How to Introduce Allergens to Baby: The Do’s and Don'ts

Did you know? In the past couple of decades, food allergies have more than doubled and nut allergies have tripled!  We don’t know all the reasons for this increase, but many experts believe old and incorrect medical recommendations that children should avoid common allergens like peanut and tree nut-based foods in infancy, may have unintentionally caused food allergy rates to soar. 

But here's the empowering news: groundbreaking research (the LEAP Study) found that regularly consuming peanut foods for the first 5 years of life, starting as early as 4-6 months, can reduce the risk of peanut allergy by up to 86%. The follow-up LEAP-Trio Study found that  this early intervention provides lasting protection through the teen years! Incredible, right?! Our co-founder, Dr. Gideon Lack, led the LEAP Studies and his discovery changed feeding guidelines around the globe to recommend starting allergenic foods, especially peanuts, once a baby starts solid foods. But babies don’t have teeth of course! So how exactly do you safely introduce nuts and other common allergens to a baby? 

Is your Baby Ready to Start Solids? 

The first question to answer is whether your baby is ready for solids. This will depend on your child’s individual development, but most babies are ready for solid foods between 4-6 months. Some signs your baby may be ready to start solids include: 

• Being able to control the head and neck.
• Sitting up with or without support.
• Showing an interest in food and reaching for it. 
• Bringing objects to the mouth. 
• Losing the tongue thrust reflex that pushes food out of the mouth. 

Is Your Baby Ready for Early Allergen Introduction? 

If your baby has successfully started solid foods, the next question to answer is whether your baby is ready for early allergen introduction. The American Academy of Pediatrics says the majority of babies can start baby-friendly peanut foods and other common food allergens around 6 months, though if your baby is high-risk (severe eczema and/or egg allergy), the AAP recommends starting as early as 4 months, but only after evaluation by a doctor and possible allergy testing first. Start conversations with your baby’s healthcare provider early (around the 2-3 month check-up) so you have a plan and the green light to get started as soon as your baby is ready for solids.

Assessing the Risk of Developing Food Allergy

Assessing the risk of developing a food allergy is crucial in determining the best approach for introducing allergenic  foods. 

Severe eczema is the single biggest risk factor for developing a food allergy. Find out why by reading our blog about the fascinating link between eczema and food allergies. An existing food allergy also increases a baby’s risk. Family history of food allergies also increases the risk slightly, but not significantly. 

To create a personalized strategy, consult your pediatrician before introducing allergens, especially if your baby is at higher risk. For high risk babies, your healthcare provider may recommend allergy testing or even introduction in a clinical setting. 

For most babies, however, the recommendation is to introduce allergenic foods at home. And a 2020 consensus statement from the leading allergy organizations in the US and Canada recommended against allergy testing because of the potential for delays, which can cause babies to miss the magic window for prevention. So there is some debate about the best approach and it’s always best to follow your own doctor’s advice. 

What is a Food Allergy?

It’s also important to do a little homework to understand what a food allergy is and what signs to look for to identify a food allergy. Food allergies occur when the body's immune system mistakenly identifies a specific food protein as harmful, triggering an allergic reaction. This reaction can range from mild symptoms like hives, vomiting and itching to severe, life-threatening conditions like anaphylaxis. Common food allergens include peanuts, tree nuts, milk, eggs, fish, shellfish, wheat, and soy and sesame.

It's important to note that food allergies differ from food intolerances, which are generally less severe and usually involve the digestive system, rather than immune system.  

Know the Signs of an Allergic Reaction and How to Respond

Allergic reactions are a common concern, however they are rare and the first year of life is the safest time to introduce potential allergens. Still, it’s important to know the signs of an allergic reaction, and what to do if one occurs. If your child does have an allergic reaction to any food, stop feeding the food and consult a physician.

