Your baby is ready to start solid foods – what an exciting time! As a parent, you get to help your child learn what kind of foods they like! You get to see their reaction as they taste new fruits, vegetables, cereals, textures, and flavors. You get to discover with them if they like more sweet, salty, or sour flavors of foods. As you continue to introduce new solid foods to your baby, it is important to know a bit about food allergies. 

According to the Centers for Disease Control and Prevention (CDC), the 8 most common allergenic foods are:

• Milk
• Eggs
• Fish
• Wheat
• Soybeans
• Shellfish
• Tree nuts
• Peanuts
• Sesame (emerging)

Introducing foods with an allergy risk is sometimes nerve-wracking but also very important. Research shows that introducing allergenic foods at a younger age, before 1 year of life, helps to reduce the risk of having a food allergy later on. While you may feel nervous, we encourage you to work with your child’s pediatrician to develop a plan for introducing allergenic foods sooner than later. In general, if you do not have a significant family history of food allergies then your baby is likely not at a greater risk for having an allergy, however we always suggest families consult with their pediatrician if they are feeling worried about introducing allergenic foods.

Some tips to support you through this process:

• Offer small to start
  • It does not take a large amount to be considered an ‘exposure’ to an allergenic food. You could start with ⅛ teaspoon and slowly increase over time
• Offer and observe
  • Current recommendations include introducing allergenic foods as soon as your baby is ready for solids. 
  • Recommendations also indicate that we do not need to wait 3-5 days in between new foods. Most allergic reactions happen within 2 hours of ingesting a food. 
  • Offer a new allergenic food and watch your baby for any signs of an allergic reaction. If there is not reaction, they are likely safe to eat that food! 
  • Keep in mind that not all babies with allergies will react during their first exposure. Try keeping the serving sizes small in the beginning until you are confident there is no allergic reaction. 
• Offer where you are comfortable
  • You can introduce new foods in the comfort of your home. If you are concerned about a potential reaction, try to offer allergenic foods on days where you do not have work or other plans. You might also offer earlier in the day. This allows you time to observe your child during the day ahead and makes it easier to contact your doctor if needed. 
  • If you are especially concerned, work with your doctor to schedule an appointment to offer an allergenic food at their office with support!
• Offer regular exposure
  • Once an allergen is safely introduced into your child’s diet, keep that food in the regular rotation. 
  • Ideally, offer an allergenic food to your baby on a weekly basis at minimum. 
• Offer developmentally appropriate opportunities
  • Keep in mind your child’s age and stage of development. For example, your child may not be ready to eat a whole peanut, but we can offer peanut butter puffs, peanut butter melted into oatmeal, or peanut butter spread thin on a teething cracker. 
  • Another example, while whole cow’s milk is not recommended before 1 year of age, you may introduce processed dairy products such as whole milk yogurt or greek yogurt mixed with fruit that your baby has already had in their diet
  • Think about how we can modify allergenic foods to offer them in a way that will help your baby be successful

After each new food, watch and observe for any allergic reactions. Call your pediatrician if you observe symptoms such as:

• Rash
• Hives
• Swelling
• Changes in breathing
• Changes in color (pale)
• Vomiting
• Diarrhea

As a parent, you are helping your little one explore and learn about a variety of foods, including allergenic ones. Building in opportunities for them to taste and try allergenic foods on a regular basis is a great way to provide consistent exposure to these foods while following a responsive approach to mealtimes!

Written by: Nicole Bing, OTD-S

Resources

https://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Food-Allergy-Reactions.aspx

https://solidstarts.com/starting-solids/allergies/

Samady, W., Campbell, E., Aktas, O. N., Jiang, J., Bozen, A., Fierstein, J. L., Joyce, A. H., & Gupta, R. S. (2020). Recommendations on complementary food introduction among pediatric practitioners. JAMA Network Open, 3(8). https://doi.org/10.1001/jamanetworkopen.2020.13070