AAAAI and NIAID guidelines recommend feeding baby peanut to help prevent peanut allergies. But when can you safely feed baby peanut butter? Find out here.
Several sets of recent clinical guidelines recommend introducing your baby to peanut early and often to help prevent future peanut allergies, based on the results of the groundbreaking LEAP trial. But when can you safely introduce peanut butter? The answer may surprise you. Find out when and how you can safely introduce peanut butter, based on the American Academy of Allergy, Asthma, and Immunology (AAAAI) and National Institute of Allergy and Infectious Diseases (NIAID) guidelines for peanut introduction and peanut allergy prevention.
The LEAP Study and Peanut Allergy Prevention Guidelines
Thanks to the landmark Learning Early About Peanut Allergy (LEAP) study’s results, we now know that we can help prevent future peanut allergies by introducing babies to peanut early and often, starting as early as 4 months of age.
The LEAP study focused on babies 4-11 months of age who were at high risk for peanut allergy. Babies were randomly assigned to one of two groups:
- The first group avoided peanut completely until they reached 5 years of age.
- The second group consumed peanut-containing foods regularly (at least three times per week) until they reached 5 years of age
Much fewer children in the group that consumed peanut regularly developed a peanut allergy by age 5, compared to the children who were told to avoid peanut for several years.
In fact, the early, consistent peanut introduction reduced children’s risk of developing a peanut allergy by over 81%.
Learn more about the LEAP trial from the New England Journal of Medicine:
The LEAP study’s results show that early, frequent peanut introduction can help prevent peanut allergy in children.
Now, several leading medical organizations have published peanut allergy prevention guidelines for babies, focused on the early, sustained feeding of peanut. All of these guidelines were prompted by the LEAP study’s results.
Notably, new guidance from the American Academy of Allergy, Asthma, and Immunology (AAAAI) and other leading medical organizations recommend feeding all babies peanut early and often to help prevent future peanut allergies.
Start feeding peanut as early as 4-6 months of age
The AAAAI guidelines state, in order “to prevent peanut… allergy, peanut… should be introduced around 6 months of life, but not before 4 months.” This guidance applies to all babies, regardless of their risk for peanut allergy.
Feed peanut regularly for peanut allergy prevention
The AAAAI guidelines recognize that feeding babies peanut only once or twice is not enough for peanut allergy prevention. Rather, as the LEAP study’s results showed, sustained (regular) introduction is crucial.
So, the AAAAI recommends feeding baby 2 grams of peanut protein at least three times per week. This is based directly on the amount and frequency of peanut that the LEAP study used.
But many parents wonder if peanut butter is a safe way to introduce baby to peanut and help prevent peanut allergy. As we’ll cover below, the AAAAI offers guidance on when and how to introduce peanut butter.
Is it safe to give a baby peanut butter?
In short, the answer is no.
It is never safe to give your baby (or toddler) peanut butter by itself. Lumps and spoonfuls of peanut butter are choking hazards for young children. In fact, it is not safe to give a child peanut butter on a spoon, or lumps of peanut butter, until they’re at least 4 years old.
Chunky peanut butter poses a clear choking risk, because it contains hard peanut pieces. But smooth peanut butter (by itself) is also a choking hazard for children under 4.
This guidance comes from peanut introduction guidelines from the American Academy of Allergy, Asthma, and Immunology (AAAAI) and the National Institute of Allergy and Infectious Diseases (NIAID). Below, we’ve included quotes from each set of guidelines:
“Whole-peanut kernels and chunks of peanut butter are potential choking hazards and should not be given to children younger than 4 years.”
NIAID Guidelines: “Peanut butter directly from a spoon or in lumps/dollops should not be given to children less than 4 years of age.”
The AAAAI and NIAID share, though, that there is a safe way to modify and give smooth peanut butter to babies.
Diluted smooth peanut butter: The one safe way to give baby peanut butter
The AAAAI and NIAID agree that there is one way to offer peanut butter to babies safely. How? By thinning (diluting) smooth peanut butter in water.
But if you decide to give thinned peanut butter to baby, only use smooth peanut butter that contains peanut as its only ingredient.
- This way, you’ll avoid added sugar, salt, and other additives babies don’t need.
- Never use chunky peanut butter, as it’s a choking hazard even when thinned.
Thinned smooth peanut butter
- Measure 2 teaspoons of smooth peanut butter and scoop them into a bowl.
- Gradually add 2 to 3 teaspoons of hot water.
- Stir the mixture until the peanut butter is thinned and dissolved.
- Let the mixture cool.
- Serve the cooled mixture to baby.
- If needed, you can increase the water amount used to achieve a consistency that your baby is comfortable with.
- You can also add infant cereal or puree (that your baby has previously eaten) to the mixture.
(Note: The AAAAI guidelines reference and recommend using the NIAID’s recipe for thinned smooth peanut butter.)
Other ways to introduce peanut to babies
There are plenty of other ways to introduce peanut to babies safely and in age-appropriate ways. All of the ways we’ll cover below are based on AAAAI and NIAID guidance.
The NIAID recommends four main forms of peanut for safe infant peanut introduction: the thinned smooth peanut butter recipe we covered above, peanut powder, peanut flour, or peanut puff snacks.
Similarly, the AAAAI advises that “peanut-containing products, such as powders/flours and snacks (e.g., peanut puffs), have…been used as safe forms of peanut for infants.”
But the AAAAI advises that peanut puff snacks (like Bamba) aren’t the best option for early and sustained peanut introduction, as they aren’t healthy to feed baby regularly. Instead, the AAAAI recommends using peanut powder or flour for early peanut introduction, mixed into other foods such as baby’s puree.
As the AAAAI explains, “Although Bamba was specifically used as a peanut snack in the LEAP trial and provides a dissolving textured food, it is not necessarily a long-term, healthy weaning food option; therefore, thinned, natural peanut butter or peanut flour (powder) is preferred as early weaning food.”
Whichever form of peanut a family uses, baby should be closely monitored for at least 2 hours after they eat peanut. This way, you can make sure baby doesn’t develop symptoms of an allergic reaction.
Easier ways to introduce peanut (plus other allergens)
Introducing peanut to babies early and often is key to preventing future peanut allergies. By itself, peanut butter isn’t safe to introduce peanut to babies. But you can safely introduce peanut using thinned smooth peanut butter, peanut flour, or peanut powder.
No matter which safe method you choose to introduce peanut, baby should consume the AAAAI-recommended 2g peanut protein per serving, at least 3 times per week (the same amount used in the LEAP study).
But 2g peanut protein isn’t always the same as 2g of thinned peanut butter, peanut flour, peanut powder, or peanut puffs.
So, DIY methods of preparing and giving peanut can be time-consuming and frustrating. What if you don’t measure out enough peanut for prevention—or baby doesn’t eat enough?
For an easier way to introduce peanut (plus other allergy-causing foods) and help prevent food allergies, new systems are available. These powder-based products are designed specifically to introduce allergy-causing foods to babies, sometimes as early as 4 months of age.
The systems safely introduce allergy-causing foods daily in pre-measured amounts, by mixing with baby’s food (and sometimes with baby’s bottle of breastmilk or formula). Make sure to also look for a system that aligns with new USDA recommendations to avoid any added sugar for infants and toddlers.
All health-related content on this website is for informational purposes only and does not create a doctor-patient relationship. Always seek the advice of your own pediatrician in connection with any questions regarding your baby’s health.
These statements have not been evaluated by the Food and Drug Administration. Products are not intended to diagnose, treat, cure or prevent any disease.