A How-to Guide For Parents and Caregivers on Introducing Peanut-Containing Foods to Your Baby
or parents and caregivers, introducing new foods to their baby is an exciting milestone!
As with any new stage of a child’s development, it’s important to be educated about the best approach when doing something for the first time. So, how can parents and caregivers feel empowered and informed when medical recommendations change and new research becomes available? Learning about the latest guidelines and speaking to your health care provider before introducing new foods into your baby’s diet are the key first steps.
In 2017, the National Institute of Allergy and Infectious Diseases (NIAID) shared updated guidelines on how parents and caregivers can introduce certain food allergens, like peanut-containing foods. Studies have shown that introducing a variety of foods containing potential allergens into a baby’s diet early and often may prove beneficial. Specifically, the NIAID guidelines recommend introducing foods that contain peanuts as early as four to six months in age, which may reduce the risk of developing food allergies by up to 80% for at-risk babies.
Peanut allergies are the most common food allergy in children
The official guidelines include the following recommendations:
LEARN THE BEST WAY TO INTRODUCE PEANUT-CONTAINING FOODS
IF YOUR BABY HAS SEVERE ECZEMA AND/OR AN EGG ALLERGY
If your child has mild to moderate eczema
If your child has no eczema or food allergy
From your pediatrician or healthcare provider, once your baby begins eating solid foods.
Testing may be recommended prior to introduction.
Ask your child’s pediatrician or healthcare provider if you can introduce a peanut-containing food at home around six months.
You can introduce peanut-containing foods at home once your baby has tolerated other solid foods.
The best way to approach introducing food allergens to your child is through close collaboration with a trusted pediatrician or other healthcare provider, like an allergist, who can guide you through the process. With the right information and support, parents and caregivers can take this meaningful step in helping to potentially prevent the development of food allergies later on in life.
- Dr. Vivian Hernandez-Trujillo, Pediatric Allergist and Immunologist, paid advisor to Kaléo
Once you have spoken with the pediatrician, or healthcare provider, and created a plan for your baby, what’s next? Read on for some helpful tips on how to best introduce peanut-containing foods.
Step 1: WHAT STEPS SHOULD I consider WHEN
INTRODUCING PEANUT-CONTAINING FOODS TO MY BABY?
Step 2: HOW DO I INTRODUCE PEANUT-CONTAINING FOODS TO MY BABY?
DO GIVE YOUR BABY…
Smooth Peanut Butter
Mix two teaspoons of smooth peanut butter with two to three teaspoons of warm liquid (such as water, formula, or breast milk). Mix well and allow to cool before offering a taste.
If your baby is less than seven months old, soften the puffs with four to six teaspoons of water.
Blend well two teaspoons of peanut powder with two to three teaspoons of a previously well-tolerated food, such as pureed fruit or veggies, or baby cereal.
DON’T GIVE YOUR BABY…
Whole peanuts or pieces of peanut
Chunky or crunchy peanut butter
Before you start…
Age-appropriate peanut-containing foods should be introduced ONLY at home or in a healthcare provider’s office.
Make sure your baby is healthy and you can pay full attention for at least 2 hours after introducing the new food to monitor for an allergic reaction.
How to introduce peanut-containing foods to your baby:
It is important to continue feeding the peanut-containing food regularly, aiming for three times a week, through childhood.
Prepare a full portion of one of the peanut-containing recipes.
Offer your baby a small taste of peanut-containing food on the tip of a spoon. Wait 10 minutes.
If there is no allergic reaction after the initial taste, give the remaining food slowly.
Step 3: HOW WILL I KNOW IF MY BABY IS HAVInG AN ALLERGIC REACTION?
Babies and toddlers often respond differently to allergens than older children, so it can be hard to understand what is happening. Anaphylaxis can be difficult to identify in infants and toddlers, especially because they cannot describe symptoms such as itching, throat tightness, or chest tightness. In younger children, anaphylaxis often first presents as a rash or hives. For example, a parent may find when giving a baby a new food, the child quickly develops a rash around the lips. The key is to pay attention to what the baby is eating and how they react. And remember, talk with your baby’s pediatrician or healthcare provider first, so that you are aware of what to look for before introducing peanut-containing foods.
Signs and Symptoms of a Severe Allergic Reaction
No matter the situation, it’s always important to be prepared for an allergic emergency. Babies and toddlers often respond differently to allergies than older children, so it may not be immediately clear what is happening. Parents and caregivers should educate themselves on the signs and symptoms of an allergic reaction so they can act immediately should it be required.
- Dr. Vivian Hernandez-Trujillo, Pediatric Allergist and Immunologist, paid advisor to Kaléo
Anaphylaxis can be life-threatening, so if you suspect your child is having a severe allergic reaction, give an injection of epinephrine immediately, if available, and then call 911.
REMEMBER: An antihistamine will not stop a potentially life-threatening allergic reaction, only epinephrine does that.
