I don't read many medical blogs, mostly because they're often too wordy or the information they share isn't clear or not trustworthy. My hope with this blog is to provide readers (patients, students, residents, physicians) with information that is reliable and easy to understand.
Let's kick it off with the question I get asked the most by new parents: "When should I feed my baby peanuts?" followed by something along the lines of, "Can you test them first?" or "Should I park my car in the emergency department parking lot when I do it?" or "Should I have an EpiPen ready?"
Thanks to a couple of landmark studies, we now have some guidance. The Canadian Society of Allergy and Clinical Immunology have endorsed the new guideline recommendations. You can read the full version here and the American version here.
Here is the the TL;DR version:
1. Introducing foods that cause allergy (especially peanut) early in life probably prevents allergy, rather than causing it.
2. Start feeding your child solid foods when they are developmentally ready (around 4-6 months). This should include eggs, among other foods (you'll see why next).
3. If your child does not have egg allergy or severe eczema*, their risk of peanut allergy is low and they should be fed peanut at home as part of the regular solid foods that are being introduced (in a form that is safe to eat - whole peanuts are a choking hazard).
4. If your child does have severe eczema and/or egg allergy, the goal should still be to feed them early, but they should be seen by an allergist first for appropriate testing to see if it's safe.
*Severe eczema is defined as "frequent and extensive symptoms despite optimal management and adherence to treatment" - i.e. their eczema persists despite following all of your doctor's recommendations.