Many parents often wonder when the best time is to introduce their baby to food that may have a high risk of causing an allergic reaction.
“We know more and more that the earlier introduction to those high allergen foods is beneficial and protective against developing food allergies,” said Michael Endris, MD, a pediatrician at OSF HealthCare.
Food allergies in infants have increased in recent years. About 8% of children in the United States have a food allergy according to the Centers for Disease Control and Prevention.
Who’s at risk of a reaction?
Any baby can have an allergic reaction to any food.
Babies with a family history of food allergies, a prior food allergy themselves or those with eczema can be at higher risk of developing food allergies. You can talk with your pediatrician on how to safely incorporate these foods into your baby’s diet.
If you’ve already discovered that your baby is allergic to a certain food, they may be at higher risk of having an allergic reaction to other foods.
“Infants at higher risk could have testing done with their pediatrician or an allergist to help determine how to safely incorporate high allergen foods, like peanuts. I still don’t recommend eating peanut butter in the emergency department parking lot,” Dr. Endris said.
Common food allergies
There are more than 160 foods that cause allergic reactions in people.
However, according to the United States Department of Agriculture (USDA), “The Big 9” are the most common food allergies. They include milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, soybeans and sesame.
“These nine foods, and any ingredient that contains protein derived from one or more of them, are designated as ‘major food allergens,’” the USDA described.
Since these nine are the most common allergens, food labels must have a clear warning on any food that contains any of The Big 9.
When to introduce baby to allergens
Talk to your baby’s pediatrician about when the best time is to start your baby on solids. Many babies start to hit important milestones around 4 to 6 months old, including being able to hold up their head.
“Every child is going to be a little different, but usually in that 4-6-month range is a good time to introduce those foods.”
“That’s when we can start to offer a variety of different foods rich with puréed meat and high allergen things,” Dr. Endris said.
How to introduce allergens
When introducing any new food – and especially high allergen foods – it’s good to keep things as simple as possible. If they have a reaction, you want to know exactly which food triggered it.
Be patient. It can be messy. It can be helpful to nurse or feed a bit of a bottle, have a few small spoonfuls, then finish a bottle to make sure they don’t cry from hunger. But stop when they seem full, like turning away or crying. Don’t force eating.
Here are some other helpful tips for introducing allergen foods:
Need a pediatrician?
- Single ingredient purées are a good option
- Start with one food at a time
- Start with a small amount
- Serve about three to four times a week
- Watch your baby carefully for the first few hours after they’ve tried a new food
- Make foods easy for a baby to swallow – puréed, mashed, softened (infant cereals and puréed meats are excellent first foods)
Dr. Endris also recommends starting good eating habits early, like eating together as a family without screen time.
It’s a good idea to be sure your child tolerates a few foods before trying high allergen ones. Then give a small taste of a high allergen food at home. If that is tolerated, then can give increasing amounts.
Here’s how to introduce some of the common allergen foods safely.
Milk
You can incorporate whole milk into your baby’s routine around 12 months. However, they can be introduced to dairy sooner – at that 4-to-6-month mark.
Try introducing them to yogurt or using milk cooked in foods like pancakes and scrambled eggs. That way they’ll get the introduction to the dairy allergen without having to drink a bottle of cow’s milk.
Eggs
Eggs are a great food to introduce your baby to early. They’re packed with protein and are easy for babies to chew (or gum). Babies can be introduced to scrambled eggs between 4-6 months.
When preparing the eggs, make sure that you cook them thoroughly, and don’t give your baby runny yolks. Start with scrambled or hard-boiled eggs. These are often softer and easier for your baby to eat.
Peanut butter
Because peanut butter is thick, it can be a choking hazard. Choose a creamy peanut butter over chunky. You can introduce peanut butter around 4 to 6 months. When starting your baby on peanut butter, spread a very thin layer on a piece of soft toast or bread. You can also stir in a small amount of peanut butter into baby cereal. Or even water down the peanut butter and give it to your baby to lick a little off a spoon.
Infant food allergy symptoms
Watch your baby for the first few hours after they’ve tried a high allergen food for the first time. Some of the most common symptoms of a food allergy in an infant are rashes, hives or swelling of lips, tongue or face. These generally appear within minutes after eating.
In addition, you may notice:
- Eczema
- Lethargy or your baby is extra sleepy
- Nasal stuffiness
- Coughing
- Itching
- Diarrhea
- Vomiting
- Trouble breathing
If your baby has a severe reaction, including hives, swelling or trouble breathing, go to the emergency department immediately.
Infant food allergy test
If your baby has a minor reaction to a food, make an appointment with your child’s pediatrician. They’ll likely give you a referral to an allergist or other specialist. Or they’ll help you monitor their allergy.
The allergist can perform some tests on your baby, usually a type of exposure test, to see what your baby reacts to. Blood tests can be done if there is a history of a food allergy or severe eczema. Skin prick tests or even oral food challenges can be done in an allergist’s office.
Infant allergy treatment
Depending on the severity of your baby’s adverse food reaction, you may have different levels of treating them. If your baby has stomach troubles, like gas or diarrhea, you’ll likely be told by your child’s pediatrician to avoid serving your baby those foods.
If your child has ever had an allergic reaction, follow your food allergy action plan given to you by your child’s pediatrician. Work with your child’s pediatrician to update their food allergy action plan yearly.
For more severe reactions, your child may be prescribed an EpiPen, which is an injection that contains epinephrine and is used in case of an emergency to open airways. Some allergic reactions can be life-threatening, so it’s important to take reactions seriously.
Some people see their reaction to high allergen foods change throughout their life, while others simply outgrow their food allergies.
Last Updated: August 20, 2024