Introducing Peanuts Safely to Babies – Dr Mugilan Anandarajan

The guidance on introducing peanut to babies has changed significantly over the past decade. As a Consultant Paediatrician with a special interest in allergy, I am frequently asked by parents when and how to introduce peanut safely. This article explains the current UK guidance and what to do if your baby is at higher risk of peanut allergy.

Why Early Introduction Matters

Research — most notably the LEAP (Learning Early About Peanut Allergy) trial — has shown that early introduction of peanut in infancy significantly reduces the risk of developing peanut allergy. This has led to a major change in guidance: we now recommend introducing peanut early (around 6 months of age, and not before 4 months) rather than avoiding it.

Current UK Guidance

The British Society for Allergy and Clinical Immunology (BSACI) and the Scientific Advisory Committee on Nutrition (SACN) recommend:

Low-risk infants (no eczema, no existing food allergy): Introduce peanut as part of normal weaning from around 6 months of age. No specialist assessment is needed.
Moderate-risk infants (mild to moderate eczema): Introduce peanut at home from around 6 months. No specialist assessment is needed, but parents should be aware of signs of allergic reaction.
High-risk infants (severe eczema and/or existing egg allergy): Specialist assessment before peanut introduction is recommended. I can assess your baby and advise on the safest approach.

How to Introduce Peanut at Home

For low- and moderate-risk infants, peanut can be introduced at home. Important points:

Never give whole peanuts to children under 5 years — they are a choking hazard
Smooth peanut butter, peanut powder mixed into food, or peanut puffs are safe ways to introduce peanut
Start with a small amount (e.g. a quarter teaspoon of smooth peanut butter mixed into purée) and wait 20–30 minutes to observe for any reaction
If tolerated, gradually increase the amount over subsequent days
Aim to include peanut in your baby's diet regularly (e.g. 2–3 times per week) to maintain tolerance

Signs of Allergic Reaction to Peanut

Signs of an allergic reaction to peanut include:

Hives (raised, itchy red welts on the skin)
Swelling of the lips, face or tongue
Vomiting
Runny nose, watery eyes
Coughing or wheeze
Becoming pale, floppy or unresponsive (signs of severe reaction — call 999 immediately)

If your baby has a mild reaction, give an antihistamine and contact your GP or seek medical advice. If your baby has a severe reaction, call 999 immediately.

When to See a Specialist

I recommend specialist assessment before peanut introduction if your baby:

Has severe eczema (extensive, difficult to control)
Has a confirmed egg allergy
Has already had a reaction to peanut
Has a sibling with peanut allergy (this increases risk slightly, but most siblings of peanut-allergic children do not have peanut allergy themselves)

No GP referral is required. I can assess your baby at Kingsbridge Private Hospital or Ulster Independent Clinic and advise on the safest approach to peanut introduction.