The Best Methods for Preventing Food Allergies in Babies
Food allergies now affect about 1 in 13 children in the U.S., a statistic that has steadily risen over the past few decades. From 1997 to 2011, food allergies in children increased by 50%, and from 2007 to 2021, the rate grew by another 50%. This growing trend emphasizes the importance of using the best methods for preventing food allergies in babies, as early intervention can significantly impact your child’s health and well-being.
We encourage a proactive approach to reducing the risk of food allergies by integrating early allergen introduction into your baby’s nutrition plan. The science is clear: introducing common allergens early in life, specifically between 4 and 6 months, can help train the immune system to recognize certain foods as non-threatening, potentially preventing the development of allergies. This early introduction strategy aligns with the growing body of research supporting its role in promoting immune tolerance and improving overall health outcomes.
Through this intentional introduction of allergenic foods, you not only help protect your baby from developing allergies but also nourish their immune system, support gut health, and encourage optimal growth and development. By focusing on whole foods and mindful nutrition, we can work together to give your child the healthiest possible start.
Information provided is for informational purposes only and not a substitute for professional medical advice. Readers should consult with a qualified healthcare provider for any health concerns.
The Benefits of Breastfeeding
Breastfeeding is one of the most powerful ways to support your child’s immune system, and overall development. Both the World Health Organization (WHO) and the U.S. Dietary Guidelines for Americans recommend exclusively breastfeeding for the first six months of life, which means no other foods or liquids (including water) during this period.
Breast milk is rich in active immune factors and plays a crucial role in nurturing a healthy gut microbiome, both of which can help lower the risk of developing allergic diseases and help prevent food allergies in babies. This natural, dynamic nourishment offers your baby the protection they need during the early months of life. Importantly, unless your baby shows specific reactions to certain foods, there’s no need to avoid common allergens during pregnancy or breastfeeding. The key is to trust the body’s natural ability to provide and protect your baby’s developing immune system. This approach promotes long-term health while ensuring a nurturing and supportive start to life.
Early Introduction of Food Allergens: Why It Matters
Complementary foods are foods other than breastmilk or formula that are introduced to an infant’s diet when they are developmentally ready, which is typically six months of age. Introducing common allergenic foods between 4 and 6 months of age can help prevent food allergies in babies from developing, especially for infants at high risk. While this may seem to contradict the recommendation for exclusive breastfeeding, early introduction is typically recommended only for high-risk infants. Infants at the highest risk for food allergies include those with severe eczema or a family history of allergic conditions such as asthma, eczema, or hay fever. If your infant is at high risk, introducing allergenic foods between 4 and 6 months is generally recommended, but it’s always a good idea to consult a healthcare provider or dietitian first. Research suggests that introducing allergenic foods at the right time can help the immune system recognize these foods as harmless, while delaying their introduction may increase the likelihood of developing allergies. A study showed that introducing peanut-containing foods between 4-6 months can reduce the chance of developing a peanut allergy by over 80% compared to delaying introduction until after twelve months of age.
When to Start Introducing Allergenic Foods
Before introducing allergenic foods to your baby, ensure they are ready for solids. Signs of readiness include sitting up with or without support, controlling their head and neck, showing interest in table foods, and being able to grasp and rake objects, like a spear of banana. The American Academy of Pediatrics recommends waiting to intorduce solid foods until about six months of age. Too-early introduction to solid foods is not considered a good method to prevent food allergies in babies. It doesn’t benefit baby to rush. Start by introducing 2-3 other solid foods before introducing allergens, ideally around 6 months but not before 4 months. When introducing allergens for the first time, do so at home when the baby is alert and awake for a couple of hours to monitor for any allergic reactions. The chance of a severe reaction is low, but always observe closely. Avoid delaying allergenic foods, as it may increase the risk of developing food allergies. If your baby is at high risk, you can consult an allergist for skin or allergen-specific IgE testing, though it’s not required.
