Preventing Food Allergies in Babies

The top 9 common food allergens in babies (and grown-ups) are:

• Peanut
• Egg
• Milk
• Wheat
• Soy
• Fish
• Shellfish
• Sesame
• Tree nuts: almonds, cashews, pistachios, walnuts, pecans and hazelnuts

A food allergy happens because of an abnormal immune response to contact with food. The immune system reacts to a food protein because the body thinks that food protein is a threat. It is estimated that about 8% of children in the U.S. have a food allergy.

Before introducing allergens, your baby needs to be familiar with a spoon and swallowing food. If your baby isn’t showing signs that they’re ready for food, talk to your pediatrician.

When introducing allergens to your baby, start with one food at a time so you can see how your baby’s body responds to each allergen. Recognize this is a new adventure for you and baby, so try to be patient.

Risk factors for introducing allergens:

• If your baby has severe eczema or a known egg allergy, talk to your baby’s pediatrician before introducing any allergens. In this case, it’s typically better to introduce allergens as early as possible after 4 months of age.
• If your baby does not have severe eczema or a known egg allergy, it’s OK to start a little later. Keep in mind that you’ll still want to introduce common allergens before 9 months of age. Remember, early introduction reduces their risk of developing an allergy.

What is severe eczema?

Severe eczema affects a large portion of the skin on the body, and often the face/scalp. It requires treatment with medications and moisturizers prescribed by a healthcare provider who considers the eczema to be severe.

Once you introduce a potential allergen (if you don’t recognize any signs of reaction) continue to offer that food frequently as part of your family’s regular diet. You don’t have to stick with a strict schedule, but it’s important for your baby’s immune system to “remember” these foods.

At each feeding, offer your baby a small taste of food and wait 10 minutes. If there are no signs of an allergic reaction, slowly offer the rest of the food.

Keep in mind:

• Offer allergenic foods when your baby is well, not sick.
• Pay close attention to your baby for at least 2 hours after trying a food allergen to watch for a reaction.
• Puree or mix allergens with foods your baby is already eating.
• Once you introduce a potential allergen, continue to offer that food frequently as part of your family’s regular diet. You don’t have to stick with a strict schedule, but it’s important for your baby’s immune system to “remember” these foods.

Try mixing 2 teaspoons of peanut butter or powdered peanut butter with foods you know your baby already enjoys. For instance, start with a ripe banana, applesauce or baby oatmeal. You can also offer teething puffs that contain peanut (without added sugar).

Boil an egg for 10 to 12 minutes and let it cool before peeling off the shell. Slice the egg and use a utensil to mash the whole slice into a paste. Egg allergens are in the white, not the yolk, so be sure to mash the entire mixture together. (You may need to use a food processor or immersion blender, and add some breastmilk or infant formula, to get the mixture smooth.) You can offer the paste to baby on their favorite spoon, your finger or even a teether.

Scrambled eggs are not the easiest way to offer eggs to babies in the earlier months—they usually play with more egg than they eat. Playing with food is normal and developmentally appropriate. In fact, it’s good for babies as they develop a healthy relationship with food. But, in this case, it doesn’t give them the chance to consume the amount of food they need to prevent allergies.

For tips to introduce more potential allergens, download our early introduction handout.

Print it and store it on your fridge for easy reference.

It’s normal and OK to be nervous when introducing allergens. But research shows it’s completely safe to do it at home. If you’re nervous about introducing potential allergens, talk with your child’s pediatrician about your concerns.

When babies do react to foods, mild skin symptoms, like hives, are much more common than the breathing problems seen in older children. Reactions typically start within minutes after a feeding, and usually involve skin symptoms, but a delayed reaction can take up to 2 hours. Know that a severe reaction, like anaphylaxis, is extremely rare in infants.

Minor redness around the mouth is usually skin irritation (not usually from an allergic reaction), especially if the baby is not showing any other signs. If your baby’s skin is irritated by some foods, you can try keeping a wet washcloth handy and wiping their mouth and face periodically.

While early introduction can prevent most cases of peanut and egg allergy, reactions can still occur.

Mild signs of allergic reaction in babies include:

• A few hives or welts (raised, itchy, irregular bumps)
• Swelling of lips, face or eyes
• Mild itching
• Vomiting

If your baby experiences a mild reaction, stop feeding until you’ve talked to your baby’s doctor.

Severe signs of allergic reaction in babies include:

• Many hives over the body
• Redness and vigorous scratching over the body
• Shortness of breath, wheezing or repeated coughing
• Difficult or noisy breathing or hoarse voice or cry
• Pale or blue skin
• Swelling of the tongue, excessive drooling, difficulty swallowing
• Repeated vomiting
• Sudden tiredness or going limp
• Mix of symptoms from different body areas

If your child experiences a severe reaction to a food allergen, call 911 immediately.

While your baby is trying new allergens, they're also trying a lot of new foods as they move from breastmilk or formula to solids. You may notice changes in stool consistency or color, gas, discomfort, etc. These changes aren’t typically a cause for concern.