For years, parents were told to wait until their child was two or three before giving them peanut butter. That advice was meant to protect them. But it didn’t work. Instead, peanut allergies kept rising - from 0.4% of kids in 1997 to over 2% by 2010. Today, we know why: delaying peanut didn’t prevent allergies. It made them more likely.

Why Early Introduction Works

The turning point came in 2015 with the LEAP study - a major clinical trial led by researchers at King’s College London. They looked at over 600 babies at high risk for peanut allergy - those with severe eczema or egg allergy. Half were given peanut-containing foods regularly from 4 to 11 months old. The other half avoided peanut entirely until age 5.

The results were shocking. By age 5, 17% of the kids who avoided peanut developed an allergy. Only 3% of the kids who ate peanut regularly did. That’s an 80% drop in allergy risk.

This wasn’t luck. The science behind it is simple: your baby’s immune system learns what’s safe during the first year of life. If peanut is introduced early and often, the body sees it as food - not a threat. If it’s kept away, the immune system treats it like an invader. And once it’s labeled dangerous, it’s hard to undo.

Who Needs to Introduce Peanut Early?

Not all babies need the same approach. The National Institute of Allergy and Infectious Diseases (NIAID) laid out clear risk groups in 2017, and they’re still the gold standard today.

• High-risk infants: Those with severe eczema or egg allergy. These babies should be evaluated by a doctor between 4 and 6 months. If testing shows no peanut allergy, they can start eating peanut at home - or sometimes in the clinic for safety.
• Moderate-risk infants: Those with mild to moderate eczema. Start peanut around 6 months, no testing needed. Just introduce it at home like any other solid food.
• Low-risk infants: No eczema or food allergies. You can introduce peanut anytime after starting solids, usually around 6 months. No special steps needed.

The key is timing. Waiting past 6 months cuts the benefit in half. The best window? Between 4 and 6 months. A 2023 analysis of LEAP and EAT studies showed that babies who started peanut before 6 months had up to a 98% lower chance of developing an allergy - if they stuck with the plan.

How to Safely Introduce Peanut

You can’t just hand a toddler a spoonful of peanut butter. Whole peanuts? Choking hazard. Chunky peanut butter? Same risk. The goal is to give your baby 2 grams of peanut protein - three times a week - in a safe, smooth form.

Here’s how real parents do it:

• Take 2 teaspoons of smooth peanut butter.
• Mix it with 2-3 tablespoons of warm water, breast milk, or formula until it’s runny.
• Stir it into oatmeal, pureed sweet potato, or applesauce.
• Or use a spoonable peanut butter pouch designed for babies.

The original LEAP study used a snack called Bamba - a puffed corn snack coated in peanut butter - which is now available in the U.S. Some parents also use peanut powder mixed into formula. The point isn’t the form. It’s the dose and frequency: 2 grams of peanut protein, 3 times a week.

For high-risk babies, the first taste might happen in a doctor’s office. That’s not because peanut is dangerous - it’s because we want to watch for a reaction and be ready to act. Most babies show no reaction at all. But if your baby has a rash, vomiting, or trouble breathing, stop and call your doctor.

What About Oral Immunotherapy (OIT)?

Oral immunotherapy is not prevention. It’s treatment. And it’s for kids who already have a peanut allergy.

OIT means giving tiny, increasing doses of peanut under medical supervision - day after day, month after month - to build tolerance. It doesn’t cure the allergy. It just raises the threshold so a small accidental exposure won’t trigger a reaction. Some kids can eat a full peanut after a year of OIT. Others still can’t.

It’s not for every family. It’s time-consuming, expensive, and carries risks. Some kids develop stomach pain, hives, or even anaphylaxis during treatment. That’s why OIT is only done under strict medical care - not at home.

And here’s the crucial part: OIT doesn’t replace early introduction. If your baby doesn’t have an allergy yet, early introduction is safer, cheaper, and more effective. OIT is for those who missed the window.

Why So Few Parents Are Doing It

Despite strong guidelines and clear results, only about 39% of high-risk babies in the U.S. get peanut introduced early. Why?

Parents are scared. They’ve been told for years that peanuts are dangerous. They worry about choking. They don’t know how to prepare it. They’ve been given conflicting advice by different doctors.

A 2022 survey found that 62% of parents felt anxious about introducing peanut. And only 54% of pediatricians could correctly explain the current guidelines.

There’s also a big gap in access. Black and Hispanic babies are 22% less likely to get peanut early than white babies. That’s not because of culture or choice. It’s because of unequal access to pediatric care, inconsistent advice from providers, and lack of culturally tailored resources.

What’s Changed Since 2017?

The results are in. Since the 2017 guidelines, peanut allergy rates in U.S. children have dropped from 2.2% to 1.6%. That’s about 300,000 fewer kids with peanut allergies.

The biggest drops? In high-risk groups. Babies with mild eczema saw an 85% reduction. Those with moderate eczema? 87%. Even severe eczema showed a 67% drop.

The protection lasts. The original LEAP study followed kids for another year after they stopped eating peanut. The allergy protection didn’t fade. That means early introduction doesn’t just delay allergy - it changes how the immune system works long-term.

What’s Next?

Researchers are now testing whether introducing multiple allergens at once - peanut, egg, milk, tree nuts - gives even broader protection. Early results from the EAT study extension look promising.

A new trial called PRESTO, funded by the U.S. government with $35 million, is trying to find the perfect dose and timing for high-risk babies. Results are expected in 2026.

Meanwhile, companies are responding. Peanut pouches, peanut powders, and infant-safe peanut snacks have grown 27% a year since 2018. The market is adapting - but the real change is happening in homes.

What Parents Should Do Now

If you’re pregnant or have a baby under 12 months:

• Don’t wait. Don’t delay.
• If your baby has severe eczema or egg allergy, talk to your pediatrician by 3-4 months. Ask about allergy testing.
• If your baby has mild eczema, start peanut at 6 months - no test needed.
• If your baby has no eczema or allergies, just add peanut when you start solids.
• Use smooth peanut butter or peanut powder. Never whole peanuts or chunky butter.
• Give peanut 3 times a week, consistently.

This isn’t a one-time experiment. It’s a habit. Like introducing vegetables or rice cereal. Do it early. Do it often. And do it safely.

What Doesn’t Work

Don’t waste time on unproven methods:

• Don’t avoid peanuts during pregnancy or breastfeeding - no evidence it helps.
• Don’t rely on probiotics or vitamin D - Cochrane reviews show no benefit.
• Don’t wait for your child to show signs of allergy - by then, it’s too late for prevention.

The only proven method is early, regular exposure.