Canadian Paediatric Society: Offer Peanut Butter, Milk & Eggs To Babies Early

It is estimated about 6 million kids have a food allergy. More often boys are more affected than girls and the top offenders are cow’s milk, eggs, fish and tree nuts.

Once aquired a peanut allergy is a potentially anaphylactic food allergy which is very difficult to outgrow.

In a shift in thinking, the Canadian Paediatric Society is advising parents of babies at high risk of developing allergies to offer foods such as peanut butter, milk, and eggs at about six months of age.

“There has been a sea change in our profession,” said Dr. Elissa Abrams, chair of the society’s allergy section.

Canadian Paediatric Society - Offer Peanut Butter, Milk & Eggs To Babies Early

Previously it was recommended parents avoid introducing such foods based on the thought that people become allergic through the digestive tract, which needs time to mature. This practice, however, may have contributed to the dramatic increase in the prevalence of food allergy in recent decades

“We now have learned that allergies develop through the skin. We now have studies that show that eating early is preventative. And we now have actual, real live experience that when these guidelines came out recommending avoidance, allergy rates actually inadvertently increased. So the old guidelines weren’t effective.”

It is now thought that the digestive tract trains the body to tolerate allergens. 

Common allergy-provoking foods include:

  • Cow’s milk.
  • Egg.
  • Peanut.
  • Tree nuts.
  • Fish.
  • Shellfish.
  • Wheat.
  • Soy.

An infant at high risk of developing food allergy is one with at least one parent or sibling with an allergic condition such as atopic dermatitis, food allergy, asthma or allergic rhinitis.

A “high risk” infant is defined as one with severe eczema and/or egg allergy, and an “at-risk” infant is defined as one with mild or moderate eczema

Parents of high or at-risk children are advised to seek medical advice before introducing potentially allergy-provoking foods. Otherwise, parents and caregivers are advised to offer common allergens one at a time to check for any reaction.

If you child tolerates their first meal, parents should continue to offer the food a few times a week to maintain tolerance.

For young infants who are new to solids, it is recommended parents dilute smooth peanut butter with water or mix it with a previously tolerated pureed fruit or vegetable, or breast milk.

It is recommended parents start solids when their baby has shown to have good neck control and is interested in table food. Babies who are not considered high risk should start trying foods at about six months of age.

In August 2018, Dr. Abrams published a study based on a survey of responses from 80 allergists, 170 pediatricians and 206 family practice physicians in Canada that pointed to knowledge gaps and barriers to early peanut introduction.

“The LEAP study, which randomized 640 high-risk infants (defined as those with severe eczema and/or egg allergy) in the UK to either early (age 4–11 months) or delayed (avoidance until age 5 years) peanut introduction. The trial showed that the early and regular (3 times per week) consumption of peanut in these high-risk infants reduced the development of peanut allergy by 86% by 5 years of age.”

“Although most family physicians/pediatricians recommended that allergenic solids be introduced at age six months to less than one year … most allergists recommended introduction at age four to less than six months for egg, milk, and peanut,” she wrote. 

About the author

Lisa Arneill

Mom of 2 boys and founder of and World Traveled Family. When I'm not running around after my boys, I'm looking for our next vacation spot!

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