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There have been headlines this year, and last, stating that giving peanut butter, and other peanut products, to babies reduces chance of peanut allergy, leaving parents lots of questions. Does peanut butter really reduce peanut allergy? How much, and when? Do babies need to be weaned early?
“Give babies peanut butter to cut peanut allergy by 77%.” BBC News website
“Give peanut foods to babies from four months to cut allergy risk, experts say” Guardian
“Parents urged to give babies peanut butter from 4 months old to prevent allergies” Netmums
News outlets don't have a good record of reporting science, and this is particularly true here.
You do not need to start weaning early. Most of you do not need to give peanut tastes to babies under 6 months.
Quick version: There is no change in the UK government's recommendation to wait until around six months to start solid foods. The research does not recommend all babies are given peanut butter/products at 4 months. It recommends giving peanut butter/products from 6 months, whenever the baby is developmentally ready for starting solids, if at low risk of eczema, rather than waiting till 12 months, that’s all, and giving it regularly. If your baby already has eczema and/or allergies, then seek guidance from health professionals. But this does not mean you need to start solids.
Let’s have a look at the science behind the headline, and find out what you need to know, and what you don’t have to worry about.
Peanut allergy is a serious and potentially life threatening condition. There are things that can be done to reduce the chance of a baby developing this food allergy.
The UK government guidance recommends introducing nuts to babies between 6 and 12 months. Not whole nuts, obviously that’s a choking hazard, but peanut butter on toast, peanut butter in sauces or food, ground almonds in pastry, nut oils etc.
Back in the late 1990s there was a recommendation to avoid giving peanut products to babies under one, and pregnant women were advised not to eat them, to reduce peanut allergy, but this caused a massive increase in peanut allergy, and was quickly withdrawn.
Since then the recommendation has been to avoid before six months but to definitely give babies peanuts between 6 and 12 months, unless recommended to do differently by a paediatrician (family history with nut allergies, already has allergies etc).
There has been concern in the UK, and around the world, that babies are not being introduced to nuts, and particularly peanuts, within that 6-12 month window. A report in 2010 found that only 8% of babies in the UK had been introduced to peanut foods by 8-10 months.
What does the research actually say?
We already know that giving your baby peanuts, other nuts, and other allergen foods, between 6 months and 12 months, reduces the chance of them developing an allergy. There have been two recent studies giving us more information.
The latest study was a follow up study of 11-14 year old children who had been part of a study started over a decade ago in which half were given peanut butter regularly between 6 months and a year, and half were not. The original study had found that there was a significant reduction in peanut allergies by 5 years. This update found that the impact was sustained, and the reduction in peanut allergies
The second most recent study came out a year ago, in 2023. It analysed results of three different studies into giving ‘peanut products’ to reduce peanut allergy. The ‘peanut products’ were ‘peanut puffs’, corn based snacks with peanut flavour. The studies were from UK, and looked at children aged 7+ months, with and without allergies and/or eczema.
The analysis showed that children with moderate and severe eczema were at high risk of peanut allergy and they could benefit from tastes of peanuts between 4 and 6 months. It did not stop peanut allergies in this group, but reduced the likelihood.
But those with mild eczema, or at low risk of eczema, and peanut allergy, benefited from tastes of peanuts between from 6 months, ideally nearer 6 months than 12 months. Unfortunately the researchers summarised their research by saying "benefit from taste of peanuts between 4-6 months".
And an important point about the studies this analysis was based on: the researchers received funding from peanut manufacturers! Which is not helpful to parents.
"the LEAP trial received some grant funding from the National Peanut Board and one of the authors has received grant support from Meridian foods who make peanut products, and in the EAT study, one of the authors received grant funding from the National Peanut Board." First Steps Nutrition Trust newsletter, March 2023
Further critique of the study by First Steps Nutrition Trust says
"it should be noted that the data presented in the scenarios does not provide evidence for benefit of reducing the age of introduction of peanut for infants with eczema from the existing public health recommendation of ‘around 6 months’ to ‘from 4 months’. Current relevant NHS advice is as follows ‘If your baby already has a diagnosed food allergy or eczema, or if you have a family history of food allergies, eczema, asthma or hay fever, you may need to be particularly careful when introducing foods, so talk to your GP or health visitor first’.
.. it is important to remember that the study itself is a data modelling exercise and makes a number of assumptions,
There are also weaknesses associated with merging different datasets and it is unclear whether this data is based on introducing peanut products only where readiness for solids has been established."
What do you need to do as a parent?
Don't panic, or worry. Introducing peanuts and other nuts, in appropriate forms, between 6 and 12 months, will give your baby good protection from peanut allergy.
If your baby has eczema: talk to your paediatrician or health visitor. You do not need to start weaning early to give peanut tastes, if that is suggested.
If you have peanut allergy: talk to your health visitor or doctor, and Allergy UK. Just because you had peanut allergy, doesn’t mean your baby will, but obviously you need to be cautious about giving your baby peanuts.
Everyone else:
DO start introducing solid foods from around 6 months, and include peanut butter regularly, on toast, or in food, and other nuts.
DO NOT give your baby spoons of peanut butter. This is not pleasant, and can be a choking hazard.
DO NOT give whole nuts, or large pieces of nuts as they are choking hazards.
That’s it. That’s all you have to do or worry about.
If you would like to understand more about research, and how it is often misinterpreted then I thoroughly recommend the book 'Informed is best: how to spot fake news about your bump, birth and baby' by Professor Amy Brown.
Please note, this article does not constitute medical advice. Please contact a health profession to discuss this further if you are concerned, or if this is relevant to your baby.
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