thFor years, pediatricians have cautiously recommended that parents avoid giving certain foods — especially fish, eggs, and peanuts — until after the first birthday. Delaying exposure was thought to help prevent the development of allergies to these foods. Children thought to be at higher risk of food allergy (especially those with a strong family history of severe reactions, or anaphylaxis, to certain foods) were advised to delay the introduction of some of these foods until three years old. What we saw after those recommendations were implemented was a rise in food-related allergies, leading to the AAP reversing that advice in 2008. Deborah Kotz tells us where we stand today regarding peanut allergies:

The prevalence of peanut allergies in the U.S. has skyrocketed in recent years – quadrupling from 0.4 percent in 1997 to more than 2 percent in 2010. In fact, peanut allergies, which typically begin in early childhood and are rarely outgrown, have become the leading cause of severe food-related allergic reactions and death in this country.


Researchers wanted to know why rates of peanut allergies were rising in the U.S. and U.K. during this period of peanut-abstinence while the rate in Israel — where one of the most popular first finger foods for infants is the peanut-containing snack “Bamba”  — was not. Jennifer Couzin-Frankel looks at a new study, published last week in the New England Journal of Medicine, involving 640 babies considered to be at high risk for developing peanut allergy:

The team divided the babies into two groups. Half were to avoid eating peanut products until they were 5 years old. The other half received at least 6 grams of peanut protein a week, spread across at least three meals, until they were 5 years old. Bamba was the preferred offering, though picky eaters who rejected it got smooth peanut butter.


And the winner is:

Our findings showed that early, sustained consumption of peanut products was associated with a substantial and significant decrease in the development of peanut allergy in high-risk infants. Conversely, peanut avoidance was associated with a greater frequency of clinical peanut allergy than was peanut consumption, which raises questions about the usefulness of deliberate avoidance of peanuts as a strategy to prevent allergy.


Pediatrician Scott H. Sicherer tells AAP News where we go from here:

Although specific studies are lacking, the results of the LEAP study, prior observations and AAP guidance all support the notion that introduction of peanut in the infant diet need not be delayed. It is not envisioned that peanut should become a “first food” for infants. Rather, it could be incorporated into the diets of healthy infants who have tolerated other first foods without difficulty and are developmentally ready to ingest peanut-based foods without choking.


Of course, we don’t want infants, or even toddlers, to eat any nuts whole, because of their very real risk of choking and aspirating. But it looks like the recommendation to hold off on food containing processed peanuts has bit the dust.

Is there a sound reason to avoid eggs? Can babies eat fish?

Better watch out for bones.