Dr. Abby Meyer gives tips for how to safely expose kids to peanuts at an early age.
Abby Meyer, MD
Recently, the American Academy of Pediatrics (AAP) published a study that found children exposed to peanut products at an early age were less likely to develop peanut allergies. This study showed there is a potential protective effect of early exposure to peanut products, reversing earlier recommendations from AAP that children at high risk of a peanut allergy avoid exposure until age 3. Pediatricians now recommend that the best time for parents to introduce peanut products is between 4 and 11 months.
However, pediatricians also caution that children younger than 4 years old should not be given nuts, as nuts can cause aspiration or choking. Aspiration occurs when something is lodged in a person’s airway but they can still breathe, and choking is when the lodged object blocks airflow. Aspiration can cause a child to cough or gag, or even stop breathing. It can be life-threatening, and the only way to get something like a nut out of the airway is surgical removal. If parents suspect their child is aspirating or choking, call 911 immediately.
Children younger than 4 are at risk for choking on nuts because, at those ages, kids generally don’t have all of their teeth and molars, which are important for chewing and swallowing nuts.
Additionally, young kids often eat while moving or running around, which can lead to aspiration or choking.
Introduction to kids
So how do parents safely introduce peanuts to their children? It’s recommended that parents give children younger than 4 a small amount of creamy (not chunky) peanut butter on a piece of bread, cracker, vegetable or fruit, or add peanut powder into yogurt or other soft foods. This allows parents to introduce their children to peanuts without needing to chew and swallow a nut.
There are a few exceptions to this guidance. If a child previously had a rash or allergic reaction to peanuts or another nut, they should not be exposed to peanut products. These findings are specific to preventing allergies; they don’t apply to children already diagnosed with a nut allergy. Children with severe eczema or an egg allergy should visit an allergist prior to peanut introduction, as they could be at increased risk for allergy.
While it’s important for parents to know the benefits of introducing peanut products into their child’s diet, it’s vital to understand the safest way to do so — without risking aspiration or choking. By feeding 4-11-month-old infants peanuts through soft, creamy peanut butter or peanut powder, parents can potentially lower their child’s risk for a peanut allergy.
If you have questions about how to introduce peanuts into your child’s diet, talk to your Children’s Minnesota pediatrician.
Abby Meyer, MD, is a pediatric otolaryngologist at Children’s Minnesota.