Many parents have been asking about how to safely introduce allergenic foods to their babies. This is a big and exciting milestone, and one that can also bring some understandable nerves. Fortunately, recent research has shown that early introduction of allergenic foods, such as peanuts and eggs, can actually help reduce the risk of developing food allergies later on.
Below, we’ve outlined what the latest evidence shows, and some expert tips from our colleagues at Latitude Food Allergy Care on how to get started safely when the time comes.
Why Early Introduction Matters
In the 1990s, parents were advised to delay introducing foods like peanuts and eggs. Unfortunately, this led to a rise in food allergies. That changed with the landmark LEAP Study (2015), which found that introducing peanuts between 4 and 11 months of age reduced the risk of peanut allergy by 86% compared to avoidance. More recently, new research published by the American Academy of Pediatrics (AAP) confirmed these findings on a national level for both peanut allergies and other food allergies.
Is Your Baby Ready for Solids? For Allergens?
Readiness for solids usually happens around 4–6 months. You can read our earlier blog posts on assessing readiness and checking in with your pediatrician at your 4- and 6-month visits to get the all-clear before starting. If your child has other food allergies or moderate-to-severe eczema, you may need additional guidance from your pediatrician.
Once your little one has tried a few single-ingredient foods (like pureed fruits or vegetables), it’s time to start introducing allergenic foods.
How to Start — Safely and Simply
1. Start with one new food at a time.
Introduce only one new food every 2-3 days so you can easily identify the source of any reaction.
2. Prepare the food.
Mix about 2 teaspoons of the allergenic food (like smooth peanut butter or plain yogurt) with breast milk, formula, or a familiar puree.
3. Offer a tiny taste first.
Give about ¼ teaspoon, wait 10 minutes, and observe for any reaction. If there’s none, continue feeding the rest of the portion.
4. Watch for two hours.
Some mild redness around the mouth can be irritation rather than allergy, but hives, swelling, vomiting, or trouble breathing are red flags. Call your pediatrician for any concerning reaction, and 911 for severe symptoms.
These nine foods cause the majority of allergic reactions in children: peanut, egg, milk, tree nuts, soy, wheat, fish, shellfish, sesame.
You can start with any of these once your baby is ready. A sample schedule from our colleagues at Latitude Food Allergy Care offers a plan for gradually introducing each allergen one by one.
Once your baby tolerates a new food, continue offering it 2–3 times per week to help maintain tolerance.
Q&A with Latitude Allergists, Drs. Gabrielle Robertson & Megan Bannon
What is the best age to introduce allergens?
As soon as developmentally appropriate! You can work with your pediatrician to identify the signs that indicate your child is ready for purees/solids. This usually occurs around 4 to 6 months.
What allergen should I start with first?
We recommend starting with the allergens that are most important in your family’s diet. Peanut, cashew, milk, and egg are our top four allergenic foods to get into babies’ diets sooner rather than later.
What do you think of allergen powders and ready-to-feed allergen butters? Are they safe and effective?
It is difficult to give a blanket statement on allergen powders, pouches, and ready-to-feed allergen butters because they vary widely. What is most important is getting enough protein content from each food into the baby’s diet on a consistent basis. Sometimes, the powders, pouches, and butters contain several food allergens mixed together, such that each individual food is not present in sufficient amounts to represent a true “introduction” to each food. If possible, we recommend using real food (i.e. blended nuts or single nut butters) for food introductions for babies. Aim for 1 to 2 grams of protein for each food each week. If a family would like to use a prepared/ready-to-feed allergen powder/pouch/butter, we encourage them to use single-food pouches/items for the first introductions of foods. This allows for easy identification of the culprit food, if a reaction were to occur.
How do you recommend families continue to introduce allergens once established? It seems like a lot of work to keep giving each one several times a week!
After introduction, it is very important that the food is kept in the baby’s diet regularly (about 3 to 5 times per week). This may seem daunting at first, but many of these foods are actually quite easy to incorporate into meals young children are already eating every day! Once a baby has tolerated a certain food several times, it can then be mixed together with other foods he/she has also already tolerated for ease of keeping it in his/her diet. Below are several options for babies for several common food allergens:
Milk: Yogurt, cottage cheese/other soft cheeses, & baked goods containing milk
Egg: Cooked hard-boiled/scrambled egg & baked goods containing egg
Soy: Tofu (can be mixed with anything!), crushed edamame beans
Wheat: Softly cooked pasta, cream of wheat, and bread
Tree nuts: Prioritize cashew, walnut, hazelnut, and almond. Blend whole nuts into a fine powder using a food processor and sprinkle into any food you please. Applesauce, oatmeal, & yogurt are all great options! Nut butters can also be mixed with these.
Sesame: Mix tahini into hummus. Note: Sesame seeds on a piece of bread may not have a sufficient amount of sesame protein, so tahini is a better option
Fish/Shellfish: Give a few small portions of the fish and/or shellfish that you are regularly consuming as a family.
Is there a best time/age to see a pediatric allergist if I suspect my child has a food
allergy?
It is great to see an allergist as soon as possible if you suspect a food allergy. Latitude Food Allergy Care has food allergy specialists that are able to provide clarity with testing and can create personalized, proactive treatment plans for all patients. We can see patients in a timely fashion so that there are minimal delays in further food introduction.
Why don’t you routinely send panels of blood testing for different food allergies?
Blood testing for food allergies does not tell the full story. In general, when diagnosing an allergy, we evaluate blood work, skin tests, and the history of what happened when the patient ate the food. Blanket blood work, (without skin testing and full clinical history) can result in delays in food introduction and/or unnecessary removal of foods from children’s diets, which may actually make the situation worse.
The information in this blog is intended for general educational purposes and should not be taken as medical advice for any individual case. For personalized guidance or medical concerns, please consult your child’s healthcare provider.
