Prevent peanut allergies with … peanut puff

About two years ago, I heard about an interesting study in which doctors compared the rate of peanut allergies in Jewish children being raised in Israel to the rate of peanut allergies in Jewish kids being raised in the United Kingdom. The doctors found the kids in the U.K. were 10 times more likely to develop a peanut allergy than their counterparts in Israel.

Why? The doctors theorized this difference might have been due to early exposure to Bamba, a peanut puff snack food given to young children in Israel.

This observation prompted a research study that looked at the effect of giving peanut products to children at high risk for developing peanut allergies. That’s right – doctors deliberately gave babies they were worried about Bamba snacks. Half the children were exposed to peanut products and while the others avoided all peanut products for the first five years of their lives. The study found that by age five, almost 14 percent of the kids who had avoided peanuts developed an allergy to them compared with only 2 percent in the group that ate the peanut snacks.

Findings from this research, called the Learning Early About Peanut allergy (LEAP) study, led the National Institute of Allergy and Infectious Diseases to recommend safely (for the right infant, and within the right timeframe) introducing infants to peanut products early in life.

I discussed this recent change with Drew Bird, M.D., a pediatric allergist at UT Southwestern, to get the scoop for all you soon-to-be parents who want to plan ahead:

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How common are peanut allergies right now?

Recent estimates suggest peanut allergy affects 0.6 percent to 1.3 percent of the U.S. population.

From a practical standpoint, how should parents approach peanut products and implement this new recommendation?

Infants have a high risk of developing a peanut allergy if they have severe atopic dermatitis, commonly called eczema, or if they develop an egg allergy in the first 4 to 6 months of life, or both of the above. In this situation, safely feeding your infant age-appropriate peanut products could very likely prevent the child from developing a peanut allergy.

For parents with a child falling into this group, the data is compelling that giving at least 6 grams of peanut protein per week prevents peanut allergy.

Obviously, a lot of kids fall outside of these narrow parameters, and the recommendations for the other children are not as clear. For example, if you are the parent of a toddler with a peanut allergy and your newborn is not showing any signs of allergic disease, should you feed this newborn peanut products?

The guidelines do not make a strong recommendation for this case, but based on what we learned from the LEAP study, we can confidently say feeding peanut products during infancy is safe and generally well tolerated, and giving at least 6 grams of peanut protein per week to high-risk infants can prevent allergy.

For the parent with an allergic toddler and an infant who is not showing signs of allergic disease, we can then assume it would be reasonable to give peanut products to the non-allergic newborn in the hopes of preventing allergic disease, as you would to an infant with higher risk.

For other children outside the high-risk category, whether peanut products “should” be given on a regular basis as outlined in LEAP should be considered on a case-by-case basis.

Is there anyone you wouldn’t recommend introducing peanut products to in the first year of life?

I would not recommend giving peanut products to a child who has already had a reaction to peanuts. Children who are not allergic or at a high risk for developing the allergy can safely eat peanut products.

Is Bamba something you would recommend to U.S. parents?
Bamba is a good choice if your child is developmentally ready to eat finger foods. However, the nutritional value of Bamba is not as high as that of other peanut products such as smooth peanut butter diluted to the appropriate consistency (mix 2 teaspoons of warm water with 2 teaspoons of smooth peanut butter) or roasted peanut flour that may be mixed with another food in the infant’s diet, such as oatmeal or a fruit puree.

Regardless of the product, it is important to give at least 6 grams of peanut protein per week, divided over three or more servings.

Although the LEAP study was conducted in the United Kingdom, this is exactly the type of research that happens at academic medical centers here in the United States – resulting in significant changes that improve the health of large groups of people.

Parents who want to learn more can read further about the NIAID’s recommendations. And for those who are interested, Bamba can be ordered from numerous sources online.

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