Introducing allergens to a baby can be scary, but did you know that introducing them early can actually prevent the development of a food allergy later?
In 2015, a groundbreaking study demonstrated that the early introduction of peanuts to at-risk babies could reduce the risk of developing peanut allergy by as much as 81%. In other words, delaying the introduction of peanut could actually increase the likelihood of peanut allergies developing.[1]
Allergists and medical institutions now recommend introducing common food allergens once baby is ready to start solids, and keeping them in your baby’s diet consistently to prevent the development of food allergies. If your baby has certain risk factors, allergen introduction can start as early as 4 months of age.[2]
Is my baby high risk for food allergies?
There are two main risk factors that indicate your baby might be at an increased risk of developing food allergies: severe eczema and existing food allergies.
- High Risk: Severe eczema. Eczema is thought to increase the chances of developing a food allergy via exposure through the impaired skin barrier.[3] Severe eczema does not have a formal definition, but most physicians consider eczema severe if it covers a large percentage of the body or persists for an extended period of time despite the regular application of moisturizers and topical anti-inflammatory medications.
Note: Mild to moderate eczema is also associated with an increase in the risk of developing food allergy. That said, most medical professionals agree that well-controlled eczema of lower severity does not warrant any allergy testing or special precautions prior to introducing allergens at home.
If baby has either of the above risk factors, work closely with your child’s medical provider to map out a plan. Otherwise, you can begin to introduce common food allergens at home as soon as your baby is ready to start solids.
Top food allergens for babies
Today, one in 13 children have a food allergy in the United States. Of those children with food allergies, 40% will be allergic to more than one food.[6] Although it is possible to be allergic to any food, the most common food allergens are:[7]
- Cow’s Milk
- Egg
- Finned Fish
- Peanut
- Sesame
- Shellfish
- Soy
- Tree Nuts
- Wheat
What do allergic reactions look like?
Allergic reactions often occur within minutes of consuming the allergenic food. Your baby may not have an allergic reaction the first time they are exposed to the food, so be watchful on the second and subsequent exposures.
Mild symptoms of an allergic reaction can include ONE of the following
- Itchy or runny nose, sneezing
- Itchy mouth
- A few isolated hives, mild itching
- Mild nausea or gastrointestinal discomfort
If you note any of these symptoms, stop feeding the allergen and contact your health care provider for guidance.
More severe reactions may include any of the following, either alone or in combination:
- Shortness of breath, wheezing, repetitive cough
- Pale, ashen or bluish skin
- Swelling of face, lips, or tongue – this may lead to drooling
- Widespread hives on body
- Repetitive vomiting or diarrhea
- Sudden tiredness/lethargy/seeming limp
If your child is having any of the above symptoms or multiple mild symptoms, call 9-1-1/local emergency services immediately and request an ambulance with epinephrine on board. Do not wait.
How to introduce allergenic foods to babies
Introducing food allergens doesn’t have to be terrifying. After you’ve gotten a little bit comfortable with offering solid food to baby, you can start to introduce allergens. For step-by-step guidance, download the Solid Starts App.
Tips for introducing common food allergens
- Start small. The smaller the quantity served, the less severe an allergic reaction may be. For example, you can dip your finger in yogurt or smooth peanut butter thinned with water so it is loose and saucy, then let baby taste from your finger.
- Introduce allergens early in the day. Introduce allergens in the morning or right after a morning nap so you can observe your child during the day ahead. This way, it is easier to contact a doctor during working hours in the unlikely event of an emergency.
- Introduce one food allergen at a time. This way, if there is a reaction, you’ll know which food was responsible. You can offer multiple new foods each week, as long as you aren’t introducing common food allergens simultaneously.
- Regular exposure. Once you’ve safely introduced a food allergen, keep that food in regular rotation—consistency is key. Try to offer the allergen at least once a week, ideally 2 to 3 times if possible.
- Don’t worry too much about volume: If your baby doesn’t consume the entire serving, that’s okay. Relatively modest quantities of allergen exposure (~2 grams of protein per week) can be effective for allergy prevention, as long as exposure remains consistent.[8]
- Focus on the Big 3: The research is the strongest for early introduction of peanut, egg, and dairy.[9] Aim to introduce all three in the first few months of solids.
Need help introducing allergens? Get the Solid Starts App for step-by-step guidance on introducing and regularly serving allergens.
Just getting started on your solid food journey? Check out the new book Solid Starts: How to Introduce Solid Food and Raise a Happy Eater for everything you need to know about starting solids and raising a happy eater. Coming April 1st—available for pre-order now!
[1] Fleischer, D., Spergel, J., Assa’ad, A.H., Pongracic, J. (2012). Primary prevention of allergic disease through nutritional interventions. The Journal of Allergy and Clinical Immunology: In Practice, 1(1). Retrieved February 25, 2021.
[2] Food Allergy Education & Research. Learning Early About Peanut Allergy (LEAP). (website) Retrieved March 29, 2020.
[3] Scientists identify unique subtype of eczema linked to food allergy. (2019, February 20). National Institutes of Health (NIH). https://www.nih.gov/news-events/news-releases/scientists-identify-unique-subtype-eczema-linked-food-allergy
[4] What Is a Food Allergy? (2022). Food Allergy Research & Education. Retrieved 2022, from https://www.foodallergy.org/resources/what-food-allergy
[5] Sicherer, S. H., Wood, R. A., Stablein, D., Burks, A. W., Liu, A. H., et al. (2010, May). Immunologic features of infants with milk or egg allergy enrolled in an observational study (Consortium of Food Allergy Research) of food allergy. Journal of Allergy and Clinical Immunology, 125(5), 1077-1083.e8.
[6] Facts and Statistics. FoodAllergy.org. Retrieved 2022, from https://www.foodallergy.org/resources/facts-and-statistics
[7] Common Allergens. FoodAllergy.org. Retrieved 2022, from https://www.foodallergy.org/living-food-allergies/food-allergy-essentials/common-allergens
[8] Fleischer, D. M., Chan, E. S., Venter, C., Spergel, J. M., Abrams, E. M., Stukus, D., Groetch, M., Shaker, M., & Greenhawt, M. (2021c). A Consensus Approach to the Primary Prevention of Food Allergy Through Nutrition: Guidance from the American Academy of Allergy, Asthma, and Immunology; American College of Allergy, Asthma, and Immunology; and the Canadian Society for Allergy and Clinical Immunology. The Journal of Allergy and Clinical Immunology: In Practice, 9(1), 22-43.e4. https://doi.org/10.1016/j.jaip.2020.11.002
[9] Fleischer, D. M., Chan, E. S., Venter, C., Spergel, J. M., Abrams, E. M., Stukus, D., Groetch, M., Shaker, M., & Greenhawt, M. (2021c). A Consensus Approach to the Primary Prevention of Food Allergy Through Nutrition: Guidance from the American Academy of Allergy, Asthma, and Immunology; American College of Allergy, Asthma, and Immunology; and the Canadian Society for Allergy and Clinical Immunology. The Journal of Allergy and Clinical Immunology: In Practice, 9(1), 22-43.e4. https://doi.org/10.1016/j.jaip.2020.11.002
