Confusing Advice on Allergies Made Less Confusing

Feeling like the advice you get about food allergies changes monthly? Not sure what advice to follow? You are not alone. As a practicing pediatrician, I see parents everyday who don’t know when to introduce food to their kids. Frustrating as it may be, part of the reason is that this area of medicine is under very active scrutiny with new clinical studies emerging yearly.

Only a few years ago, guidelines pushed families to delay exposure of high risk allergens like peanuts to infants and toddlers. Guess what? That was bad advice based on expert opinion. Should you run away now from medical doctors giving you such bad advice? Absolutely not. As research continues, we will continue to improve the advice and care we provide, but sometimes we have to make some educated guesses based on collective experience and knowledge while we wait for the research to be done. While it is not 100%, we are right a good proportion of the time which compared to non-experts, leads to far better outcomes for patients.

The new advice with food is to stop avoiding peanuts. More specifically, give kids peanut products early, in fact as early as 4-6 months. Now don’t start popping peanuts into your infant just learning to eat. There are some rules to follow and safe forms of peanuts that are not choking hazards. One example would be mixing peanut butter into pureed fruits or vegetables. So here are the general rules:

1. Got an infant with significant eczema or egg allergy? Talk to your pediatrician or allergist to have your child tested prior to introducing peanut. This can be by blood test or skin test.
2. Infants with any eczema should wait until around 6 months of age to introduce peanut into their diet and after other foods are successfully introduced.
3. Infants without eczema or food allergies may introduce peanut products freely into the diet with other solid foods.

Don’t despair if you are still confused. Reach out to your doctor to discuss the new recommendations and get updated on the emerging evidence on food allergy. Chances are, advice is going to continue to change and improve. Having an ongoing dialogue with your pediatrician is good advice that will not change.

Michael Martin, MD
Einstein Pediatrics, Vienna
www.einsteinpeds.com