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Introducing Peanuts: A Guide for Parents

Allergy to peanuts is one of the most common food allergies. It tends to develop early in life and can persist through adulthood. Reactions can range from mild to life threatening. The current treatment for peanut allergy is avoidance and carrying epinephrine.

Research released in 2015 showed that early introduction of peanut-containing food to infants considered at high risk was beneficial. "High risk" is described as those with severe eczema, egg allergy or both.

Low risk for food allergy

If your infant has no eczema or any food allergy, then you can freely introduce peanut-containing foods into their diet around 6 months of age, as part of family’s diet and preferences.

Medium risk for food allergy

If your infant has mild to moderate eczema, they are encouraged to eat peanut-containing foods introduced into their diet around 6 months of age. This may be done at home or in the office setting, your health care provider will discuss this option with you.

Peanuts should be introduced when the family is comfortable introducing peanuts based family’s dietary preferences.


High risk for food allergy

If your infant has severe eczema, egg allergy or both, check with your PCP before feeding. They may either to do a blood test or send you to an allergy specialist for additional testing. The results will help determine if peanuts should be introduced into your infant’s diet. If the test results determine that it is safe, this may be done at home or it may be recommended to do it in an office setting. Introduction can occur at 4 to 6 months of age. If test results are high, then avoidance may be recommended at this time.

Infants should never be given whole peanuts due to choking hazard. Introduce other solid foods before trying peanut-containing foods.

Information provided by US Department of Health and Human Services

Introducing peanuts into your infant's diet

  1. Feed your infant at home on a day they are well
  2. Start small, offer a tiny bite of peanut serving first
  3. Wait 10 minutes and if no reaction is noted then continue feeding at a normal feeding pace

Options for feeding

Thinned smooth peanut butter

  • Mix 2 teaspoons mixed with hot water or breastmilk (2-3 teaspoons)
  • Stir until peanut butter dissolved and well blended
  • Let cool, more liquid can be added if still too thick

Smooth peanut butter puree

  • Mix 2 teaspoons of peanut butter with known tolerated pureed fruits or vegetables (2-3 teaspoons). More can be added if still too thick

Peanut flour or peanut butter powder

  • Mix 2 teaspoons of peanut flour or powder to tolerated pureed fruit or vegetable (6-7 teaspoons). More can be added if still too thick

Bamba Peanut Puffs

  • Can be found in specialty grocers or ordered online
  • 21 pieces will need to be eaten

What are symptoms of a reaction?

Mild symptoms:

  • A new rash or a few hives (red raised bumps) around the mouth or face

More severe symptoms:

  • Lip swelling
  • Vomiting
  • Widespread hives (red raised bumps over the body)
  • Face or tongue swelling
  • Difficulty breathing
  • Wheeze
  • Repetitive coughing
  • Change in skin color (pale/blue)
  • Sudden tiredness/lethargy/seeming limp

If you have concerns about your infant’s response to peanuts, seek medical attention/call 911.

Information provided from Journal of Allergy and Clinical Immunology January 2017