How to safely introduce the top 9 allergens to your baby

Starting Solids

The Top 9 Allergens for Babies: A Comprehensive Guide to Early Introduction

Food allergies are a growing concern for parents, especially when starting solids with their baby. According to the Australasian Society of Clinical Immunology and Allergy (ASCIA), 10% of infants in Australia experience food allergies. One of the most effective ways to minimise this risk is to introduce allergenic foods early and consistently. In this guide, we’ll explore the top 9 allergens, the benefits of early introduction, and practical tips for safely incorporating these allergenic foods into your baby’s diet.

What Are the Top 9 Allergens for Babies?

The top 9 allergens are responsible for 90% of food allergies in Australia. They include:

Peanuts
Eggs
Cow’s milk
Tree nuts (e.g., almonds, cashews, walnuts)
Shellfish (e.g., prawns, crab, lobster)
Fish (e.g., salmon, tuna, cod)
Soy
Wheat
Sesame seeds

These foods are not only potential allergens but also highly nutritious. If your baby tolerates them, including these foods regularly in their diet can provide significant nutritional benefits.

Note: If you have a family history of food allergies, consult your GP or paediatrician before introducing these allergenic foods to your baby.

The following introductions are from ASCIA and apply to full-term healthy babies in an Australian population:

Peanuts

When: From 6 months (or when your baby starts solids) and before 12 months.
How: Take a small amount of smooth peanut butter or ground peanuts and rub it along the inside of your baby’s lip. If no reaction occurs after a few minutes, offer 1/4 tsp of peanut butter on a spoon or mixed into food your baby has already been exposed to (e.g., sweet potato). Increase the amount by 1/4 tsp each time. Thin peanut butter with water or neutral oil to avoid choking hazards.

Eggs

When: From 6 months (or when your baby starts solids) and before 12 months. Offer both egg whites and yolks.
How: Boil an egg and blend it. Dab a tiny amount on the inside of your baby’s lower lip. If no reaction after a few minutes, offer 1/4 tsp and increase gradually. Alternatively, prepare an omelette, cut it into strips, and offer as a finger food.

Tree Nuts

When: From 6 months (or when your baby starts solids) and before 12 months.
How: Use smooth nut butter or ground nuts (e.g., almonds, cashews). Rub a small amount on your baby’s lip. If no reaction after a few minutes, offer 1/4 tsp mixed into a familiar food. Thin nut butters with water or neutral oil to avoid choking hazards.

Cow’s Milk

When: From 6 months (or when your baby starts solids) and before 12 months.
How: Add a small amount (1/4 tsp) of cow’s milk to puréed foods your baby has already tried. Use cow’s milk only in cooking (e.g., porridge). Do not give cow’s milk as a drink, as babies’ kidneys cannot handle its mineral composition.

Soy

When: From 6 months (or when your baby starts solids) and before 12 months.
How: Offer finger-sized strips of tofu, tempeh, or puréed edamame beans. Avoid soy sauce due to high sodium levels.

Sesame

When: From 6 months (or when your baby starts solids) and before 12 months.
How: Offer 1/4 tsp sesame as tahini (sesame paste) or sesame seeds. Thin tahini if necessary to reduce choking risk. Spread thinly on a finger food (e.g., soft-cooked apple or banana). You can also roll finger foods in sesame seeds or offer hummus made at home (store-bought hummus is often too high in sodium).

Wheat

When: From 6 months (or when your baby starts solids) and before 12 months.
How: Offer a finger-sized strip of toast or a pasta spiral as a finger food. Couscous mixed into purée is another option.

Shellfish (Prawns, crabs, shrimps, crayfish, and lobsters)

When: From 6 months (or when your baby starts solids) and before 12 months.
How: Ensure shellfish is fully cooked. Offer in appropriate finger food sizes (e.g., avoid whole scallops or octopus due to choking risk). Blend well-cooked shellfish, like mussels and oysters, into purées with familiar foods.

