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AL L E R G I E S Revised Guidelines Recommend Early Introduction of Peanut-Containing Foods Rather than avoiding peanuts, new guidelines recommend introducing peanut-containing foods to infants at an early age — as young as 4 -to-6 months for those believed to be at the highest risk — to prevent the development of peanut allergies. “The thinking used to be that it was best to put off introducing highly allergenic foods such as egg whites and white fish until children turned at least 1, and peanuts until after they turned 3,” says Ronald Tsao, MD, a UCLA pediatrician and internal-medicine physician in Redondo Beach. “But recent studies show that early exposure, particularly to peanut-containing foods, lowers the risk for food allergies.” Peanut allergies tend to develop in childhood and can cause severe reactions ranging from sneezing, coughing and vomiting to, in the most severe cases, loss of consciousness, drop in blood pressure and even death. “For parents, having a child with a severe peanut allergy can cause a great deal of anxiety,” Dr. Tsao says. “You have to be constantly vigilant about what your child eats, and there is a fear about exposing the child to new foods that might contain peanuts or were even processed in a facility where they could come into contact with peanuts.” “The challenge is that children with these allergies can be inadvertently exposed, such as when they share food they didn’t realize came into contact with peanuts,” adds Gifty-Maria Ntim, MD, a UCLA pediatrician and internal-medicine physician in Santa Clarita. UCLAHEALTH.ORG 1-800-UCLA-MD1 (1-800-825-2631) “If we can prevent peanut allergies from developing by introducing peanut-containing foods earlier, that will make a huge impact on the lives of families at risk.” The new guidelines from the National Institute of Allergy and Infectious Diseases recommend that infants who are believed to be at high risk for peanut allergies — typically because they have severe eczema (itchy or inflamed skin), an egg allergy or both — be given peanut- containing foods at 4-to-6 months of age, and that infants with mild or moderate eczema be introduced to the foods at about 6 months of age. Infants without eczema or any food allergy can have the peanut-containing foods introduced whenever it is deemed appropriate. Because peanuts are a choking hazard for infants, the first serving can involve a small amount of peanut butter mixed with a food the child likes, such as yogurt. “If your child is in the high-risk category, it may be best to have a test done first and introduce the peanut-containing food in a doctor’s office,” Dr. Ntim says. She explains that an allergy blood test can be performed by a pediatrician, or the child can be sent to an allergist to perform a skin-prick test before giving an oral food challenge, where the child is given the food in front of the doctor to test for the reaction. To learn more about peanut allergy and the revised guidelines, go to: uclahealth.org/peanutallergy