Pediatrics | Published May 30, 2019

Ask the pediatrician: Peanut allergy

Dr. Collison,

What are the current age guidelines for introducing peanuts? My babysitter apparently gave my 13-month-old some peanut butter today - no reaction thankfully but I would love some tips I could pass on. Thanks!

This is a good question. Until recently, the American Academy of Pediatrics recommended delaying the introduction of peanut products to possibly prevent the development of allergic reactions. Now, the latest guidelines from the National Institute of Allergy and Infectious Diseases recommends dividing babies into three groups:

  • Babies with severe eczema and/or egg allergy. Those that fall within this category should be tested for peanut allergy. If an allergy is present, the recommendation is to introduce peanut products between four and six months. Additionally, it is best for the introduction to take place at the doctor’s office so the doctor can monitor any reaction.
  • Babies with mild to moderate eczema. Babies that fall within this category do not necessarily need a peanut allergy test, but parents are advised to discuss when to introduce peanut products. Introduction should take place at six months of age.
  • Babies without eczema or a food allergy. For babies that do not have eczema or other food allergies, peanut products can be introduced at the parents’ discretion.

Whenever you are ready to give your baby peanut products again, smooth peanut butter is a good choice. Chunky peanut butters or whole peanuts may pose a choking hazard for babies.

Hope this helps!