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Dad making peanut butter sandwich for his child

Prevent Peanut Allergies by Introducing Peanuts Early

By Dr. Angela Duff Hogan, Allergy, Asthma and Immunology 

For years, parents were told to delay giving peanut-flavored foods to children until they were 3 years old, because of concerns the child would have an allergic reaction.

But now studies have shown that early introduction of peanut-containing foods actually reduces the chances of a child having allergies to peanuts. Of course, you don't want to feed them whole peanuts, which are a choking hazard, but you can blend peanut products, such as thinned peanut butter, into foods that are easy to consume.

The evidence has been building for years, and yet some parents are still hesitant.

In January 2021, three organizations, the American Academy of Allergy, Asthma, and Immunology; the American College of Allergy, Asthma, and Immunology; and the Canadian Society for Allergy and Clinical Immunology released guidance for parents, caregivers, and pediatricians to help prevent peanut allergies. Here’s their advice:

  • All infants between four and six months of age should be introduced to peanut-flavored foods, along with a diverse range of foods, once they’ve been introduced to common starter foods.
  • Previously, children who had siblings with peanut allergies or who had been identified as having severe eczema or egg allergies were advised to be screened and have the peanut introduction in a doctor’s office. Now guidelines recommend at-home introduction, and screening only if the parent has a concern.
  • The foods need to be age-appropriate, and you’d never want to feed a baby or children under 5 years of age whole nuts or spoonfuls of peanut butter they could choke on.
  • Babies should try other common starter foods before introducing peanut-flavored foods, to be sure they're developmentally ready. Then you can try two teaspoons of peanut butter mixed with two or three teaspoons of hot water, formula, or breast milk, and allowed to cool. Also, two teaspoons of peanut butter combined with two or three tablespoons of previously well-tolerated food, such as infant cereal, applesauce, yogurt, pureed fruits, or vegetables will work.
  • Maintaining tolerance requires making peanut-based foods part of the regular diet. Regular exposure for several years is felt to be more important than focusing on a particular fixed dosing interval or amount. A reasonable amount and frequency, such as 1 to 2 teaspoons of peanut butter at least once weekly, works well, and larger amounts if your child enjoys the food.
  • Eggs or products containing eggs should also be introduced to all infants around six months of age, but not before four months. Use only cooked forms of egg and avoid raw, pasteurized egg-containing products.
  • The guidance also recommends not deliberately delaying foods, such as soy, wheat, fish, or shellfish, just because you’re worried your child will have a reaction. Delaying the introduction of these foods could actually be harmful, and lead to allergies.

It’s a game changer that parents and pediatricians alike need to know about. Using a child’s natural immunity system can help reduce the number of children who suffer from allergies, and let them enjoy foods without fear of a reaction.

Dr. Hogan will be giving a presentation to a Coastal Food Allergy Support group meeting on February 16, 2021, at 8 p.m. by Zoom (Meeting ID: 373 205 5397 / Passcode: 226150). Find more information about the presentation at, or by emailing

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About Children's  Specialty Group Children's Specialty Group is the only pediatric multi-specialty practice serving southeastern Virginia and northeastern North Carolina. The physicians of Children's Specialty Group base their practices at Children's Hospital of The King's Daughters and serve as faculty in the Department of Pediatrics at Eastern Virginia Medical School. Learn more about our specialists here.