Common Allergenic Foods to Introduce
Introducing allergenic foods early has the strongest evidence for peanuts and eggs (cooked, not raw). Other common allergens include cow’s milk, tree nuts, fish, shellfish, soy, wheat, and sesame. Research supports introducing peanuts and eggs as early as 4 – 6 months, but don’t delay the introduction of other allergens once your baby starts eating solid foods. This strategy helps to prevent development of food allergies in babies.
How to Safely Introduce Allergenic Foods
At Whole Lifecycle Nutrition, we encourage a mindful, nourishing approach to introducing solid foods to your baby. Begin with simple, single-ingredient foods such as mashed or pureed vegetables and fruits to help your baby adjust to solid foods gently. If you’re following a baby-led weaning approach, consider offering soft, spear-shaped vegetables or fruits that are easy for little hands to grasp. For added convenience, you can introduce fortified infant cereals that are free of added sugars and salts. Avoid rice cereal and other rice-based infant foods due to the possibility of higher arsenic levels, which can negatively impact your baby’s development. The smooth consistency of early foods helps prevent choking, so feel free to mash or puree soft foods like sweet potato, avocado, carrot, or apple.
Once your baby has comfortably adjusted to 2-3 solid foods, you can begin introducing allergenic foods in a safe, age-appropriate manner. Here’s how to do that:
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Peanuts (or tree nuts and sesame): Begin with natural, smooth peanut butter (about ¼ teaspoon) thinned with breast milk, formula, or warm water. Alternatively, try peanut flour or peanut powder mixed into a puree. Baby peanut puffs, like Bamba, are also an option but should be softened with breast milk, formula, or water for infants under 7 months. Keep in mind, though, that these puffs are not ideal as a long-term snack.
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Eggs: Start with about ⅓ of a medium egg, fully cooked. You can mash hard-boiled eggs with a tolerated food or offer scrambled eggs. Omelet strips are another option to consider.
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Fish and Shellfish: Steam, puree, or mash the fish and serve it on its own or mix with other foods. Be sure to remove all bones and skin, and limit fatty fish to 2 portions per week.
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Soy: Puree soft or silken tofu, or offer fortified soy yogurt or soy milk.
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Wheat: Prepare infant wheat cereal as directed on the package or offer softly cooked wheat pasta.
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Milk: After 6 months, you can offer full-fat, plain yogurt or thin strips of mozzarella or cottage cheese. However, cow’s milk should not be introduced before 12 months of age.
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Sesame: Hummus or tahini can be mixed with puree, breast milk, formula, or warm water to introduce sesame safely.
When introducing any new allergenic food, it’s important to offer one food at a time and wait 3-5 days between introducing new foods to monitor for any signs of allergic reactions. Start with peanut-containing foods, as they are among the most studied for allergy prevention. Always ensure that hot food has cooled down before serving, and never place allergenic foods on your baby’s skin, as this may cause irritation that could be misinterpreted as an allergic reaction.
If your baby tolerates the food, continue offering it regularly, ideally 2-3 times a week, with a goal of introducing it at least once a week until age 5. This consistent exposure can help maintain tolerance and prevent future allergies. If a specific allergen doesn’t fit your family’s lifestyle, that’s okay. Simply discuss it with your healthcare provider or dietitian to find the best plan for preventing food allergies in your baby.
As always, trust your intuition and approach your baby’s nutrition with patience and care, honoring their unique needs as they grow and develop.
Using Tools to Support Your Baby’s Food Introduction
Shout out to my favorite tech recommendation for families starting solids! 🙌 Solid Starts is an invaluable app created by a team of pediatric professionals, offering step-by-step guidance on introducing over 100 solid foods to your infant. Whether you’re navigating baby-led weaning or traditional spoon-feeding, this app is a game-changer for helping you feel confident in your baby’s solid food journey. If you’re looking for expert advice at your fingertips, this is the app you need! 🍴💡
It includes support for baby-led weaning, as well as transitioning from spoon-feeding or purees to finger foods. Baby-led weaning allows your baby to feed themselves with finger foods, encouraging independence in eating. Whether you prefer baby-led weaning, spoon-feeding, or a mix of both, there’s no increased risk of choking with either method, as long as the food is prepared safely and age-appropriately.
