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Babies and Peanut Butter

babies and peanut butter

When is a good time to introduce peanut butter into child's diet? Everything you read is so conflicting.

In the last 5 years, there have been dramatic changes in recommendations on starting solid foods. Once strict guidelines with threatening warnings have now been replaced by loose, evidence based guidelines. This whirlwind change has lead to continued confusion on this issue.

Prior to the updated recommendations when parents asked me, “When can we feed our baby peanut butter?” I use to ask “Are you asking me or the American Academy of Pediatrics?”. I would then explain the old AAP recommendation to wait until 3 years old and also explain my disagreement with that recommendation. Fortunately, times have changed and now I agree with the current recommendations.

Both the American Academy of Pediatrics and the American Academy of Asthma Allergy and Immunology now feel peanut butter and other major food allergens are safe after 4 to 6 months.

As of 2008, the current American Academy of Pediatrics recommendation states: “Although solid foods should not be introduced before 4 to 6 months of age, there is no current convincing evidence that delaying their introduction beyond this period has a significant protective effect on the development of atopic (allergic) disease regardless of whether infants are fed cow milk protein formula or human milk. This includes delaying the introduction of foods that are considered to be highly allergic, such as fish, eggs, and foods containing peanut protein.”

The American Academy of Asthma Allergy and Immunology currently states: “The introduction of solid foods should not be delayed beyond 4 to 6 months of age. Delaying the introduction of potentially allergenic foods, even in infants at risk for food allergy, has not been clearly shown to be beneficial.”

Not only is there a lack of evidence that waiting to introduce peanut butter is beneficial, there is now evidence that early introduction is best. In 2009, Drs. Faith Huang and Anna Nowak-Wegrzyn published research titled “Early Consumption of Peanuts in Infancy Is Associated with a Low Prevalence of Peanut Allergy”. Their paper showed that early introduction and frequent exposure to peanut products actually reduces a child’s risk of acquiring food allergies. They found a 10 fold greater risk of peanut allergy in children who were exposed to peanuts later in life.

In our home, we have traditionally introduced peanut butter after 12 months old. I was never impressed by the “wait until 3 years old” evidence and we do not have a family history of food allergies. Our 6th child was fed a peanut butter sandwich at 9 months by his babysitting older sister. Our current 8 month old has had some peanut butter cooked into other foods, but not a peanut butter sandwich (that I know of). I’m sure we will serve her a PB&J as she gets closer to 12 months. Sure peanut butter is a major allergen, but it also poses a choking hazard for young children.

When you do decided to feed your child a peanut butter sandwich spread the peanut butter thin. Ideally, new foods should be introduced during a week day when you can observed your child for a few hours and call your doctor if there are any problems.

 

 

 

Written September 2013 by
Dr. Gordon, Orlando Pediatrician

 

 

 

References

“Early Consumption of Peanuts in Infancy Is Associated with a Low Prevalence of Peanut Allergy”, Faith Huang and Anna Nowak-Wegrzyn PEDIATRICS Vol. 124 No. Supplement 2 November 1, 2009 pp. S118 -S119 (doi: 10.1542/peds.2009-1870V)

 

 

 

 

 

gregorygordonmd.com is intended to help parents understand the needs and behaviors of children. The information presented in the site is the opinion of Gregory Gordon, M.D.and does not reflect the opinion of his partners. This website is owned exclusively by Doctors insights LLC. The advice in this site does not apply to all children. Always consult your healthcare provider for your individual needs.

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