peanut butterDear Dr. Debbie,

My older child goes to a peanut-free preschool, so I’m very conscientious about the ingredients of anything I send in with his lunches. I’ve gotten in the habit of making him sunflower seed butter sandwiches and haven’t even bought peanut butter in two years. My little one, however, just had her 4-month-old visit to the pediatrician and the nurse practitioner asked if we were planning to start letting her have peanut butter. Apparently there’s new research that has reversed the advice about waiting at least a year before introducing peanut butter to children.

Now I’m worried about the younger siblings of friend’s whose children have the allergy. I’m anxious to share this information with them in case it could prevent the allergy for these younger siblings.


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Dear Confused,

Yes, you should share this information. As awareness of this potentially life threatening allergy grew around the end of the last century, the number of children diagnosed with peanut allergies mysteriously continued to rise. Peanut allergies have quadrupled since 1997, and are among the eight most common food allergens. New research on possible causes, prompted by an international comparison, reveals that the popular practice of avoiding feeding young children peanuts and peanut butter may have been at least partly responsible.

About 15 years ago, Dr. Gideon Lack, a professor of pediatric allergy at King’s College London, noticed that Israeli pediatricians did not have nearly the proliferation of peanut allergy cases as did doctors in the U.K or the U.S. His curiosity about this difference led him to discover that Israeli babies commonly eat a snack food called “Bamba” that is made from peanuts and corn. Lack and his team then conducted a study of infants in the U.K., at the average age of 7 months, who were randomly assigned either to avoid peanuts for five years or to freely eat the peanut-based snacks. He found that “at 60 months of age, 13.7 percent of the avoidance group and 1.9 percent of the consumption group were allergic to peanuts.” He concluded that the common practice of avoiding peanuts was actually contributing to the allergy.

The American Academy of Pediatrics has completely reversed its longstanding recommendation to avoid peanuts until at least the age of 3. Read a brief on the new AAP recommendations on peanuts here. The AAP now recommends introducing peanuts at 4 to 6 months based on increasing corroborating research.

Because peanuts and peanut butter are tricky to chew and swallow, it is recommended to mix smooth peanut butter into a fruit puree. Parents who are wary about an allergic reaction can ask for their children to have their first serving of peanut butter in the doctor’s office. The key is to keep feeding the children peanut butter three to four times per week.

Your friends should be encouraged to speak with their pediatricians about this. It will be challenging for a family to continue to have an older child avoid peanuts while the younger one is having to avoid the allergy. Perhaps these parents will welcome the chance for mom and baby and peanut butter play dates at your house!

Dr. Debbie

Deborah Wood is a child development specialist in Annapolis. She has a doctorate in Human Development from the University of Maryland at College Park and is founding director of the Chesapeake Children’s Museum. Long-time fans and new readers can find many of her “Understanding Children” columns archived on the Chesapeake Family Magazine website. You can find her online at

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