The key is to introduce a wide variety of nutrient-dense foods to ensure your baby receives balanced nutrition. When introducing allergenic foods for the first time, avoid letting your baby self-feed, as food smeared on their skin can be misinterpreted as an allergic reaction. For finger foods, cut food into manageable pieces, usually in spear shapes that your baby can easily grasp. Once your baby’s pincer grasp develops (when they can hold small objects with their thumb and pointer finger), you can start offering smaller bite-sized pieces.
Examples of great finger foods include soft-cooked vegetables (like carrots and broccoli), slices of soft fruits (like peaches and bananas), strips of avocado, and small omelet strips. Solid Starts helps guide you through this journey, ensuring your baby is safely and happily exploring new foods.
Recognizing and Responding to Allergic Reactions in Infants
Allergic reactions occur when the immune system mistakenly identifies a food as harmful, prompting the body to produce immunoglobulin E (IgE) antibodies to protect itself. These reactions can happen quickly, typically within minutes of eating a food, but can also take up to 2 hours to develop. In infants, recognizing a food allergy can be more challenging since they can’t explain what is happening. This is why it’s so important to stay vigilant when introducing potential allergens for the first time (and any other food, for that matter). Make sure to discuss this topic with your pediatrician or other qualified healthcare provider. Information provided here is for informational purposes only and does not take the place of professional medical advice.
Signs and Symptoms of a Mild to Moderate Allergic Reaction (which can also indicate anaphylaxis):
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A few isolated hives
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Mild itching
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Vomiting
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Swelling of the lips, face, or eyes
Signs and Symptoms of Anaphylaxis in Babies:
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Full-body hives or rash
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Swelling of the tongue or throat
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Wheezing or persistent cough
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Difficult or noisy breathing
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Hoarse voice or difficulty vocalizing
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Pale or floppy appearance
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Sudden behavioral changes, such as irritability, inconsolable crying, or clinging to a caregiver
If anaphylaxis is suspected, administer a junior dose of an epinephrine auto-injector immediately (if available) and call 911 right away. While waiting for help:
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Position your baby lying flat in your arms, unless they are struggling to breathe, in which case let them sit.
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Avoid allowing them to stand, walk, or remain upright.
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If they are unconscious or vomiting, place them on their side to prevent choking.
Food Protein-Induced Enterocolitis Syndrome (FPIES) is a rarer type of food sensitivity that involves severe vomiting and diarrhea several hours after eating the trigger food. Common triggers for FPIES include cow’s milk, soy, rice, and oats. Unlike typical food allergies, FPIES does not involve the IgE antibody response. The symptoms can often mimic a stomach virus but are consistently triggered by specific foods. Treatment often involves anti-nausea medications prescribed by a healthcare provider, and in more serious cases, your baby may need IV fluids to recover.
As always, if you are concerned about food allergies or have questions, it’s important to connect with your pediatrician or a healthcare provider who can guide you on safe, gentle practices to support your child’s health and well-being. Make sure to check out our other blog post to learn more about managing food allergies and in children.
Key Takeaways
As food allergies continue to rise, one of the most impactful steps you can take to support your baby’s health and to prevent the development of food allergies in babies is the early introduction of the 9 common food allergens, ideally around 6 months of age. Research highlights that introducing peanuts and eggs early offers the strongest protection against developing allergies. For babies at higher risk, it may be beneficial to begin allergen introduction between 4 and 6 months, with the guidance of your healthcare provider. Once these foods are introduced, aim to offer them regularly, two to three times a week, with the goal of at least once a week until your child turns 5. Remember to always monitor your baby closely when trying new foods.
If you’re unsure about how to navigate this process, our dietitians are here to help you create a personalized plan for introducing allergens in a safe and thoughtful way. We would love to hear from you. Book a call here to chat with one of our integrative and functional pediatric dietitians about the best methods for preventing food allergies in babies.
