Current guidelines from the National Institutes of Health state that it is best to introduce allergenic foods early on, at the same time as other foods. This can actually decrease the risk of becoming allergic.
Common Allergenic Foods:
- Peanuts
- Other nuts
- Eggs
- Dairy
- Fish
- Shellfish
- Wheat
- Soy
- Sesame
Guidelines for Introducing Allergenic Foods
- Talk to your pediatrician first, especially if your baby has moderate or severe eczema, has a known food allergy, or has a sibling with a food allergy.
- Feed non-allergenic foods first, to make sure baby is developmentally ready to eat solid foods.
- Once your baby is ready for solid foods, usually around 4 to 6 months, introduce allergenic foods at the same time as other first foods.
- Introduce single-ingredient foods one at a time, every 3 to 5 days, so you can identify any allergic reactions to specific foods.
- Do not feed a food if you already know your baby is allergic to it.
Symptoms of Allergic Reaction:
Mild:
- A new rash
- A few hives around mouth or face
Severe:
- Lip swelling
- Vomiting
- Widespread hives over body
- Face or tongue swelling
- Difficulty breathing
- Wheeze
- Repetitive coughing
- Change in skin color
- Sudden tiredness/lethargy/seeming limp
When to Introduce Peanuts
If baby has severe eczema, an egg allergy, or both:
- They have an increased risk for peanut allergy. They should have peanuts at 4 to 6 months to reduce their risk of later allergy. Speak with your healthcare provider first. They may recommend an allergy test or that you introduce peanuts under medical supervision.
If baby has mild or moderate eczema:
- They have a somewhat increased risk for peanut allergy. It is recommended to introduce peanuts around 6 months to reduce later risk, but you can base this decision on your family’s dietary routines and preferences.
If baby has no eczema or food allergy:
- Likely not at increased risk, so you may introduce peanuts based on family’s preferences, at the same time as other foods.
How to Introduce Peanuts
So you’re ready to introduce peanut— but how do you do it? Whole nuts or thick nut butters are a choking risk, so follow these steps for a safe introduction. Discuss any questions with your doctor.
- Feed when infant is healthy
- Feed at home, and when an adult will be able to monitor the infant for at least two hours after feeding
- Prepare one of the recipes below
- Offer a small portion on the tip of a spoon
- Wait 10 minutes
- If there is no allergic reaction after this small taste, continue feeding the remainder of the food, at the infants own pace.
For more information about introducing peanuts and other allergenic foods, speak with your pediatrician. You may also refer to these resources:
- National Institutes of Health: https://www.niaid.nih.gov/diseases-conditions/guidelines-clinicians-and-patients-food-allergy
- American Academy of Allergy Asthma & Immunology: http://www.aaaai.org/aaaai/media/medialibrary/pdf%20documents/libraries/preventing-allergies-15.pdf
Babies First Peanut Recipes
- Stir together 2 teaspoons of smooth peanut butter with 2-3 teaspoons of hot water, until well-blended. Let cool. If consistency is not right, add more water or else already tolerated baby cereal
- Smoothly blend 2 teaspoons of smooth peanut butter with 2-3 tablespoons of tolerated fruit or vegetable puree
- Mix 2 teaspoons of peanut flour/peanut butter powder with 2-3 tablespoons of tolerated fruit or vegetable puree
If you have any concerns, please seek immediate medical attention or call 911.
(Source: NIH Prevention of Peanut Allergy Guidelines)
Diet During Pregnancy and Breastfeeding
Unless you or your infant have an allergy, there is no need to avoid highly allergenic foods while pregnant or breastfeeding.
