Introducing Peanuts and Other Common Allergen Foods
Introducing solids can be overwhelming, but also having to try allergen foods for the first time can make any parent stressed. What do I offer first? What allergen foods do I give? How do I offer it? How long do I wait before trying something new? These are all common questions I get from first-time parents when their baby turns 6 months of age. Continue reading for more insight on what I recommend.
When to introduce common allergens
In December 2019, the Canadian Pediatric Society (CPS) updated their recommendation around introducing common allergens for high-risk infants. The recommendation is as follows:
“For high-risk infants, and based on developmental readiness, consider introducing common allergenic solids at around 6 months of age, but not before an infant is 4 months of age.” [1]
High-risk infants are considered those that “have either a personal history of atopy or a first-degree relative with atopy” [1]. In other words, if a parent has a history of eczema, food allergy, or asthma, their baby would be considered at high-risk for developing food allergies.
For infants with no or low risk for food allergies, it is recommended to introduce complementary foods at around 6 months of age [1].
Although these recommendations point to 6 months of age, not every baby is ready for solids when they reach that milestone. It’s important for your baby to be developmentally ready for solids before starting. Typically, the family doctor or pediatrician will assess developmental readiness at your baby’s doctor’s appointment. Some babies may be ready at 4 or 5 months, while others may need some more time and start later.
What common allergen(s) do I offer first?
Food Allergy Canada lists the common allergens as [2]:
Peanut
Egg
Milk
Wheat & triticale
Soy
Tree nuts
Fish
Crustaceans & molluscs
Mustard
Sesame
When starting solids, I usually recommend introducing peanut as the first allergen food due to it being one of the most common food allergies. As mentioned earlier, whether your baby is considered high-risk or low-risk, introducing peanuts around 6 months of age is recommended by CPS. Once peanuts are tolerated, I usually recommend introducing egg as the next allergen food. However, there is no strict guideline on which allergen foods should be introduced first.
How should I offer peanuts?
A recipe I commonly share with parents is from Food Allergy Canada [3]:
Take 2 tsps of smooth peanut butter and add 2-3 tsps of hot water.
Stir until dissolved and well blended.
Allow to cool.
Offer a small amount on the tip of a spoon.
Monitor for 10 minutes and up to 2 hours after for symptoms.
If you choose to offer a new allergen food that day, make sure all other foods and fluids offered that day are familiar and tolerated by your baby. This way, if any symptoms arise, it is likely due to the allergen food.
How long do I wait before offering another allergen food?
I’ve seen some recommendations say to wait 24-48 hours before offering a new allergen food, and other recommendations say 24 hours is long enough. Personally, I advise parents to monitor for 24 hours just in case delayed symptoms show but there’s no harm in waiting an extra day if parents are concerned. The important thing is to continue exposure of tolerated allergen foods by offering them 2-3 times per week [3].
Other tips to consider
If your baby has a confirmed food allergy, work with an allergist (or ask your doctor for a referral if you don’t have one) to help manage the allergy and possibly reintroduce it if possible. Working with a dietitian is also recommended to ensure your baby is getting all the necessary nutrients for growth and development.
When introducing a new allergen food, offer it in the morning when your baby is the most alert (e.g., right after a nap). You will then have the entire day to monitor for any symptoms or changes.
Written by: Cheryl Ching, MSc, RD
Reviewed by: Pauline Bakowski, MHsc, RD & Kristie Pun, MHSc, RD
References
Abrams, E. M., Hildebrand, K., Blair, B., & Chan, E. S. (2019). Timing of introduction of allergenic solids for infants at high risk. Canadian Paediatric Society. https://cps.ca/documents/position/allergenic-solids
Food Allergy Canada. (n.d). Priority food allergens. Food Allergy Canada. https://foodallergycanada.ca/food-allergy-basics/food-allergies-101/what-are-food-allergies/priority-food-allergens/
Food Allergy Canada. (2021). Eat early. Eat often. Food Allergy Canada. https://foodallergycanada.ca/wp-content/uploads/FAC_EarlyIntro_4pager_April2021_Web.pdf
