For instance, when it comes to peanuts, the new recommendations from the American Academy of Pediatrics (AAP) suggest that for infants not at high risk for peanut allergy, peanuts can be introduced as solids are introduced. Families of babies who are at high risk should seek out a plan for introduction with their doctor that will involved testing and food introduction under the guidance of the doctor. What’s been surprising in the latest research and recommendations is that earlier introduction seems to be protective against the development of peanut allergies, which is the opposite of what we’d previously thought. In terms of the other highly allergenic foods, there’s no evidence that delaying these foods prevents food allergies. Some foods are more likely to cause an allergic reaction than others. The most common food allergies are to:
Milk Eggs FishShellfishTree nutsWheatPeanutsSoybeans
The FDA requires that foods containing any of the ingredients listed above be clearly labeled, which should make it much easier for parents to shop safely for their children. Based on a review of the current literature, the most recent AAP report suggests that there is no evidence that delaying the introduction of allergenic foods beyond when solids are introduced (around 6 months) prevents the development of allergies. If your infant is showing the developmental signs of readiness for solids, and isn’t at high risk for food allergies, you can introduce the more highly allergenic foods along with the other first foods. As with any food introduction, keep an eye on baby to watch for any signs of allergies or intolerance.
When to Introduce Allergenic Foods
As noted above, for infants not at high risk for food allergy, there’s no benefit to waiting to introduce the more allergenic foods. They can be introduced right along with other “first foods”.
Milk: liquid cow’s milk should not be introduced until a child’s first birthday. This is because you want an infant to fill up on human milk or formula, which contain the nutrients they need for growth and development. Cow’s milk does not provide the nutrient profile a human infant needs. You can, however, include yogurt into an infant’s food options once they start solids. Prior to that, they should be breastfed or formula-fed. Eggs: scrambled eggs can be an easy food for infants learning to feed themselves to grasp and put to their mouths. An omelet cut into strips or a hard boiled egg cut into thin slices can also be options a baby can pick up on their own. If you’re using purees, crumbled hard boiled egg yolk can be added to cooked oatmeal. Fish and shellfish: Opting for fish that is lower in mercury and higher in omega 3 DHA fats is a good idea, like salmon or sardines. Be sure to remove all bones from thoroughly cooked fish before offering to baby. Tree nuts: Whole nuts are choking hazards and shouldn’t be offered to a baby or toddler. Surprisingly the same goes for nut butters, unless they’re spread very thin onto toast or thinned with water. Something like peanut butter can be stirred into oatmeal or yogurt. Wheat: Toast spread with hummus or a thin layer of nut butter and cut into strips a baby can hold can be a great way to introduce wheat. If you’re using purees, a hot wheat cereal made with breast milk or formula can be a way to introduce it. Peanuts and peanut butter: Peanut butter must be thinned with water or human milk/formula before offering it to an infant. It can also be very thinly spread onto a piece of toast that is cut into strips a baby can grasp or stirred into plain yogurt or oatmeal. Soy: A strip of tofu makes a simple way to offer a baby soy. In addition, edamame can be pureed with spices and oil and used as a spread on toast or spooned as a puree.
Unless your infant is at high risk for a food allergy (eczema, egg allergy, family history) then introducing the more highly allergenic foods shouldn’t be much different than other foods. However, babies can often sense nervousness from parents and it’s important to make mealtimes as calm as possible. If speaking to your pediatrician or a pediatric registered dietitian will help you feel more confident and relaxed during the initial solid food meals with baby, it’s a great idea.