Fish

When: From 6 months (or when your baby starts solids) and before 12 months.
How: Start with 1/4 tsp of steamed or baked fish, such as salmon, white fish, or tinned sardines with bones. Serve as a finger food or blend into purée with foods your baby already tolerates.

Why Introducing Allergens Early Is Important

Introducing allergens is often one of the most worrisome aspects of starting solids for parents. However, current research indicates that offering allergenic foods to your baby before 12 months of age can help build tolerance and significantly reduce the risk of developing food allergies later in life.

Early introduction is especially important for peanuts and eggs, as these two allergens have the strongest evidence supporting their early and regular inclusion in a baby’s diet. Beyond allergy prevention, these foods are rich in essential nutrients of choline, iron, omega 3s and antioxidant lutein, making them a nutrient dense part of your baby’s overall nutrition.

When Should You Start Allergenic Foods?

ASCIA recommends introducing all allergenic foods by 12 months of age. However, it’s crucial to start once your baby has already tried and tolerated a variety of non-allergenic foods. This approach ensures that your baby is developmentally ready to handle new textures and flavours while reducing the risk of a severe reaction.

The optimal time to offer allergenic foods is during the morning or early afternoon. This timing gives you more daylight hours to observe your baby for any signs of a reaction, which might be missed if the food is introduced in the evening or before bedtime.

How to Introduce Allergens Safely

Introducing allergens safely involves a step-by-step process:

Start with Peanuts and Eggs:
- Research shows that early introduction of peanuts and eggs offers the most protective benefits against allergies. For peanuts, try diluted peanut butter or peanut powder mixed with other foods. For eggs, start with cooked egg (e.g., scrambled, omelette or hard-boiled).
Introduce One Allergen at a Time:
- Offer one allergenic food at a time, waiting at least three days before introducing another. This allows you to identify any reactions clearly.
Monitor for Reactions:
- Observe your baby closely for any signs of an allergic reaction (see the list below).
Repeat Consistently:
- After successfully introducing an allergen three times without a reaction, continue to include it in your baby’s diet at least twice a week. Consistency is key to building tolerance.
Avoid Risky Scenarios:
- Do not introduce allergens if your baby is unwell or if you’re unable to monitor them closely.

Important: If your baby has an existing allergy or a family history of severe allergies, consult a healthcare professional before introducing allergenic foods.

Signs of Food Allergies in Babies

Understanding the signs of an allergic reaction can help you respond quickly and appropriately. Reactions can range from mild to severe.

Mild to Moderate Allergic Reactions:

Swelling of the eyes, lips, or face
Hives or welts on the skin
Abdominal pain or vomiting

If you notice these symptoms, stop offering the food and consult your healthcare provider for further advice.

Signs of Anaphylaxis:

Anaphylaxis is a severe allergic reaction that requires immediate medical attention. Symptoms include:

Difficulty or noisy breathing
Swelling of the tongue
Swelling or tightness in the throat
Wheezing or persistent coughing
Difficulty talking or a hoarse voice
Persistent dizziness or collapse
Pale and floppy appearance (in young children)

Final Thoughts

Introducing allergenic foods can be intimidating, but it’s an essential step in your baby’s journey to healthy eating. By following the guidelines outlined above and staying informed, you can reduce the risk of food allergies while supporting your baby’s growth and development. Remember, consulting your GP or paediatrician is always a good idea if you have concerns or a family history of allergies.

Ready to start introducing allergens? Begin with small, consistent steps and watch your baby explore a world of nutrient dense foods and all of the different textures, colours and flavours!

References:
ASCIA: Allergy Prevention Guidelines
ASCIA: How to Introduce Solid Foods
ASCIA: Clinical Update on Infant Feeding and Allergy Prevention
ASCIA: Allergy Prevention
ASCIA: Clinical Updates on Allergy Prevention

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