Mild to Moderate Signs: 

• Itching, sneezing, hives, rashes, nausea or vomiting, diarrhea or stomach pain. 
• Note that if two or more body systems are affected, however (e.g., vomiting/stomach and hives/skin), it is considered severe. 

Severe Symptoms: 

• Severe symptoms may include trouble swallowing or breathing, loss of consciousness and a weak pulse among others. 
• Severe symptoms can be a sign of life-threatening anaphylaxis and require immediate treatment with epinephrine. 
• In the case of severe symptoms, go to the nearest Emergency Room. 

If you suspect your child has a food allergy, it’s important to avoid that food and seek evaluation by an allergist quickly. Unnecessarily avoiding certain foods may increase the risk of a food allergy developing, so don’t delay seeing an allergist if you suspect a food allergy. (Note that redness around the mouth is often caused by skin irritation, but is frequently mistaken for a food allergy). 

Do’s For Introducing Allergens

Ok, now that you’ve done your homework, if your baby has started solids and is cleared for allergen introduction, here are some tips on how to do it safely:

• Start with other solids first - Introduce commonly allergenic foods after your little one has successfully eaten other solid foods like cereals, veggies, or meat purees.
• Start early in the day - Start well before nap time, when you can monitor your baby for a few hours after feeding.
• Start small - Start with a small amount of the allergen and monitor your baby. Give a small amount on the tip of a spoon. Wait 10 minutes, then feed the full infant portion at the baby’s pace. Most reactions occur within 2 minutes to 2 hours.
• Keep it diverse - Diet diversity is vital for proper nutrition and development. Feed various foods from all food groups, including common food allergens and iron-rich foods like fortified cereal, green veggies, and meats.
• Continue breast milk or formula - Breast milk or formula remains an important source of nutrition after starting solids and throughout the first year of life.

Don’ts of Introducing Allergens

• Don't begin when baby is sick or fussy - You don't want to mistake illness for a food allergy reaction. 
• Don't introduce multiple allergens at one time - This way if there is any sign of reaction you will know which food caused it. 
• Don't use whole nuts or nut butters - These are a choking risk to babies and toddlers, as are many commonly allergenic foods in their natural form. Prepare soft foods that are easily dissolved with saliva. 
• Don't start and then stop - Once allergens are introduced, it's important to keep them in the diet regularly in sufficient amounts. The AAP recommends 6g of peanut protein per week for high-risk infants (that's the equivalent of 1 pouch of Mission MightyMe Organic Peanut Butter Puffs).
• Don't put food in a bottle - The AAP and CDC do not recommend putting rice cereal or any other food in a bottle.

How Do I Introduce Peanut Butter Safely to Baby? 

Nuts and globs of nut butters are a choking hazard for babies, so it’s important to introduce peanuts and tree nuts in a baby-safe food form and start with a small amount. 

Safe ways to include nuts in a baby’s diets include: 

• Dilute nut butters with water, breast milk or formula 
• Mix peanut powder into a favorite puree 
• Nut butter puffs like Mission MightyMe Nutty Puffs 

Once peanuts and tree nuts are successfully introduced, aim to keep them in the diet regularly. Mission MightyMe Nutty Puffs make it easy and enjoyable to regularly include a variety of nuts in your little one’s diet with less stress and less mess. They were formulated to match the research with the doctor behind the groundbreaking prevention studies that changed feeding guidelines globally. 

Here are some of the reasons Nutty Puffs make a great choice for busy parents who want to avoid the hassle of preparing special foods: 

• Developed with the doctor who led the research 
• Nut protein levels that match the research 
• More than 50% nuts
• Clean, simple ingredients
• Every product has won the Clean Label Project Purity Award  
• No cane sugar 
• Organic & non-GMO ingredients
• Versatile serving options for different ages and stages (soften with water, crumble into purees or enjoy on-the-go for bigger kids).
• They’re a delicious snack for the whole family! 

We hope this information empowers you to feed confidently and give your little one the healthiest start in life. You’ve got this! 

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.