This post may contain affiliate links. If you shop from one of our links, we may earn a commission.
Introducing allergens to your infant that may cause an allergic reaction can feel intimidating and nerve-wracking at first. It’s a bit terrifying as a parent to know when and how to introduce allergens to your infant without really knowing how they will respond. In the United States, 8% of children have a food allergy, that’s 1 in 13 kids. As a parent, you don’t need to be fearful about offering the common food allergens to your baby. But it is good to be prepared.
The latest research shows that introducing the most common food allergens to your infant sooner rather than later helps decrease the likelihood of developing an allergy to that item. This is particularly important for kids who have a higher risk of developing an allergy if there is a family history of food allergies. Food allergies generally present themselves in young children, especially if there is a family history of food allergies. Although it is not uncommon to see allergies develop until adulthood. Some children may outgrow their food allergies, but that isn’t the case for everyone.
Food allergy versus food intolerance
Food allergy and food intolerance are not the same. A food intolerance occurs when the body is unable to digest a particular food or substance. For example, individuals with a lactose intolerance are unable to digest the milk enzyme, lactase. This can result in issues with the digestive system such as bloating, gas, or diarrhea. Food allergies happen when the body’s immune system reacts to a particular substance in the food, this is generally a protein. This begins a chain reaction within the body that quickly leads to symptoms that can be very mild to life-threatening. Symptoms to monitor include hives or rashes, severe eczema, red puffy eyes, nasal congestion, difficulty breathing, swelling of the lips and tongue, nausea, vomiting, dizziness, or fainting.
What are the top allergens?
In the United States, the eight common allergens include milk, eggs, peanuts, tree nuts (including almonds, walnuts, and cashews), fish (including pollock, salmon, cod, tuna, snapper, eel, and tilapia), crustacean shellfish (including shrimp, lobster, and crab), wheat, and soy. These foods account for 90% of food allergy reactions in the United States.
According to the American Academy of Pediatrics and the World Health Organization, mothers who are able to breastfeed are encouraged to exclusively nurse until their child is 6 months of age. According to the American Academy of Allergy Asthma and Immunology, mothers do not need to restrict their diet of allergens while nursing or breastfeeding, when their child is well, as a way to prevent food allergies. Breastfeeding, if able, is recommended for the first 6 months of your baby’s life to help strengthen their body’s immune system and is not as likely to cause an allergic reaction. The World Health Organization reports babies are able to thrive from the nutrition of breast milk alone for the first 6 months.
If your 6-month-old does not appear developmentally ready for solids or is having a difficult time transitioning, breastmilk is still fine for 9-12-month-olds. However, after 6 months of age, infants will begin to need additional sources of zinc and iron from solids. Food is mainly for fun for the first year of life as long as your child is continuing to grow and develop appropriately. A mother’s breastmilk has an incredible way of modifying its nutritional composition as the baby ages in order to best meet the needs of the child.
Signs of Developmental Readiness to Start Solids
Here are some signs to look for when determining if your child is ready to start solids:
- Good head and neck control and can sit upright without support
- They show an interest in what you and others are eating
- They open their mouth when offered food on a spoon
- Baby does not automatically push food out of their mouth
- Baby demonstrates a “pincer” grasp by picking up objects between their thumb and forefinger
When to introduce solids
It was formerly thought that the top allergen foods should not be offered until infants were 12 months of age. Peanuts, tree nuts, and fish were once said to not be offered until 36 months. But, a 2015 Learning Early About Peanut (LEAP) study discovered there was an 80% less chance of children developing a peanut allergy when they were offered them more frequently as babies. Since this discovery, the timeline has shifted to offering these foods as soon as babies begin solids, generally around 6 months of age.
The Enquiring About Tolerance (EAT study) was funded by the UK’s Food Standards Agency with results published in 2016. This study also verified that early introduction of allergenic foods did not increase the infant’s risk of developing a food allergy.
How to introduce solids
From 4-6 months of age, infants can begin with single-ingredient foods. Items such as fruits (applesauce, pears, peaches, bananas), vegetables (sweet potatoes, peas, green beans), and cereal grains (rice or oat cereal) one at a time are great first options.
After your child has demonstrated an ability to tolerate less allergenic foods, you may begin to gradually introduce the major allergens one at a time. It is not necessary to wait 3-5 days before introducing new foods as this can significantly limit the timeline of trying them and increase the risk of developing a food allergy later on. Although, it is wise to not offer new foods when trialing some of the common allergens. This can help better identify which food is causing a reaction.
