Chances are you’ve heard about the recent New England Journal of Medicine study suggesting that deliberately feeding babies peanuts can help protect them against food allergies. British infants 4 to 11 months old who were deemed at high risk of developing a peanut allergy were randomly assigned either to be regularly fed peanut products, or receive no peanut-containing food at all. By age 5, those who consumed the foods that had peanuts in them were far less likely to be allergic to peanuts.
The idea that babies should be fed peanuts early and often to help reduce food allergy risk is a dramatic shift from the guidelines most of us followed when our older children were babies: that giving kids peanut products in infancy or even toddlerhood—basically, before age 3—could predispose them food allergies. Among the 8 percent of U.S. kids who have food allergies, peanut-allergic kids tend to be at risk for the most severe reactions, including life-threatening anaphylaxis. So this is huge, potentially protocol-altering news.
However, leading up to the new study, there have been other allergy experts who’ve questioned the conventional wisdom of shielding babies from common allergens. Last year, while researching and writing a Parents magazine feature story, The New Rules for Food Allergies, I spoke with one of them: Kari Nadeau, M.D., who runs the Nadeau Lab at Stanford University, where she is associate professor of allergy and immunology. Yesterday, I reached out to Dr. Nadeau, to see if she could put the new research into perspective for our readers. In the midst of her busy clinic, she offered a few helpful pieces of advice, which I’ll share here.
HHK: Is the NEJM study surprising to you at all?
Dr. Nadeau: It makes sense and it is excellent data. Dr. Lack and his team and the NIH ran a very important study. We need to understand how to better diagnose infants and children at risk before we institute the healthiest, least risky diet to prevent food allergy.
HHK: Given the new evidence, what would be your advice to parents as to how to feed their babies?
Dr. Nadeau: I’ve long told all families without a high risk infant to diversify the diet early on at 4 to 6 months with many different foods. In addition, breast feeding and a healthy diet for the mom during pregnancy are helpful. I would suggest that all parents carefully diversify their infant’s diet to include common ‘allergenic’ foods unless told otherwise by their pediatrician.
HHK: If your child is high-risk for allergies—has a strong family history of food allergies, or eczema—would you advise a specific protocol for introducing these allergenic foods during infancy?
Dr. Nadeau: We need further data to support the exact dosing of a diversified food regimen that helps infants decrease the risk of any food allergy.
In other words, though the new study strongly supports the idea that introducing peanuts might have a protective effect against this dangerous allergy in particular, it’s still a good idea to talk to your child’s pediatrician about how to introduce foods, and when. (It’s also important to note that whole peanuts and sticky peanut butter can be choking hazards for babies.) Some doctors might suggest that a high-risk child try his or her first taste of peanuts in his or her office, just in case a severe reaction follows. And stay tuned for more developments on the food allergy front by bookmarking the excellent, parent-friendly site, FARE (Food Allergy Research & Education). Even if your own child isn’t allergic to certain foods, the skyrocketing food allergy rates make it near certain that she or he has a friend or classmate who is, and it pays for all of us to be aware.
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