Of all the foods to introduce to children, parents may be most apprehensive about peanuts and tree nuts. They are common food allergies in children and can cause severe reactions, like anaphylaxis. Other reactions to peanut and tree nut allergies include digestive and respiratory conditions. It wasn’t long ago that parents were encouraged to delay introducing peanuts and tree nuts until 2 years of age to ward off the onset of a related allergy. But recent science has shown the opposite to be true – that feeding your baby allergenic foods as young as 4 months of age helps to reduce the risk of later developing a food allergy. And yes, this includes peanuts and tree nuts.
In our Children & Food Allergies series, we’ll uncover what parents need to know about peanuts and tree nuts, their health benefits, and how to safely introduce them to their child’s diet.
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Peanuts vs. tree nuts
While they sound similar, peanuts and tree nuts are quite different. Part of the legume family, peanuts grow in the ground. Tree nuts on the other hand grow – you guessed it – on trees. These include almonds, hazelnuts, pecans, walnuts, pistachios, and cashews.
Despite their technical differences, peanuts and tree nuts have similar health benefits, as both are loaded with antioxidants and can promote heart health. More good news? Being allergic to one doesn’t mean your child will be allergic to the other, as they are in separate allergy categories. Only 30% of those with a peanut allergy are also allergic to tree nuts. Furthermore, an allergy to one tree nut doesn’t mean a child will be allergic to all of them. For example, a child could be allergic to cashews but not walnuts and almonds.
What science says
We discussed earlier that science is now showing an early introduction to allergenic foods can prevent the onset of food allergies. So, what does this mean and how early is “early”?
In 2022, the North American Allergy Societies updated its guidelines to recommend introducing allergens to children as early as 4 to 6 months of age. While this might sound daunting, research shows that early introduction, with consistent exposure thereafter to these foods, can significantly reduce the risk of an allergy. Because a child’s immune system is maturing in infancy, this form of exposure to allergenic foods at a young age trains the immune system to recognize those foods as safe.
How to safely introduce peanuts and nuts
Giving your baby a spoonful of peanut/tree nut butter can be a choking hazard. I recommend mixing the peanut/tree nut butter with a puree that you know your child is not allergic to. Sweet potatoes or butternut squash are great options. This changes the consistency of the peanut/tree nut butter, making it less sticky and more tolerable for a baby to consume. Because whole or chopped nuts can also pose a serious choking risk, I recommend using this same approach for all nuts. If the nut butter does not exist for a particular nut, you can grind the nut in a food processor to powder form.
My "Taste, Bite, Normal Portion" strategy allows you to safely introduce and monitor allergens.
A typical schedule includes:
- Day 1: Offer a small amount of the allergen, then closely observe and monitor for reactions. Most reactions occur within minutes to two hours after exposure.
- Day 2: Offer a slightly larger amount of that same food and then monitor for reactions.
- Day 3: Increase the food offered to a "normal" serving size and monitor for reactions.
While there are no official guidelines on how much to offer each day, based on research studies and my client work, I recommend:
- Day 1: ¼ teaspoon
- Day 2: 1 teaspoon
- Day 3: 2 teaspoons
After three days of introduction, it is still possible for a reaction to occur, but the more consistently you offer the allergen, the more you can reduce the risk of an allergy.
Outgrowing peanut and tree nut allergies
Approximately 20 to 25% of children will outgrow a peanut allergy, and of those, 80% of them will do so by age 8. Still, this leaves a large percentage of children with a peanut allergy who have it for the rest of their lives.
Tree nut allergies tend to be more permanent, as over 90% of those with an allergy to tree nuts are likely to have them for the rest of their lives.
Because of the likelihood of a peanut or tree nut allergy remaining with your child for their entire life span, it is critical for parents to consider early introduction and regular exposure to these foods to help prevent allergies.
Parents shouldn’t make this decision alone. Before introducing any allergy-risk food to your child, I strongly recommend consulting with your pediatrician. They can discuss the risks and benefits and answer questions that will help you make the best decision for you and your family.
