Peanut allergy

A: We don’t know all the reasons why some children develop food allergies, but it is sensible to do what you can to reduce your child’s risk. Here are some things you can do:

Breastfeed. Breastfed babies have lower rates of eczema than formula-fed babies, and severe eczema seems to be related to food allergy. Breastfed babies are exposed to a diverse menu of food proteins very early in life, which may help them build tolerance. Eating a variety of foods during pregnancy may help, too.

Give first tastes early. New guidelines endorsed by the American Academy of Pediatrics and other expert groups suggest giving your baby a “first taste” of peanut protein between 4 and 6 months. Recent research has shown that babies given peanut protein between 4 and 11 months of age had a lower risk of peanut allergy in elementary school. (But be careful: Peanuts and sticky peanut butter are choking hazards. And we still don’t know how much peanut practice is needed to protect kids from allergies.) A tiny amount of smooth peanut butter or peanut powder mixed into food purees is a good way to start. Watch baby carefully, and increase the amount slowly over time.

Provide vitamin D. Infant formula is fortified with vitamin D, but breastfed babies should take a supplement. Research shows babies deficient in vitamin D are more likely to have food allergy.

Consider probiotics. Researchers are looking into the benefits of probiotics—and the harms of unnecessary early antibiotics—in the prevention of allergic disease.

Acknowledge family history. If your baby’s biological mother, father or sibling has a food allergy, then your baby has a higher risk of developing one himself. Use extra caution when introducing foods.

Take precautions. If your baby already has food allergies or is at higher risk because of eczema or family history, talk to his doctor before introducing peanuts. He may need an allergist’s help in developing a personalized plan.

Stay informed. Food allergy is a very active area of research, so recommendations on how to prevent it are changing frequently. As we learn more about what causes food allergy, we’re realizing that some of the old medical guidelines were wrong. Keep current by talking to your pediatrician, and recognize that no one has all the answers. If your child has food allergies, seeing a specialist regularly will keep you and your family safe and up-to-date as we learn more.

—Kerry McGee, MD, a private practice pediatrician in Pittsburgh, Pennsylvania