Frequently Asked Questions
We have summarized questions we hear most from parents about the introduction of foods and food allergies in infants.
Frequently Asked Questions Resource
What are the current U.S. recommendations for introducing babies to foods that commonly cause allergies?
Strong research and promising studies show that introducing a wide variety of healthy foods into a baby’s diet early and often is recommended – and it may help lower the risk of certain food allergies. According to the American Academy of Pediatrics (AAP), you can start introducing single-ingredient foods like fruits (apples, pears and bananas), vegetables (green vegetables, sweet potatoes, squash and carrots) and cereal grains (rice or oat cereal) between four to six months, when your infant is developmentally ready. Once these first foods have been successfully added into your baby’s diet, you can move onto foods that commonly cause allergies (defined as allergens).
What were the previous recommendations?
As recently as the early 2000s, the widely accepted advice was that babies at risk for food allergies should avoid many allergy-causing foods until age one or even older. With the benefit of new science, this guidance has changed. Delaying foods that commonly cause allergies will not prevent food allergies from developing and introducing a wide variety of foods as early as four to six months is now recommended.
What is the research behind the change in the recommendations?
The groundbreaking Learning Early About Peanut Allergy (LEAP) study showed that feeding peanut-containing foods early to babies at high risk for peanut allergy reduced their chances of developing a peanut allergy by 80%. The LEAP-On study, a follow-up to LEAP, found that the peanut allergy risk reduction from eating peanut foods early is stable over time.
The evidence is building for the other top allergens. For some children at higher risk for allergies to milk, peanut, egg, sesame, fish or wheat, the Enquiring About Tolerance (EAT) study indicates that introducing these foods early has the potential to lower the risk of developing these allergies, particularly egg. Additional studies suggest that feeding your baby many diverse foods and food groups might also lower the risk of food allergy.
When can I start to introduce foods that commonly cause allergies into my baby’s diet?
Every child is different, but most babies are ready for solid foods between four and six months. Your baby’s two- or four-month well-child visit is a great time to begin this conversation with your child’s pediatrician. For babies at high risk, it is important to discuss with your pediatrician and allergist early (before they are 4 months old) as they may benefit most from introducing allergens early, potentially reducing the risk of food allergy.
After consulting with your pediatrician and once your baby began eating other solid foods, you can safely introduce allergens early and often between four to six months. Once these foods have been introduced and are tolerated, parents should make them part of baby’s regular diet to reduce the likelihood of developing food allergies.
How does the guidance for introducing allergens differ for high risk babies?
Specifically for peanut allergy, there are three separate guidance for early introduction, depending on risk level:
- High risk (child has severe eczema, egg allergy or both): Introduce age-appropriate peanut-containing foods between four and six months to reduce the risk of developing peanut allergy. Your child’s healthcare provider might recommend an allergy test (either a skin prick test or blood test) prior to feeding your child peanut foods. This will help decide on the safest way to introduce peanut. For high risk babies, it is important to discuss with your pediatrician and allergist early (before they are 4 months old) as they may benefit most from early introduction.
- Moderate risk (child has mild or moderate eczema alone): Introduce age-appropriate peanut-containing foods at around six months to reduce the risk of developing peanut allergy. A healthcare provider can tell you whether your child’s eczema is mild to moderate. See your child’s pediatrician if you have any specific concerns.
- Low risk (child has neither eczema nor egg allergy): Introduce age-appropriate peanut-containing foods depending on your family’s preferences and cultural practices.
Parents should work with their child’s pediatrician or allergist early (at the two- or four-month well-child visit) to evaluate your baby’s risk factors.
If my baby is older than 6 months, is it too late to introduce foods that commonly cause allergies?
Not at all! While research indicates beginning earlier is better for reducing the risk of food allergies (as early as 4 months), foods that commonly cause allergies can be introduced any time after your baby has begun eating solid foods. It should be done in an age-appropriate way and in accordance with family preferences and cultural practices. Consult your pediatrician if your child is high risk for food allergies or you have other concerns.
How exactly do you introduce foods that commonly cause allergies into your baby’s diet?
For low- or moderate-risk babies, you can introduce allergy-causing foods at home.
Pick a time when your infant is healthy and can have your full attention for at least two hours so that you can watch for an allergic reaction.
These foods can be boiled, pureed, or mixed with foods already well-tolerated by your baby. Be sure egg white is fully cooked before serving it to your child. For peanut, prepare a full portion of one of the peanut-containing foods from the recipes provided on this page [link to Introducing peanut foods to infants]. Each provides a 2-gram serving of peanut protein.
Foods that commonly cause allergies should initially be given to your baby in small tastes. The amount can gradually be increased in a developmentally appropriate manner if there are no signs of allergic reaction.
How will I know if my baby is having an allergic reaction?
The first symptoms of the allergic reaction usually appear between a few minutes and two hours after exposure to a food. Symptoms can range from mild to severe or even life-threatening and can occur alone or in combination. If you have any concerns about your baby’s response to a new food, seek medical attention or call 911 right away.
- Mild symptoms can include a new rash or a few hives around the mouth or face. (Hives are red, itchy welts on the skin.)
- More severe symptoms can include swelling of the lips, face or tongue; vomiting; diarrhea; widespread hives over the body; wheezing; repetitive coughing; difficulty breathing; skin color changing to pale or blue; sudden tiredness or lethargy; seeming limp.
Does breastfeeding have an impact on whether my baby develops food allergies?
It’s not clear whether breastfeeding, or a mother’s diet while breastfeeding, has an effect on the development of food allergies. Current evidence does not support avoiding foods while breastfeeding as a means of preventing food allergy. Additionally, exclusively breast feeding beyond 3 to 6 months is not recommended.
What is FARE’s role in early introduction?
In 2008, FARE (Food Allergy Research & Education) partnered with the National Institute of Allergy and Infectious Diseases (NIAID, a division of the National Institutes of Health) to fund this critical research as part of our commitment to advancing promising prevention strategies, treatments and cures for food allergy. As the world’s largest private source of food allergy research funding, FARE has invested nearly $3 million in game-changing discoveries that highlight the benefits of introducing certain allergens early.