did the widespread belief that it was unsafe to introduce babies to peanut butter until age two cause a rise in allergy diagnoses? We really don’t know. “Recent studies show it may have, but it is not the only factor,” Dr. Parikh says. “Our environments have also made us more allergic. The shift towards city living, industrialization, over sanitization and processed food consumption plays a very large role in rise of peanut allergies.”
However, The American Academy of Allergy, Asthma, and Immunology does assert that “researchers found children at high risk of developing peanut allergy were far less likely to develop an allergy when introduced to peanuts before they turned 12 months old.”
So, if parents want to be proactive about food allergies, there is only so much they can do. But including introducing their babies to nuts early on may be one such proactive step.