Some babies should be given peanuts early say new US guidelines

Babies should be given peanut early – some at four months old – in order to reduce the risk of allergy, according to new US guidance,” BBC News reports. The guidelines are based on UK-led research that found early exposure reduced allergy risk.
The new US guidelines, which are informed by expert panel discussions and a new UK study, suggest that if an infant has severe eczema or an egg allergy, peanuts may be introduced at around four to six months. And that waiting later may increase the risk of an allergy developing.
However, they suggest checking with a health professional first if the infant does have these severe allergies.
For babies with no signs of allergies or mild to moderate eczema the new US guidelines recommend that peanuts can be introduced without seeking medical advice.
Current UK guidelines say that if your child already has an allergy (such as eczema or a diagnosed food allergy), or there’s a family history of allergy, you should get medical advice before giving them peanuts for the first time. See Food allergies in babies.
If there’s no history of food allergies or other allergies in your family, UK guidelines say you can give your baby peanuts from the age of six months, as long as they’re crushed or ground into peanut butter. Whole nuts, including peanuts, shouldn’t be given to children under five as they can choke on them. See Food to avoid giving your baby.

Who produced the guidelines?

The guidelines were produced by the National Institute of Allergy and Infectious Diseases, part of the Department of Health and Human Services, National Institutes of Health in the US.

What evidence did they look at?

Despite the guidelines being for the US, they are actually based on research from the UK; specifically a clinical trial called the Learning Early About Peanut Allergy (LEAP).
LEAP was a randomised controlled trial (RCT) involving 600 children aged between 4 and 11 months with severe eczema, egg allergy or both. The babies were randomised to eat or avoid peanut-containing foods (but not whole nuts) until 60 months of age.
At the age of five the children were given a “peanut oral food challenge” which involves exposing the mouth to a small amount of peanuts (2 to 3.9g) to see if there was any allergic reaction(s).
The researchers found that regular consumption of peanut-containing foods in early life reduced the risk of developing a peanut allergy by 81%.
We discussed this study in detail in February 2015.
Along with this evidence, the guideline committee also carried out a literature review of recent research and asked an expert panel, consisting of 26 experts from clinical, public health and scientific backgrounds, to contribute to the guidelines.

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