National Institute of Allergy and Infectious Diseases | health information 

NIAID

Addendum Guidelines for the Prevention of 

Peanut Allergy in the United States

Summary for Parents and Caregivers

Background

Peanut allergy tends to begin early in life and persist through adulthood. Allergic reactions to peanut 

can range from mild to severe and even life-threatening. To avoid these reactions, people with peanut 

allergy must be vigilant about the foods they eat and the environments they enter, which can be 

extremely stressful for them and for their families.

New Clinical Trial Results on Peanut Allergy Prevention

Recent scientific research has shown that peanut allergy can be prevented by introducing peanutcontaining foods into the diet early in life. Researchers conducted a clinical trial called Learning 

Early About Peanut Allergy (LEAP) with more than 600 infants considered to be at high risk of 

developing peanut allergy because they had severe 

eczema, egg allergy, or both. The scientists randomly 

divided the babies into two groups. One group was 

given peanut-containing foods to eat regularly, and 

the other group was told to avoid peanut-containing 

foods. They did this until they reached 5 years of 

age. By comparing the two groups, researchers found 

that regular consumption of peanut-containing foods 

beginning early in life reduced the risk of developing 

peanut allergy by 81 percent.

A mother feeding her infant.

Development of Clinical Practice Guidelines

Based on the strength of the LEAP findings, the National Institute of Allergy and Infectious 

Diseases (NIAID), part of the National Institutes of Health, worked with 25 professional organizations, federal agencies, and patient advocacy groups to develop clinical practice guidelines to address 

the prevention of peanut allergy. A panel of experts developed the Addendum Guidelines for the 

Prevention of Peanut Allergy based on the LEAP findings and other recent scientific research.

This fact sheet summarizes the guidelines and provides a starting point for conversations with 

your infant’s healthcare provider about how best to prevent the development of peanut allergy.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

National Institutes of Health

National Institute of Allergy and Infectious Diseases
2

NIAID

Note that infants and small children should never be given whole peanuts due to the risk of choking. 

Introduce other solid foods into your infant’s diet before trying peanut-containing foods.

Guideline 1

Guideline 1 recommends that if your infant has severe eczema, egg allergy, or both (conditions that 

increase the risk of peanut allergy), he or she should have peanut-containing foods introduced into 

the diet as early as 4 to 6 months of age. This will reduce the risk of developing peanut allergy.

Check with your infant’s healthcare provider before feeding your infant peanut-containing foods. 

He or she may choose to perform an allergy blood test or send your infant to a specialist for other 

tests, such as a skin prick test. The results of these tests will help to determine if peanut should 

be introduced into your infant’s diet and, if so, the safest way to introduce it. If your infant’s test 

results indicate that it is safe to introduce peanut-containing foods, the healthcare provider may 

recommend that you introduce peanut-containing foods to your infant at home. Or, if you prefer, 

the first feeding may be done in the healthcare provider’s office under supervision. On the other 

hand, testing may indicate that peanut should be carefully introduced at a specialist’s facility or 

not introduced at all because your child may already have developed an allergy to peanut.

Follow your healthcare provider’s instructions for introducing peanut-containing foods to your infant.

Guideline 2

Guideline 2 suggests that if your infant has mild to moderate eczema, he or she may have peanutcontaining foods introduced into the diet around 6 months of age to reduce the risk of developing 

peanut allergy. However, this should be done with your family’s dietary preferences in mind. If peanutcontaining foods are not a regular part of your family’s diet (and your infant does not have severe 

eczema, egg allergy, or both), do not feel compelled to introduce peanut at such an early stage.

Your child’s healthcare provider can tell you whether your child’s eczema is mild to moderate. You 

may then choose to introduce peanut-containing foods at home. However, if you or your healthcare 

provider prefer, the first feeding can be done in the provider’s office under supervision.

Guideline 3

Guideline 3 suggests that if your infant has no eczema or any food allergy, you can freely introduce 

peanut-containing foods into his or her diet. This can be done at home in an age-appropriate 

manner together with other solid foods, keeping in mind your family’s dietary routines and 

preferences as described in Guideline 2.

January 2017

www.niaid.nih.gov