Updated: Nov 28, 2019
My 5 year old just recently started Kindergarten, which means I'm now at the stage of packing LUNCHBAGS every morning! Little did I know, coming up with all these different lunchbag combinations was so difficult! You've got to be creative, man! And above all, you've got to be prepared for a whole week's worth of lunchbags that 1) includes a fruit, a vegetable, a protein and a starch 2) preferably finger foods 3) doesn't need to be heated up 4) is something my kid will actually eat 5) is not the same every day and 6) doesn't include peanuts.
Yep, no PB&J's, y'all. My go-to when there's nothing else in the house and I'm in a rush. The kids like it, it's shelf stable, it's easy, it's cheap and it's semi-healthy. But most schools nowadays are peanut-free, so no PB&J's, peanut muffins or peanut granola bars allowed in lunchbags. Understandably so, because peanut allergies are no joke, y'all!
According to statistics of the American Academy of Allergy, Asthma and Immunology (AAAAI.org), peanut allergy is the most common food allergy in the US, followed by milk and shellfish. In 2014, more than 4 million children in the US suffered from food allergies, and most of them are allergic to peanuts! Peanut allergies can be a dangerous thing: Severe, life threatening allergy attacks can occur from being exposed to even tiny amounts of peanuts. In severe cases, the peanuts don't even have to be ingested: simply being in the same room as someone who is eating peanuts can trigger symptoms in extremely sensitive individuals. Quite scary, if you are the parent of a child with peanut allergies. I will gladly comply with the rules of 'no peanuts in schools', even if my daughter is not allergic to them.
I know the question in every new parent's mind is: How do I introduce peanuts to my baby, without knowing if they are allergic or not? And furthermore: Can I prevent my child from getting a peanut allergy in the first place? When is the best time to introduce peanuts to a child?
The LEAP study
In the past, allergists have recommended avoiding allergenic foods such as peanuts for at least the first 2 years to prevent food allergies. The result? A steep rise in peanut allergies and other food allergies over the past 20 years. The LEAP (“Learning Early About Peanut Allergy”) study, published in the New England Journal of Medicine, therefore investigated the following: Can EARLY introduction of peanuts prevent peanut allergies? LEAP followed over 600 children who were considered at high risk for peanut allergy until they were 5 years old. When they were between 4 and 11 months of age, they were randomized to either consume a peanut product at least 3 times per week, or completely avoid peanuts. When they reached the age of 5 years old, they compared which group had developed a higher rate of peanut allergy.
Lo and behold, over 17% of the kids who had avoided peanuts developed a peanut allergy, versus only about 3% of kids who consumed peanuts early on - that's an 81% relative risk reduction of developing peanut allergy in those kids who were introduced to peanuts in infancy!
As a result, the National Institute of Allergy and Infectious Diseases (NIAID), which is part of the National Institute of Health (NIH), has come out with NEW GUIDELINES for the introduction of peanuts to infants:
Guidelines for Introducing Peanuts
Infants with severe eczema, egg allergy, or both should have an introduction with age-appropriate peanut-containing food as early as 4 to 6 months of age, and after a few other solid foods have been introduced to show the infant is developmentally ready. It is also recommended that either a peanut specific immunoglobulin E (IgE), skin prick test, or both be performed by the child's pediatrician prior to the introduction of peanut.
Infants with mild to moderate eczema should have an introduction of age-appropriate peanut-containing foods around 6 months of age, and after a few other solid foods have been introduced to show the infant is developmentally ready.
Infants without eczema or any food allergy may have age-appropriate peanut-containing foods freely introduced into their diet, together with other solid foods.
(A pdf with these recommendations developed by the NIH can be found here)
How to introduce Peanuts to Babies?
So much for the Guidelines, but we all know Peanuts are a choking hazard for kids under 5 years old. Peanut butter isn't much better because it is thick and sticky and can block baby's airways just as well!
So, how DO you introduce peanuts to babies?
Option 1: Peanut Powder or Ground Peanuts in Puree
You can either buy peanut powder at select stores (or here on amazon ), or simply make your own by finely grinding whole peanuts with a fine cheese/lemon zest grater (make sure it grinds the nuts very finely, I recommend using this one). Add this to apple sauce or other food puree and mix well.
Option 2: Peanut Puffs
Peanut Puffs were actually used during the LEAP trial. I used a brand from ALDI, but there is actually a better brand which can be found here where the first ingredient is peanuts (versus corn grits in the product I had). If your baby is less than 7 months of age, Peanut Puffs can be softened by soaking in water for about 5 minutes. Older infants should be able to eat the puffs without soaking.
Option 3: Peanut Puree
Mix 2 teaspoons of peanut butter with 2 to 3 teaspoons of water, breast milk or formula. Stir until peanut butter is dissolved and well blended.
Option 4: Peanut Butter on Toast
For older infants, or infants who follow Baby Led Weaning practices, spread peanut butter thinly on toast and cut into stripes. Caution: This option is only for infants who are at least 6 months old and capable of eating soft textured items.
It goes without saying, always use caution and common sense when introducing new foods to your baby. Seek medical attention immediately if your child exhibits any signs of a food-allergic reaction, such as
Itching or scratching of the mouth or throat
Swelling or eczema around the mouth, lips, face, tongue or throat
Abdominal pain, diarrhea, nausea or vomiting
Dizziness, lightheadedness or fainting
While this post was written by a Registered Dietitian and follows the most recent evidence-based recommendations, allergic reactions CAN happen and the general information found in this article does not substitute for individualized medical advice from your child's pediatrician, nurse/nurse practitioner or Dietitian who know your child's medical history personally.