LEARN MORE ABOUT TREATMENT OPTIONS FOR YOUR BABY:
When speaking to your child’s pediatrician or healthcare provider about introducing food allergens, ask about AUVI-q (epinephrine injection, USP) 0.1 mg. It is the only FDA-approved epinephrine auto-injector for babies and toddlers weighing 16.5-33 pounds.
Electronic voice guides caregivers through administration, whether trained or not.
About the size of a credit card and thickness of a cell phone.
Shortest needle length available—not visible before, during, or after an injection.
• Patients may not feel the epinephrine injection when it occurs.
• To administer, just press and hold in place for 2 seconds.
To minimize the risk of injection-related injury, hold a young child’s or infant’s leg firmly in place when administering AUVI-q.
AUVI-q 0.1 mg comes with a Trainer so you can walk through the injection process of administering AUVI-q with your caregivers.
Visit to learn more and talk to your doctor to see if AUVI-q is right for your family or your child.
Parents and caregivers deserve to enjoy every milestone in their child’s life. By talking with your baby’s pediatrician or healthcare provider, and preparing yourself with the available information and resources, introducing new foods to your baby can be a fun and rewarding experience.
AUVI-Q (epinephrine injection, USP) is a prescription medicine used to treat life-threatening allergic reactions, including anaphylaxis, in people who are at risk for or have a history of serious allergic reactions.
AUVI-Q is for immediate self- (or caregiver) administration and does not take the place of emergency medical care. Seek immediate medical treatment after using AUVI-Q. Each AUVI-Q contains a single dose of epinephrine. AUVI-Q should only be injected into your outer thigh, through clothing if necessary. If you inject a young child or infant with AUVI-Q, hold their leg firmly in place before and during the injection to prevent injuries. Do not inject AUVI-Q into any other part of your body, such as into veins, buttocks, fingers, toes, hands or feet. If this occurs, seek immediate medical treatment and make sure to inform the healthcare provider of the location of the accidental injection. Only a healthcare provider should give additional doses of epinephrine if more than two doses are necessary for a single allergic emergency.
Rarely, patients who use AUVI-Q may develop infections at the injection site within a few days of an injection. Some of these infections can be serious. Call your healthcare provider right away if you have any of the following symptoms at an injection site: redness that does not go away, swelling or tenderness, or if the area feels warm to the touch.
If you have certain medical conditions or take certain medicines, your condition may get worse or you may have more or longer-lasting side effects when you use AUVI-Q. Be sure to tell your healthcare provider about all the medicines you take, especially medicines for asthma. Also tell your healthcare provider about all of your medical conditions, especially if you have asthma, a history of depression, thyroid problems, Parkinson’s disease, diabetes, heart problems or high blood pressure, have any other medical conditions, are pregnant or plan to become pregnant or are breastfeeding or plan to breastfeed. Epinephrine should be used with caution if you have heart disease or are taking certain medicines that can cause heart-related (cardiac) symptoms.
Common side effects include fast, irregular or “pounding” heartbeat, sweating, shakiness, headache, paleness, feelings of overexcitement, nervousness or anxiety, weakness, dizziness, nausea and vomiting or breathing problems. These side effects usually go away quickly, especially if you rest. Tell your healthcare provider if you have any side effect that bothers you or that does not go away.
Please see the full Prescribing Information and the Patient Information at www.auvi-q.com.
You are encouraged to report negative side effects of prescription drugs to the FDA.
Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
IMPORTANT SAFETY INFORMATION
1. Food Allergy Research & Education. Peanut Allergy. Accessed November 2020.
2. Togias A, Cooper SF, Acebal ML, et al. Addendum guidelines for the prevention of peanut allergy in the United States: report of the National Institute of Allergy and Infectious Diseases—sponsored expert panel. Ann Allergy Asthma Immunol. 2017;118(2):166-173.e7.
3. Fleischer DM, et al. Consensus communication on early peanut introduction and the prevention of peanut allergy in high-risk infants. Pediatrics. 2015;136:600. DOI: 10.1542/peds.2015-2394.
4. Simons FER. Anaphylaxis in infants: can recognition and management be improved? J Allergy Clin Immunol. 2007;120(3):537-540.
5. Sampson HA, Munoz-Furlong A, Campbell RL, et al. Second symposium on the definition and management of anaphylaxis: summary report – Second National Institute of Allergy Infectious Disease/Food Allergy and Anaphylaxis Network symposium. J Allergy Clin Immunol. 2006;117(2):391-397.
6. Simons FE, Sampson HA, Anaphylaxis; unique aspects of clinical diagnosis and management in infants (birth to age 2 years). J Allergy Clin Immunol. 2015;135(5):1125-1131.
7. Kim L, Nevis IF, Tsai G, et al. Children under 15 kg with food allergy may be at risk of having epinephrine auto-injectors administered into bone. Allergy, Asthma & Clinical Immunology.
8. AUVI-Q [Prescribing Information]. Richmond, VA: kaleo Inc. https://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=6180fb40-7fca-4602-b3da-ce62b8cd2470&type=display.
For general information purposes only. Talk to your healthcare provider if you have any questions.