Feeding infants a teaspoon of cashew nut spread thrice a week from six to eight months is safe and viable.

In an effort to decrease peanut allergy rates, current infant feeding guidelines suggest introducing peanuts in an appropriate form (e.g., peanut butter) during complementary feeding. However, the lack of randomized trial evidence has led most guidelines to exclude tree nuts from infant feeding and food allergy prevention recommendations.

A single-blinded (outcome assessors), three-arm (1:1:1 allocation), parallel, randomized controlled trial aimed to evaluate the safety and feasibility of recommended dosage consumption for introducing infant cashew nut spread.

Term infants from the general population, aged 6-8 months, were randomly assigned to one of three groups. The first group (Intervention 1, n = 59) received 1 teaspoon of cashew nut spread, three times per week. The second group (Intervention 2, n = 67) followed an elevating dosage regime, starting with 1 teaspoon at 6-7 months, rising to 2 teaspoons at 8-9 months, and 3 teaspoons from 10 months onwards, also three times per week.

The third group (Control, n = 70) did not receive any specific advice regarding cashew introduction. At 1 year of age, the participants were evaluated for cashew nut allergy mediated by IgE through a food challenge.

Intervention 1 demonstrated a greater compliance rate (92%) compared to Intervention 2 (79%). During the study, only a single infant experienced delayed (at 5 h) facial swelling and eczema flare when introduced to cashew at 6.5 months, but interestingly, this infant did not develop a cashew allergy by the age of 1 year. On the other hand, among the infants in the Control group, only one developed a cashew allergy at 1 year, and it was noted that this particular infant had not been introduced to cashew until they were 12 months old.

Feeding infants one teaspoon of cashew nut spread three times a week from six to 8 months of age was deemed feasible and safe.