Introducing Milk
You may have heard your pediatrician state you should not offer your infant milk before 1 year of age. It is true that cow’s milk is not designed to replace breast milk or infant formula. However, dairy products can still be offered before your child is 1. It is perfectly fine to introduce dairy items such as yogurt, cottage cheese, small pieces of cheese (when developmentally ready), or use in baking.
Introducing Peanuts/Tree Nuts
This tends to be the most scary allergen for parents to offer as many kids today have peanut allergies. But here is a simple way to start providing an early peanut introduction:
1. Do not offer right before your child takes a nap to ensure you are able to monitor for any reactions.
2. Begin by taking 1-2 teaspoons of creamy peanut butter and mixing it in with a serving of oatmeal.
3. Offer a couple of bites of the oatmeal and then wait 10-15 minutes to observe any side effects.
4. If your baby tolerates the oatmeal without complications, feel free to serve the remainder of the cereal. Monitor for any allergic reactions.
5. Continue to offer 3 or more servings of peanuts per week through 12 months of age.
Additional Ways to Serve Peanuts
- Spread a very thin serving of nut butter on a piece of toast
- Mix into yogurt
- Offer peanut butter puffs
- Avoid offering a spoonful of peanut butter as this can be a choking hazard for infants.
Introducing Eggs
It is perfectly fine to serve both the egg yolk and the egg white once your child is developmentally ready to begin solids. Be sure to offer eggs in small servings to reduce the risk of choking. You may serve hard-boiled eggs, omelets, scrambled eggs, baked in muffins, mixed in cereal (oddly my kids loved scrambled eggs mixed in their oatmeal), or however else your family enjoys eating them.
Introducing Fish and Shellfish
Fish is a highly nutritious option providing protein, omega-3 fatty acids, vitamins, and minerals. It’s also easy to serve as most fish is tender and easy to manage for little ones. Salmon, tilapia, crab cakes, sardines, and tuna (not albacore tuna due to the mercury content) are all great options to start with.
Introducing Wheat
It is not necessary to avoid wheat or gluten unless your family has a history of Celiac disease or you suspect this in your infant. This also allows for a lot more variety for your baby. Wheat bread and wheat cereal are both easy ways to introduce wheat.
Introducing Soy
There is a lot of mixed information out there regarding soy and its potential side effects in regard to hormones and cancer. However, research shows that minimally processed soy products are perfectly safe to consume.
Food Allergy Diagnosis
Talk to your medical provider if you suspect your child may have a food allergy. But take your child to the emergency room if you observe a severe allergic reaction. Your child’s pediatrician may refer you to an allergist/immunologist for further testing for food allergies.
Diagnostic food allergy tests:
Skin Prick Test
This is an inexpensive test that can be performed in the doctor’s office and provides immediate results. The skin prick test measures the presence of IgE antibodies in a specific food. To perform the test, a drop of solution containing the food is placed on the forearm or back. The allergist will scratch the surface of the skin to allow the solution in, this is typically not painful. The results are ready within 30 minutes. There are rarely any false negatives, however, 50-60% of the tests provide a false positive. This means the test will report an allergy to a food that the person isn’t actually allergic to.
Blood Test
The blood test is similar to the skin prick test in that they both test for the presence of IgE antibodies. However, the results for this test often take several days. This test also has 50-60% of tests providing a false positive. Although there is a high chance of false positive results, this information can be particularly helpful for a trained allergist to help diagnose.
Elimination Diet
Your pediatrician may suggest combining the skin prick test or blood test with an elimination diet. They may also suggest an elimination diet alone. The elimination diet can last 2-4 weeks. You can gradually add eliminated foods back in, monitoring for any reactions to the potential allergens.
How to Read Food Labels
If your child has a food allergy it is vitally important that you know how to read nutrition labels. Thankfully labels are fairly easy to read if your child is unable to have any of the major food allergens. The Food Allergy Labeling and Consumer Protection Act (FALCPA) requires the top 8 allergens to be clearly listed on nutrition labels. This document from the Food Allergy Research and Education organization provides detailed information on reading labels to safely feed your child.
In Summary:
When your infant is around 6 months of age and developmentally ready to begin solids, you can offer complementary foods and other common allergens in small amounts. Introduce top allergens one at a time to better identify what food may be causing the allergic reaction. If your child tolerates these without complications you should offer these items 2-3 times per week. This can help reduce your child’s risk of developing a food allergy.
