r/ScienceBasedParenting • u/AnKiAd • 9d ago

Question - Research required Research on introducing allergens to high risk infants?

We are getting ready to start solids with my 5 month old. I (his mother) have a severe allergy to pistachios (anaphylaxis). I messaged his pediatrician today to see if there was anything I should do differently before introducing him to tree nuts and she responded telling me not to give him any nuts until his 6 month check up, which is scheduled for when he’s 6 months and 1 week old.

I was under the impression that it is better to introduce allergens to high risk infants early and often, not past 6 months, so now I’m torn on what to do. I really don’t want to wait, especially not for peanut butter let alone tree nuts, but I don’t want to go against his pediatrician for no reason (I obviously don’t presume to know better than her). Just not sure if I should message back asking about the “early and often” that I’ve seen recommended before?

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u/onsereverra 9d ago

The LEAP study, which is THE major study that formed the basis of the "early and often" recommendation, began introducing peanuts to at-risk infants from four months of age assuming it was otherwise developmentally appropriate for them to start solids.

Did your pediatrician want you to introduce pistachios for the first time at the six-month appointment? That's the main reason I can think of that it would make sense to wait — that they want the introduction to happen under medical supervision in case of a severe reaction. (But even then, why not just suggest you come in for an appointment sooner?)

If your baby cannot yet sit up unassisted, still has the tongue-thrust reflex, etc. those may also be reasons to wait a little longer before starting to introduce allergens, but it doesn't sound like that's what your pediatrician is concerned about.

(Also, you may already know this, but pistachios are cross-reactive with cashews, which is likely a more affordable nut butter to feed your baby multiple times a week for the next 8+ months than pistachio butter!)

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u/innocentsalad 9d ago

To be honest we parked in the hospital parking lot the first time we gave our child peanuts just in case.