Did you know that bravery was a prerequisite for parenthood? I have to admit, I didn’t realize how often I would have to muster up my courage as a mom.

I think the first time it truly hit me was when I was in the hospital about to give birth. I have never been more frightened in my entire life. I wanted to run as far away from that place as possible. But then some deep-seated instinct kicked in, because I knew I had to be brave for the child I was about to welcome into this world. 

Over and over again, throughout my eight-and-a-half years as a parent, I’ve had to be brave for my child’s sake. Whether it was the first time I gave him solid food, let go of him in the swimming pool, sent him off to preschool, or watched him wave goodbye from the camp bus, each of these scary feats were actually critical steps in his development.

As most of us are well aware, there are so many more moments ahead (cell phones, overnight camp, dating, driving, college, etc.) when we’ll have to be courageous for our kids, even if it feels like we are jumping off a cliff.

The latest bravery test for parents involves peanuts. Even though many of us grew up with peanut butter and jelly sandwiches as a staple lunch option, we now see peanut-free classrooms and lunchrooms, and are very cautious about serving food with peanuts during playdates and birthday parties.

This is because over the last 10 years the number of peanut allergies has doubled in countries where parents are advised to avoid peanuts during pregnancy, lactation, and infancy. According to CNN, two percent of American children currently suffer from a peanut allergy.

A peanut allergy is serious business. It can lead to anaphylaxis and even death if allergic children are exposed. Unfortunately, no treatment exists for this type of allergy, so the only option is to avoid the trigger. This causes inconvenience and panic on a daily basis for parents, schools, and others responsible for children’s lives.

In fact, for years we’ve been told to not give our children peanuts at a young age because it could cause them to develop an allergy. Many parents, myself included, avoided giving their children peanuts until they were at least three years old, as recommended by the American Academy of Pediatrics (AAP). But many scientists now believe that exposing our children to peanuts at an early age will help their immune system to better tolerate the peanut proteins, and therefore prevent a peanut allergy from forming.

New guidelines issued this month advise parents to introduce peanuts into their children’s diets as early as possible to protect them against peanut allergies later in life.

New recommendations

Collaborating with 25 professional organizations, federal agencies, and patient advocacy groups, the National Institute of Allergy and Infectious Diseases of the National Institutes of Health (NIH) just released new guidelines for introducing peanuts into a child’s diet.

The recommendations fall into the following three categories:

Children who are believed to be most likely to develop a peanut allergy

This recommendation is for infants who have severe asthma, an egg allergy, or both. Parents have two options: 1) Either introduce your child to food containing peanuts at four to six months or 2) visit an allergist who will administer a skin prick test or a blood test to determine whether your child is allergic to peanuts.

If your child is not allergic, you can introduce peanut-containing foods at four to six months. If your infant is allergic, you should refrain from feeding any products containing peanuts.

Children with mild to moderate eczema

These children are less likely to have an allergy. You should introduce peanut-containing foods when your child is six months old.

Children with no eczema/food allergies, and no family history of either

These children can be fed peanut-containing foods at the same time they are introduced to other solid foods.

No matter which category your child seems to fall into, the experts still encourage you to consult with your child’s pediatrician for help determining if your little one is at risk and how to safely add peanuts to their diet. It is good practice to keep your pediatrician in the loop when you plan to introduce peanuts in case there is an adverse reaction. (This is where the bravery really comes into play!)

Why the change?

Medical experts began to question the existing guidance on peanuts as they saw a major difference in the number of allergy cases in various countries depending on when children began eating peanut products. There were lower rates of allergies in countries where children typically eat high levels of peanut protein starting in infancy compared to countries like the United States where peanuts are avoided during the first few years of childhood.

As scientists explored this trend, they found that eating peanuts can actually help prevent allergies. This idea is known as the dual-allergen exposure hypothesis, which suggests that eating small doses of the allergen at a young age can help children develop a tolerance and reduce their chances of forming an allergy.

A large medical trial, known as the Learning Early About Peanut allergy (LEAP) study, led to these new recommendations. It is the first and only large, randomized prevention trial for peanut allergies. More than 600 children participated in the study. Each child was randomly assigned to one of two groups: The first group ate low-dose peanut-containing food three times a week starting in the first year of life and continuing to age five. The children in the second group avoided eating peanuts for the first five years of their lives.

The children in the first group were given peanut butter or Bamba, a peanut-flavored puff snack produced in Israel, instead of whole peanuts because they’re a choking hazard for young children. All the children participating in the study were considered high risk for developing a peanut allergy due to family history or having eczema or an egg allergy.

At age five, the children in both groups were given peanuts and observed. The study found that 18 percent of the children who had been avoiding peanuts had a peanut allergy at age five, while only one percent of the children who had been introduced to peanut-containing foods at a young age were allergic.

According to experts who conducted the study, this result showed that early introduction of peanut flour had a prevention effect of more than 80 percent. They also evaluated the children a year later and discovered that all the kids who did not have an allergy at age five still did not have peanut allergy at age six.

Advice for feeding your child peanuts for the first time

You may be very nervous to feed your child peanuts for the first time. Fortunately, the NIH guidelines walk you through the best way to approach this risky moment:

1 | Prepare a full portion of a peanut-containing food such as:

 

  • Peanut butter dissolved or thinned with water
  • Peanut butter
  • Peanut flour or powder mixed with a fruit or vegetable puree
  • Several pieces of Bamba, a puffed snack containing peanuts that can be softened with water.

 

2 | Offer your infant a small part of the peanut serving on the tip of a spoon.

3 | Wait 10 minutes.

4 | If there is no allergic reaction after this small taste, then slowly offer the rest of the snack. According to the Mayo Clinic, typical allergic reactions to peanuts include runny nose, skin reactions, like hives or swelling, itchy or tingling in or around the mouth and throat, choking or gagging, shortness of breath, or wheezing.

It is a good idea to give your child the first bite of peanut-containing food during the day when your pediatrician is in the office. Keep the number handy just in case you notice an allergic reaction.

Feeding our baby peanuts for the first time may feel like risky business, but we now know that it’s the best way to prevent an allergy from forming later on.