Science says feeding your baby peanuts early may be the key to thwarting allergies

Parents and doctors have been wrestling with nutrition-based allergies for years. This study could be the game changer.
Unrecognizable little boy sits at a table eating peanuts (Getty Images/iStockphoto)

I know how to use an Epipen. My best friend in elementary school, Kenny Pike, was deathly allergic to Yellow Jackets. I got full training so I could save his life if death came calling in the form of a wasp's butt. "Marc, listen carefully, if you don't get this right, your best friend... will die." Cool, got it. Can you show me that one more time? Scary. But there was never any danger that Kenny would be accidentally served a Yellow Jacket sandwich in the cafeteria. My point? Food allergies are genuinely bone-chilling.

That the fate of some children rests in their proximity to a clam or peanut is decidedly unjust. And truly terrifying for parents. Thankfully, new science may assuage those fears and shed some much needed light on peanuts (that most maligned legume) and the people who fear them.

New guidelines from the National Institute of Allergy and Infectious Diseases (NIAID) are pretty clear and frankly, pretty bold. It seems most babies should be fed "peanut-containing foods early and often". Strong emphasis on "most", but allergist Alkis Togias at NIAID says, "if you introduce peanuts early, you're going to have a very good chance of preventing peanut allergy".

The brazen statement may be met with skepticism. Parents and doctors have been wrestling with nutrition-based allergies for years. Until recently, it's been something of a slippery pig and really tough to pin down. Past studies are conflicting: "avoid peanuts until 3 years", "start with peanuts before age 1", "make sure you never invite a peanut into your home because that will give it power over your family". Okay, that last one is more about vampires, but the fear is about the same. And in some cases, rightly so.

For severe allergy sufferers, contact results in anaphylaxis, a rapid-onset reaction often marked by an itchy rash, shortness of breath, swelling of the tongue or throat, lightheadedness, a drop in blood pressure, vomiting and, in rare instances, death. Again, bone-chilling. No wonder PB&Js are strictly verboten in schools. Even still, a lot of doctors think the school ban is overkill. Uh, make up your mind science!

To be sure, the issue is still pretty complex, but the new guidelines are ratified by real science and point to peanuts being back on the menu for most babies.

Important note to be read with a grave tone: this does not mean you can feed someone with a known peanut allergy a peanut now. That's still dangerous. Nor does it mean that peanut allergies no longer exist. They do and they're serious. Please read the paragraph on anaphylaxis above if you just skimmed it. These new guidelines are meant to be preventative.

What it does mean is that MOST babies should have peanuts introduced into their diets early. The clarification of "most" is as follows: if a baby has mild to moderate eczema, a skin condition commonly linked to allergies, peanuts (smooshed up well and in small doses to avoid choking) can be introduced as early as 6 months, after other solid foods. If infants have severe eczema or an egg allergy, they should be tested for a peanut allergy before getting anywhere near a peanut.

Adding more complexity to a complex issue, allergist Katie Allen says the standard skin-prick test can result in a false positive leading people to avoid peanuts when no allergy is present - which in turn could result in a peanut allergy. I know, my head hurts too.

Regardless, for all other baby humans, the "peanuts-within-the-first-year rule" still stands and will likely thwart peanuts becoming an antigen (scientific jargon for food meanie).

Recommended approaches for evaluation of children with severe eczema and/or egg allergy before peanut introduction from the Journal of Allergy and Clinical Immunology.

The science is from a 2015 trial known as LEAP (Learning Early about Peanut Allergy). LEAP separated "640 babies between 4 and 11 months old with severe eczema and/or egg allergy" into two groups with one simple dietary differentiator: peanut eaters and peanut avoiders.  In scientific terms, it was a game changer. Togias says "the results were so impressive that we felt it would be unethical to not come out with these guidelines." The results? Peanut allergy dropped by about 70 to 80 percent in the peanut fed babies. Game changer. Also, I'm imagining peanut farmers high-fiving each other.

It just got a little easier out there for a peanut. And a parent. That said, parents, peanuts, babies and anyone else reading this should always speak to a nutritionist, allergist or doctor when it comes to health or dietary concerns. Still, at the very least these new guidelines could eventually leverage food allergy fears and one day let more parents, and kids, relax a little in the presence of a good old fashioned PB&J.