In 2015, a landmark study, The LEAP Study (Learning Early About Peanut-Allergy), demonstrated that early consumption of peanuts in infants 4-6 months of age can prevent the development of peanut allergy. Since then, early peanut introduction in infants has become almost mainstream but many parents are pursuing this without any guidance. So for the parents out there – let’s review.
The original study original was born out of a curious observation that school-aged children in Israel have a significantly less peanut allergy and EpiPen use for peanut allergy. After careful observation, researchers from the UK found to that Israeli children were desensitized in the first year of life due to consumption of the insanely popular peanut snack known as Bamba!
As the son of Isareli immigrants – I can attest to the ridiculous amount of consumption of this snack in infants and young children. The popularity stems from the fact that the peanut/corn puff dissolves int he mouth of infants making safe for infants (no choking risk). Infants can be seen in strollers all over Israel chowing down on Bamba – their faces covered in peanut dust.
The Bamba phenomenon led to the Leap Study – a large-scale placebo controlled study evaluating early peanut exposure, desensitization and prevention of peanut allergy. The findings were remarkable. Early peanut exposure resulted in decrease risk of peanut allergy and Epipen use later in life. This was especially true for those infants already at high risk for peanut allergy including infants with severe eczema.
The guidelines for early introduction of peanuts to infants suggests the following:
Severe Eczema (requiring medium-dose steroids such as Triamcinalone 0.1%): See Pediatric Gastroenterologist or Pediatric Allergy for allergy testing prior to early introduction, as early as 4 months of age.
Mild-to-Moderate Eczema: Introduce peanuts at home at 6 months after discussion with Pediatrician or Pediatric Gastroenterologist or Allergy physician.
No Eczema: Introduce peanuts at home at 6 months or later in accordance with cultural/personal beliefs.
Peanuts should never be a first food. Your infant must demonstrate they can tolerate a number of “safe” foods prior to peanut introduction. Finally, although eczema appears to be a strong risk factor for peanut allergy and need for early-introduction – parents should ask their Pediatrician about other risk factors such as infant asthma or strong family history of peanut/food allergy which may trigger allergy testing prior to introduction.
For those parents that have been cleared for early peanut introduction – guidelines recommend 6g per a week. This should be continued at least 2-3 years but some recommend up to 5 years! That is some commitment! But it seems entirely worth it when you consider the alternative – a lifetime of allergy and the need for Epipen to be available at all times!
The 6g/week is equal to about 2 tsp of organic peanut butter 3x/week mixed into other solids or purees. This link provides recipes using both peanut butter, peanut flour and increasingly popular Bamba snack (now available at Trader Joe’s!). The American Academy of Allergy and Immunology has provided a tip sheet for parents/providers on early peanut introduction. Always be sure to consult with your Pediatrician, Pediatric Gastroenterologist or Pediatric Allergist for guidance.
