Most parents have heard that introducing peanut-containing foods early can help prevent peanut allergy, but new research suggests many are unclear about how and why the guidance works.
In a study published in JAMA Network Open, researchers from Ann & Robert H. Lurie Children’s Hospital of Chicago interviewed parents of infants ages 8 to 13 months and found that while awareness of early peanut introduction was high, misunderstandings about the purpose, timing and risks were common. Those gaps often led to hesitation or delays in offering peanut-containing foods.
“While some parents we talked to understood correctly that starting their baby on peanut foods trains the immune system in order to prevent the development of peanut allergy, other parents mistakenly believed that the purpose is to test if their baby is allergic,” said Waheeda Samady, MD, a pediatrician at Lurie Children’s Hospital and associate professor of pediatrics at Northwestern University Feinberg School of Medicine.
That misconception mattered. Parents who viewed early peanut feeding as a test rather than a prevention strategy were more likely to worry about triggering a severe allergic reaction and to postpone introduction altogether. According to the study, many parents were also unsure about how often peanut-containing foods should be offered once they were introduced.
“For prevention of peanut allergy, timing and consistency are of the essence,” Samady said. “We encourage peanut introduction as soon as the baby starts eating solids, before or around 6 months of age.”
Early peanut introduction guidelines were first issued in 2017 after clinical trials showed a dramatic reduction in peanut allergy risk when peanut foods were introduced in infancy and eaten regularly. Peanut allergy affects about 2% of U.S. children and is one of the least likely food allergies to be outgrown, making prevention an important public health goal.
The interviews also revealed confusion about risk factors. Many parents did not realize that eczema increases an infant’s risk of developing food allergies and makes early peanut introduction especially important.
“If a baby has eczema, peanut introduction should start early, around 4 months of age, if possible, to maximize peanut allergy prevention coupled with good skin care,” Samady said.
Parents in the study consistently identified pediatricians as their primary source of information about infant feeding. However, researchers noted that busy well-child visits may not leave enough time to explain the reasoning behind the guidelines, address fears and provide practical examples.
“Overall, we found that parents are accepting of early peanut introduction, but they need clearer guidance and more support,” Samady said.
Importantly, the study did not examine allergy outcomes themselves. Instead, it focused on how parents understand and apply existing guidance. The researchers emphasized that most allergic reactions in infancy are mild and that clearer communication could help parents feel more confident introducing peanut foods safely and consistently.
The findings highlight a broader challenge in nutrition guidance: strong evidence alone is not enough if families are unsure how to translate it into everyday feeding decisions.
This research was funded by the National Institute of Allergy and Infectious Diseases.