Food allergies affect 1 in 13 children, a figure that’s increased 50 percent from 1997 to 2011, according to the Centers for Disease Control and Prevention.

For years, experts have recommended avoiding giving children peanuts until their third birthday for fear of triggering an allergy. But new guidelines from the National Institutes of Health recommend introducing peanut-containing foods to a child’s diet as early as four months of age to reduce the risk of developing a peanut allergy.

The guidelines, issued in early January 2017, are broken down into three parts for infants at various risk levels for developing a peanut allergy:

  • Infants deemed at high risk of developing a peanut allergy, because they already have severe eczema, an egg allergy or both, should be introduced to peanut-containing foods as early as four to six months of age after consultation with their health care provider and possibly an allergist.
  • Infants with mild or moderate eczema should be introduced to peanut-containing foods as early as six months of age.
  • Infants without eczema or any food allergy can be freely introduced to peanut-containing foods.

Dr. Elizabeth Koonce of Novant Health Eastover Pediatrics in Charlotte, North Carolina, said that until the last several years, there was little research to back up recommendations, but the new expert panel sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), gives clear clinical guidelines today to aid health care providers in early introduction of peanut-containing foods to infants to prevent the development of peanut allergy.

What’s a parent to do?

Considering the recent research, parents may opt to give their children food containing peanuts within reason. In all cases, infants should start other solid foods before they are introduced to peanut-containing foods.

To avoid choking hazards, Koonce suggested introducing small amounts of peanut butter mixed in with other foods.

There is no cure for children who do have confirmed food allergies. Strict avoidance of allergens and immediate management of reactions are critical in preventing serious anaphylactic episodes. Koonce also noted that although many children’s reactions to peanuts may be mild, if a child could be having an allergic reaction, it’s always better to be safe than sorry.

“You should never hesitate to use your child’s EpiPen,” Koonce said. “Delay in giving Epinephrine is the factor most associated with poor outcome with a severe allergic reaction in patients with known food allergies.”

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