Safe Home Introduction Protocol (NIAID / AAP Guidelines)
Ready For Solids (~4-6 Months)
Infant must demonstrate developmental readiness (holding head steady, sitting upright) and have tolerated other solid foods first.
Never Whole Peanuts or Chunks
Choking hazard! Dilute 2 teaspoons of smooth peanut butter with 2-3 teaspoons of warm water or breast milk/formula, or mix into fruit puree.
Initial First Taste at Home
Offer a small spoon tip when baby is healthy and awake. Wait 10-15 minutes to observe before feeding the remainder of the dose.
Sustain Maintenance Dosing
Maintain approximately 6g of peanut protein per week (spread across 2-3 feedings) consistently through early childhood.
Eczema Risk Stratification & Mechanism
Infants with severe eczema or egg allergy have disrupted skin barriers. Environmental peanut dust on broken skin drives IgE antibody sensitization (dual-allergen exposure hypothesis). Mandatory medical evaluation / IgE testing prior to introduction.
The landmark LEAP trial primary focus. Introducing dietary peanut protein early (4-6m) presents the antigen to gut gut-associated lymphoid tissue (GALT), driving CD4+ cells into mucosal regulatory T-cells (Tregs) that suppress allergic responses.
Introduce freely at home around 6 months in accordance with family dietary preferences and infant readiness.