By Dr. Angela Duff Hogan, Asthma, Allergy, and Immunology at CHKD
For many years, parents were told to wait before giving babies foods that commonly cause allergies, such as peanuts and eggs. Today’s research has changed that advice.
Introducing peanut and cooked egg early, when your baby is ready for solid foods, may help lower the risk of developing food allergies. Current guidance supports introducing these foods around 6 months of age, but not before 4 months.
Why Has the Advice Changed?
Food allergies affect an estimated 8-10% of children, and some children are allergic to more than one food. Because there is no known cure for food allergies, researchers have been looking closely at ways to prevent them.
One of the biggest changes involves peanuts.
A major study called the LEAP trial looked at babies who were at high risk for peanut allergies. Researchers found an 81% relative reduction in peanut allergy among children who ate peanut early compared with those who avoided it. Other research has also found that introducing egg early may help reduce the risk of egg allergies.
The important message for parents is simple: Waiting longer isn't necessarily better.
When Should Babies Try Peanut and Egg?
Babies can be introduced to cooked egg and age-appropriate peanut products between 4 and 6 months when they are developmentally ready to begin eating solid foods. These foods should not be introduced before 4 months.
Your pediatrician can help you decide when your baby is ready. Food allergies are also a good topic to discuss at your baby's 2-, 4-, 6- and 9-month checkups.
And don't worry if your baby is already older than 6 months. The guidance presented by CHKD notes that introduction can still be beneficial after the early 4- to 6-month window.
How to Introduce a New Food
First foods don't have to be complicated. Dr. Angela Duff Hogan recommends making the experience simple and manageable.
Start with a basic food that isn't a common allergen to make sure your baby is ready for solids. When introducing an allergenic food, offer it in a form that does not pose a choking risk and start with a very small amount. Wait 30 minutes. If your baby does not have a reaction, you can offer more. You can introduce a new food every meal-variety is good. Important to remember to eat early and eat often. Continued exposure to common allergens helps the baby's gut develop memory (oral tolerance) for those foods. Current guidance is that dairy products (like yogurt or cheese) can also be introduced around 6 months of age, when a baby is developmentally ready for other complementary foods.
Don't rub food on your baby's skin to test for an allergy or take your baby to an emergency department parking lot for the first exposure. Allergy specialists also advise against prescribing epinephrine "just in case" before introducing foods.
What If My Baby Has Eczema?
Eczema is one factor connected with a higher risk of food allergies. When the skin barrier is damaged, it may make it easier for the body to become sensitive to allergens. Genetics, family history, and other factors may also play a role.
But having eczema doesn't automatically mean a food needs to be removed from your child's diet. Dr. Hogan specifically advises against removing a food based on eczema alone when a child has been eating it without hives. And don't take foods out of mom's diet if she is breast feeding for eczema either.
If you're concerned about your baby's individual risk, talk with your pediatrician before changing your baby's diet.
Do Babies Need Allergy Testing Before Trying These Foods?
Not usually. Routine allergy testing before introducing foods isn't required. Unnecessary testing can delay introducing foods, increase costs, and sometimes lead to an inaccurate food allergy diagnosis.
Rather than testing every child, your pediatrician can help determine whether your baby's health history calls for a different approach.
Meet Dr. Angela Duff Hogan
Angela Duff Hogan, MD, is a CHKD specialist in allergy, asthma and immunology with clinical and research interests in food allergies. Dr. Hogan is board certified by the American Board of Allergy & Immunology and the American Board of Pediatrics. She is also a founding member of the Coastal Food Allergy Support Group and is medical director for the FARE Neighborhood Initiative in Hampton Roads.
Dr. Hogan's interest in food allergies extends beyond her clinical work. Her own lifelong experiences with asthma and food allergies help fuel her commitment to educating and supporting families.
Learn more about Dr. Angela Duff Hogan
The Bottom Line for Parents
When it comes to introducing foods like peanut and egg, the advice has changed. Instead of delaying these foods, introducing them early, when your baby is developmentally ready, may help prevent food allergies.
Keep it simple, introduce new foods safely, and talk with your child's pediatrician if you have questions or concerns about food allergies.
