What We Know Now

So, what exactly are the latest clinical guidelines? Thanks to Dr. Lack’s research – which found that when babies regularly eat peanut-containing foods starting early in the first year of life through toddlerhood, it can reduce their risk of developing peanut allergies by 86%. Based on Dr. Lack’s research, the AAP recommends that most babies start peanut foods around 6 months, and that high-risk babies start even earlier (between 4-6 months). The USDA also recommends introducing all common food allergens and keeping them in the diet regularly, once a baby starts solid food. 

While we have the best prevention data for early peanut and egg introduction specifically, according to Malina, most allergy experts agree that we have good reason to believe that as more research emerges, the food allergy prevention principles we follow with regard to peanut and egg will hold true for the rest of the most common allergens as well – so it’s wise to include them all early and often, in baby-safe forms.

If you want to read more in-depth about the guidelines, check them out here.

Who is High-Risk for Food Allergies?

Current guidelines are broken down into risk buckets, and those risk buckets are based on eczema, which can also be confusing for parents. So why is eczema such a big risk factor for developing food allergies? Dr. Gideon Lack’s dual-allergen exposure hypothesis proposes that the skin acts like a barrier against food allergens in the environment. When that barrier is compromised through eczema, those allergens enter the system through broken skin because food proteins are everywhere in our environment. That makes it much more likely that an allergy will develop than if the initial exposure is by eating the food. 

That being said, because there are so many other potential drivers behind food allergy development, it’s best for ALL babies to have exposure to top allergenic foods during infancy. Case in point: Catherine’s daughter didn't have any risk factors or eczema, and would not have been considered high risk – underscoring the seemingly random way food allergies can present in some young children and not others.

The Magic Window for Prevention

Did you know that the most protective window for introduction is between four and six months of age? With every month of delay beyond six months, it may reduce the protective effects by 30%.

And according to a meta-analysis Dr. Lack conducted, while babies with eczema do have a higher likelihood of developing food allergies due to compromised skin barriers, targeting only high-risk children would reduce the population burden of food allergies by just 4.5%, compared to a whopping 77% reduction when including all babies. Consider also this statistic: Dr. Lack believes that with widespread early peanut introduction, we could prevent more than 100,000 cases of peanut allergies every year. Over a 10 year period, that would save more than 1 MILLION children from the burden of peanut allergies.  

Many parents might be thinking: “Four to six months! That sounds impossible, easier said than done.” Trust us – you can do it. Keep reading for practical tips.

Practical Tips for Introducing Allergens

Did you know the top allergenic foods – including peanuts, tree nuts, eggs, soy, wheat, cow's milk, fish, shellfish and sesame – are also some of the most nutrient-dense and minimally processed foods, making them ideal for growing bodies?  

Just remember: some of these foods will require modification before giving to babies (i.e. whole nuts or globs of nut butters are a choking hazard – which is why we turned peanuts and tree nuts into puffs at Mission MightyMe!). 

Here are some of Malina’s top tips as parents navigate that sometimes intimidating allergen introduction:

• If you’re concerned that your baby might have eczema or be considered high-risk, start those conversations with your pediatrician ASAP (solid food introduction sneaks up on you!). Screening and early detection can be key.

• Feed a little tiny bit of the food on the tip of a spoon and wait for 10 minutes, as reactions usually happen within a few minutes to about two hours of eating. 

• After 10 minutes, if the baby has tolerated the food, you can feed the rest of the portion at the baby's regular feeding pace.

• Rest easy knowing that the most common reactions during infancy are vomiting and hives, which are usually mild.  

• If you see any signs of a reaction, stop feeding the food and call the pediatrician. 

• Severe reactions are really uncommon, and there have been no recorded deaths on first introduction during infancy.

And don’t underestimate the importance of diet diversity! Gone are the days of food phobia culture with little ones (thankfully, we’ve embraced more interesting and adventurous foods for babies and moved past the boring rice cereal!). A diverse range of foods during infancy can be incredibly beneficial. Research is ongoing, but the idea is that the more you can introduce different foods, flavors and textures to babies during infancy and help them develop a taste for them, the more likely they’ll be able to enjoy and accept those foods down the road. 

As Malina put it, “the most important thing is to feed the foods.” Can somebody put that on a t-shirt?! See ya never, picky eating.

Consistency, Consistency, Consistency

Consistency is SO important – so remember to maintain regular exposure to allergens rather than just introducing them once. As Malina explained, the infant immune system doesn't seem to like it when we introduce an allergen and then stop – it’s not a good idea to halt introduction if a baby is tolerating it, because that helps maintain tolerance over time. That’s why repeat exposure over time is key. (The LEAP Study babies regularly consumed peanut foods till age 5 to achieve the dramatic prevention results). 

For high-risk babies (with severe eczema and/or egg allergy), the American Academy of Pediatrics (AAP) recommends 6 grams peanut protein per week. DYK: one pouch of MightyMe Peanut Butter Puffs per week meets the AAP recommended amount, and two pouches of MightyMe Nut Butter Puffs per week = 10 grams nut protein (2 grams per nut!

Similarly, Malina’s recipes have been calculated to include sufficient allergenic protein amounts per serving, giving parents peace of mind. That being said, it's rare that a baby finishes a portion of food you put in front of them – so what might be more impactful than hitting exact targets is continuously and consistently offering those foods regularly in the rotation. Her best advice? Once those foods are introduced and tolerated, serve regularly in preparations your baby likes and keep ‘em coming! 

When you’re first starting out with solid foods and allergen introduction with your baby, you can also keep an informal tracker in your phone notes app or regularly update a notebook in your kitchen. Be sure to check out our Early Allergen Introduction Guide and download-ready checklist as a helpful resource!

Bye, Bye Guilt 

Parents might feel guilt about following older guidelines, especially if their child developed a food allergy – but outcomes are never guaranteed and parents can only make decisions based on the information available to them at the time. We do the best we can with the information we have when we have it, and remember: about 97% percent of children will not develop a food allergy. 

There’s a quote we love from Maya Angelou: “Do the best you can until you know better. Then when you know better, do better.” We like to think that applies to everything in parenting. We’re all just trying to do the best we can.

P.S. If you’re craving even more Malina x Mission MightyMe content, check out our previous blog post covering everything you need to know about early allergen introduction, including in-depth info on the “Big 9” allergens, early feeding how-tos, sample meal plans, and more. Be sure to follow her on Instagram @healthy.mom.healthy.kids! 

Please note: This blog post is for information purposes only and shouldn’t be used as personal, health, nutritional, or medical advice. Always consult your pediatrician with any questions about what to feed your child.

*FDA HEALTH CLAIM: For babies with an increased risk of peanut allergy (babies with severe eczema, egg allergy or both), introducing age-appropriate, peanut-containing foods as early as 4 months may reduce the risk of developing a peanut allergy. Caregivers should check with the baby’s healthcare provider before feeding the baby peanut-containing foods

Mission MightyMe products must be avoided by anyone who has a known or suspected allergy to any of the ingredients. If you have any questions about what you’re feeding your baby, consult your pediatrician