A special thank you to Emily Woo, our incredible dietetic intern from Simmon’s University, for her thoughtful research and support in shaping this blog post.
Want to chat more about preventing food allergies? Book a call here.
Medical Disclaimer:
The information provided on this blog is for educational and informational purposes only and is not intended as a substitute for medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider, such as your physician, pediatrician, or a registered dietitian, before making any changes to your or your child’s diet, health routine, or treatment plan.
While we are a medical practice specializing in integrative and functional nutrition, the content shared here reflects general knowledge and holistic guidance, and may not be appropriate for every individual. Reliance on any information provided on this site is solely at your own risk.
References:
- Facts and Statistics. FoodAllergy.org. Accessed November 7, 2024. https://www.foodallergy.org/resources/facts-and-statistics.
- Koukou Z, Papadopoulou E, Panteris E, et al. The Effect of Breastfeeding on Food Allergies in Newborns and Infants. Children. 2023;10(6):1046. doi:10.3390/children10061046.
- Minimizing Risk of Food Allergy in Infants. eatrightpro.org. Published November 9, 2023. Accessed November 7, 2024. https://www.eatrightpro.org/news-center/practice-trends/minimizing-risk-of-food-allergy-in-infants.
- Trogen B, Jacobs S, Nowak-Wegrzyn A. Early Introduction of Allergenic Foods and the Prevention of Food Allergy. Nutrients. 2022;14(13):2565. doi:10.3390/nu14132565.
- Fleischer DM, Chan ES, Venter C, et al. A Consensus Approach to the Primary Prevention of Food Allergy Through Nutrition: Guidance from the American Academy of Allergy, Asthma, and Immunology; American College of Allergy, Asthma, and Immunology; and the Canadian Society for Allergy and Clinical Immunology. The Journal of Allergy and Clinical Immunology: In Practice. 2021;9(1):22-43.e4. doi:10.1016/j.jaip.2020.11.002.
- Food Allergy Canada, Canadian Society of Allergy and Clinical Immunology. Eat Early. Eat Often. Accessed November 7, 2024. https://foodallergycanada.ca/wp-content/uploads/Eat-Early-Eat-Often.pdf.
- Preventing a Food Allergy. FoodAllergyPrevention.org. Accessed November 8, 2024. https://foodallergyprevention.org/for-parents/preventing-a-food-allergy/.
- Your baby’s first solid foods. nhs.uk. Updated October, 2022. Accessed November 8, 2024. https://www.nhs.uk/conditions/baby/weaning-and-feeding/babys-first-solid-foods/.
- Fortified Cow’s Milk and Milk Alternatives. cdc.gov. Updated May 25, 2022. Accessed November 8, 2024. https://www.cdc.gov/nutrition/infantandtoddlernutrition/foods-and-drinks/cows-milk-and-milk-alternatives.html.
- Abrams EM, Ben-Shoshan M, Protudjer JLP, Lavine E, Chan ES. Early introduction is not enough: CSACI statement on the importance of ongoing regular ingestion as a means of food allergy prevention. Allergy Asthma Clin Immunol. 2023;19(1):63. doi:10.1186/s13223-023-00814-2.
- National Allergy Council. How to recognise an allergic reaction. PreventAllergies.org.au. Accessed November 8, 2024. https://preventallergies.org.au/allergic-reactions/how-to-recognise-an-allergic-reaction/.
- National Allergy Council. What to do if you think your baby is having an allergic reaction. PreventAllergies.org.au. Accessed November 8, 2024. https://preventallergies.org.au/allergic-reactions/what-to-do-if-you-think-your-baby-is-having-an-allergic-reaction/.
- Food Protein-Induced Enterocolitis (FPIES). ACAAI Public Website. ACAAI Patient. Updated March 21, 2019. Accessed November 6, 2024. https://acaai.org/allergies/allergic-conditions/food/food-protein-induced-enterocolitis-syndrome-fpies/.
