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When Can Kids Eat Peanut Butter?

by Sharon Perkins

Few foods are as much of an staple for American kids as peanut butter. But peanuts also have a well-deserved reputation as a high-allergen food. And because of its thick consistency, peanut butter can also be a choking hazard for young kids. While you can probably introduce your baby to this all-American classic after she starts eating solids between ages 4 to 6 months, it's prudent to take common-sense precautions to reduce the risk of choking and life-threatening reactions.

Allergies and Peanut Introduction

Before 2008, pediatricians routinely recommended that parents not introduce peanuts in any form -- including peanut butter -- into their child's diet until age 3 or later. The prevailing thought was that early introduction of high-allergen foods, like peanuts, increased the risk of developing an allergy to the substance. In January 2008, the American Academy of Pediatrics (AAP) reversed their position on this issue in an article in the journal "Pediatrics." The article stated that there was no evidence that delaying introduction of foods after 4 to 6 months reduced the incidence of allergies. In fact, Dr. Robert Wood, director of allergy and immunology at The Johns Hopkins Children's Center in Baltimore, suggests that earlier exposure to peanuts might help develop tolerance.

What the Studies Show

The AAP based their 2008 recommendations to allow babies to start eating potential allergens such as peanut butter after age 4 to 6 months on clinical studies. A British study published later that year, in the November 2008 issue of "The Journal of Allergy and Clinical Immunology," compared the rates of peanut allergy in over 5,000 British children of Jewish descent and a similar number of Israeli children. Researchers found that British children had a 10 times higher risk of developing a peanut allergy than Israeli children. Israeli children eat more peanut products each month and start eating peanut products at a much younger age, so that study postulated that feeding children peanuts earlier may prevent peanut allergies from developing.

Choking Risks

Even if introducing your baby to peanut butter at 4 to 6 months doesn't increase his allergy risk, you still shouldn't start spooning globs of peanut butter into his mouth at that age. Because peanut butter is thick and sticky, large amounts of it can block a baby's airway. If you do give your baby peanut butter, pediatrician Dr. William Sears recommends spreading it thinly on crackers or bread. Never give a baby chunky peanut butter, since he won't be able to chew the chunks. Wait until age 4 or later before feeding your child whole nuts or pieces of nuts, Kids Health advises.

Safe Introduction of Peanut Butter

When you introduce any high-allergen food, especially if you have a family history of allergies, give him his first taste at home, with an oral histamine handy in case of reaction, the Mayo Clinic suggests. Start with a very small amount of peanut butter -- a dab on a cracker, for example, and watch closely for any signs of reaction, such as rash, wheezing or diarrhea. Start one new food every three to five days, the Mayo Clinic advises, so that if a reaction occurs, you can determine which food was the culprit. Discuss the introduction of high-allergen foods such as peanut butter with your child's pediatrician and follow his advice on when to give your child his first taste, since he knows your child's history best.

About the Author

A registered nurse with more than 25 years of experience in oncology, labor/delivery, neonatal intensive care, infertility and ophthalmology, Sharon Perkins has also coauthored and edited numerous health books for the Wiley "Dummies" series. Perkins also has extensive experience working in home health with medically fragile pediatric patients.

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