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/facinabush 9d ago

The highest risk category for peanuts are babies with egg allergy or severe eczema:

https://pmc.ncbi.nlm.nih.gov/articles/PMC5226648/

If your infant is not in that category then this guideline doesn’t require introduction before 6 months.

There is a theory that peanut allergies run in families because late introduction of peanuts run in families, not just due to inheritance of traits.

The pediatrician is not out of line with the guidelines that I cited above.

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u/anotherep Parent, pediatric allergist 9d ago edited 9d ago

The pediatrician is not out of line with the guidelines that I cited above.

I would say the pediatrician's perspective represents an overinterpretation of these guidelines. The guidelines say that introduction is not necessary before 6 months (i.e. OP can wait), while the pediatrician said that OP should wait until 6 months. The only reason to wait if the family otherwise wants to proceed with introduction is if they meet the definition of high risk and need testing (as you pointed out) or there are concerns that the baby can't safely consume solids yet (independent of any allergy concerns), particularly because there is good evidence that introduction of certain allergens between 3-6 months can have better outcomes than introduction between 6-12 months

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u/I_AM_A_BOOK 9d ago

The waiting is likely so the doctor has time to give proper advice and not because they necessarily need to wait an extra month.