New allergy-prevention guidelines on introducing peanuts to babies

For all those parents concerned about how to safely start feeding peanut-containing foods  to their young children, the National Institute of Allergy and Infectious Diseases issued new guidelines Thursday on how to introduce even babies at high risk for adverse reactions to this common nut and to help prevent peanut allergies.

The bottomline:  the experts still say early is better - even as early as four months, including for babies thought to be at high peanut-allergy risk.

The panel of numerous  pediatric experts  came with three basic guidelines:

- For the highest risk children, such those with severe eczema, egg allergy or both, strongly consider a medical evaluation by a skin prick test, blood test or oral food challenge. Based on the results, introduce peanut-containing food at age four to six months.

- For moderate risk babies with mild-to-moderate eczema, introduce peanut-containing foods at around six months of age.

- For children at the least risk for adverse reaction with no eczema or any other food allergy, introduce according to family preference and cultural practices. Overall research has suggested introduction is related to allergy prevention.

The new guidelines also offer detailed recommendations on how to introduce peanut-containing foods. Some of the suggestions include diluting smooth peanut butter with water, mixing it with a food the baby already tolerates well or feeding liquid softened-Bamba, a peanut-containing puff snack that is popular in Israel and has figured in past research.

Peanut allergy is serious business and a growing health concern. The new guidelines note it is the leading cause of death in food allergic reactions, although that occurrence is relatively low. But the allergy has grown. In 1999, peanut allergy affected an estimated .4 percent of children. By 2010, that had increased to two percent of children in a national survey.

Research has increasingly shown that feeding peanut foods to babies - compared to older recommendations to wait until children are even a couple years old -  appears to reduce the rate of allergy.

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