Who Feeds Babies Peanuts Early? Not Often Low-Income or Minority Parents

The Importance of Early Peanut Introduction in Infants

Introducing peanut-containing foods to infants at an early stage can significantly reduce the risk of developing a peanut allergy later in life. This critical information has been highlighted by recent research, which emphasizes the importance of timely and informed guidance from healthcare providers. However, the study also reveals significant disparities in how this advice is being shared with different groups of parents.

Key Findings from the Study

A large-scale study conducted by Northwestern Medicine examined the practices and knowledge of over 3,000 U.S. parents with children aged between 7 and 42 months. The results showed that white parents were more likely to introduce peanut-containing foods to their infants before the age of one compared to parents from minority backgrounds. Specifically, 51% of white respondents had introduced peanuts by the child's first birthday, while only 42% of Black, 36% of Hispanic, and 35% of Asian American parents had done so.

The study also found that high-income and college-educated parents were more likely to receive guidance on when and how to introduce peanuts. Only about half of Black and Hispanic parents reported that their pediatrician discussed this topic, compared to nearly two-thirds of white parents. Additionally, fewer Black parents believed that introducing peanuts before 12 months could help prevent allergies, highlighting a gap in understanding and trust in medical advice.

Disparities in Healthcare Access

These findings are particularly concerning because children from low-income and minority families already face higher rates of food allergies and more severe outcomes. Dr. Christopher Warren, the lead author of the study, emphasized that families from racial and ethnic minority groups and those with lower incomes are less likely to receive accurate, timely guidance from their primary care providers regarding the introduction of peanuts during infancy.

Warren noted that this inequity persists despite the safety and effectiveness of early peanut feeding. He pointed out that this is the first study to closely examine how the food allergy prevention guidance received by parents varies based on race, income, and other background factors.

National Guidelines and Their Impact

Since 2017, national guidelines have recommended introducing peanut-containing foods around 4 to 6 months of age. This shift was prompted by a landmark clinical trial that demonstrated early introduction reduces the risk of peanut allergy by more than 80%. Prior to this, many parents were advised to delay peanut feeding due to concerns about triggering allergies.

Peanut allergy, which can be life-threatening, now affects an estimated 2% of U.S. children. Evidence from randomized trials shows that early and frequent exposure to peanut products, along with other complementary foods, helps prevent peanut allergy later in childhood, especially for babies with risk factors like eczema or egg allergy.

Recommendations for Equitable Access

To address these disparities, Warren suggests that primary care providers, especially those serving underserved communities, need better tools and resources. He emphasized the importance of equipping both parents and healthcare providers with high-quality information and simple, effective guidance during well-child visits.

Linguistically and culturally tailored handouts can also help parents feel more confident in introducing peanuts safely at home. Additionally, larger policy efforts, such as including peanut-containing products in WIC food packages, could improve access for low-income families.

With about 40% of U.S. infants insured through Medicaid, Warren believes that Medicaid state programs could play a key role in scaling education and outreach efforts. These steps are essential in ensuring that all families have the knowledge and resources needed to protect their children from peanut allergies.