
Once a food allergen is safely introduced, try to keep it in the diet on a regular basis, at least once and ideally twice a week. It is okay if you occasionally miss a week, or if your baby doesn’t eat much of the food when it is offered. The goal is steady exposure over time.
Once they are introduced, common food allergens do not need to be served on their own. They can be mixed into meals, and you can offer dishes that check the box for multiple food allergens at once, such as:
▶ energy balls (peanut, tree nuts)
▶ ground-up granola (peanut, tree nuts)
▶ pancakes (dairy, egg, wheat)
▶ peanut noodles (peanut, wheat)
▶ tofu egg scramble (egg, soy)
Once peanut and tree nuts are safely introduced, mixed nut butter and ground-up granola are the fastest way to maintain exposure to multiple food allergens at once.
You can buy or make mixed nut butter or ground-up granola from scratch, and use them in meals in different ways. Got bread, fruit, and yogurt? Sprinkle some finely ground-up granola on fruit or yogurt one day, then spread some mixed nut butter on toast on another day, and you’re good to go for the week.
If you need meal ideas with just peanut or a specific tree nut, below are few ideas to try.
swirl peanut butter into porridge
thinly spread peanut butter on toast
mix peanut butter and yogurt
sprinkle ground up peanuts on fruit
use peanut sauce to dress noodles
roll fruit or vegetables in almond flour
swirl almond butter into mashed fruit
make dip with almond butter and water
drizzle almond butter dip on a waffle
use almond meal in pancakes
stir cashew butter into porridge
sprinkle ground-up cashew on fruit
try cashew cheese or cashew yogurt
mash cashew butter and vegetables
use cashew cream to dress pasta
roll fruit or vegetables in hazelnut meal
mix ground-up hazelnuts into porridge
mash hazelnut flour with vegetables
blend hazelnut and vegetables into dip
use hazelnut meal in pancakes
roll fruit spears in ground-up walnuts
mix ground-up walnuts into porridge
sprinkle ground-up walnuts on yogurt
mash walnut butter with vegetables
blend walnuts and vegetables into dip
Aaïla, 8 month old, eats cashew sprinkled on egg noodles
Wei Wei, 7 months old, eats oatmeal topped with chopped nuts
Adie, 15 months old, eats yogurt with a nut sprinkle
mash hard-boiled egg with avocado
use brioche or challah to make toast
make scrambled eggs any time of day
toss egg noodles with a favorite sauce
make egg strips or egg cups to freeze
Malden, 9 months old, eats hard-boiled egg
spread cream cheese on toast
use milk instead to make oatmeal
whip ricotta cheese to make a dip
stir shredded cheese into vegetables
serve yogurt for meat or grains
Tifa, 10 months old, eats pancakes
mix wheat pasta with sauce
cook wheat flour waffles to serve and freeze
make couscous mixed with mashed avocado
keep iron-fortified wheat cereal for quick breakfasts
serve naan or pita bread
Zeke, 14mos eats cous cous
swirl tahini in porridge or yogurt
drizzle tahini on fruit, waffles, or toast
mix tahini and lemon to make a sauce
mash tahini with roasted vegetables
stock up on hummus
Amelia, 11 mos, eats Tahini Applesauce
try soy yogurt and silken tofu
use soy milk to make porridge
mash tofu with scrambled eggs
crumble firm tofu into grains
prep some edamame mash to freeze
Maya, 6 months old, eats edamame on toast
stock the pantry with canned sardines
add canned salmon to noodles
spread fish salad on a food teether
flake canned fish from into vegetables
make fish cakes to serve and freeze
Adie, 20mo, eats fish cakes
Once a common allergen is safely introduced, try to offer it at least once ideally twice a week when possible. It is okay if you occasionally miss a week, or if your baby doesn’t eat much of the food when it is offered. The goal is steady exposure over time.
The exact quantity isn’t as important as consistency. Even small amounts (like a spoonful of yogurt, a smear of peanut butter, or a bit of scrambled egg) can help maintain tolerance.
It's okay. Tolerance is built and maintained through regular, ongoing exposure over months and years. Short breaks are common. Babies and toddlers often go through phases of food refusal, and sometimes they eat more breast milk or formula than solid food when they are sick or tired. Taking a short break from eating common food allergens is not likely to reverse a child’s tolerance to that food once it has been established. Long gaps carry more risk; for example, if an allergen is completely avoided for many months due to dietary restriction, illness, or extended food refusal), there’s a greater chance that tolerance may wane, particularly in the early years. If your baby or toddler needs to skip an allergen for a week or two, simply reintroduce it when possible.
Try different dishes that contains the allergen. Not all babies and toddlers take to all foods easily. Fortunately, many allergens can be incorporated into dishes and presented in many forms. There's nothing we can do to "make" a child eat, but we can control what foods get served, and we can get creative, model how we eat and enjoy foods, and continue to offer them with no pressure in the hopes that they will eventually give it a try.
Keep up exposure through the first 5 years of life. This is when the immune system is still actively learning to recognize foods as safe. After age 5, the risk of developing a new IgE-mediated allergy to foods that have been consistently consumed is much lower, and maintaining allergens in the diet is helpful, but it doesn’t require the same level of careful tracking. As long as a child continues to eat these foods as part of their normal diet, they’re likely to sustain tolerance.
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