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Introducing Allergens

You are about to begin introducing common allergens to your baby. Allergists and medical institutions recommend introducing common food allergens early, and keeping them in your baby’s diet consistently to prevent the development of food allergies. This module will walk you through introducing allergens and will give you ideas to keep them in your baby’s diet.

The most common food allergens are: cow’s milk, egg, finned fish, shellfish, peanut, tree nut, sesame, soy, and wheat.

There are two main risk factors that indicate your baby might be at an increased risk of developing food allergies: severe eczema and existing food allergies. If your baby has either of the above risk factors, talk to your child’s medical provider before introducing allergens to come up with a plan.

How You Do it

  1. Start small. The smaller the quantity served, the less severe an allergic reaction may be. If there is no reaction, gradually increase the amount over the next few days. Once you’ve ruled out an allergy to that food (a few days of daily ingestion is enough to establish that a food is well tolerated), aim to offer it to your baby at least once a week.

  2. Introduce allergens early in the day. Most allergic reactions occur within two hours of ingestion and often within minutes. Introduce allergens in the morning or right after a morning nap so you can observe your child during the day ahead; should an allergic reaction occur, it is easier to contact your doctor for guidance.

  3. Introduce one food allergen at a time. This way, if there is a reaction, you’ll know which food was responsible. Don’t be afraid to offer multiple new foods each week, as long as you aren’t introducing common food allergens simultaneously–don’t introduce two new allergens on the same day.

  4. Regular exposure. Once you’ve safely introduced a food allergen to your child, keep that food in regular rotation—consistency is key. Allergists often recommend aiming for the inclusion of common allergens 2-3 times per week but don’t stress if you can’t get each common allergen on the menu that frequently.

  5. Don’t worry too much about volume: if your baby doesn’t consume the entire serving of allergen offered that day, that’s ok. Relatively modest quantities of allergen exposure (~2 grams of protein per week) can be effective for allergy prevention, as long as exposure remains consistent.

What do allergic reactions look like?

Allergic reactions often occur within minutes of consuming the allergenic food. There is, however, a small percentage of babies who may experience a delayed allergic reaction, typically presenting as GI symptoms. Your baby may not have an allergic reaction the first time they are exposed to the food, so be watchful on the second and subsequent exposures.

Mild symptoms of an allergic reaction can include ONE of the following

  • Itchy or runny nose, sneezing

  • Itchy mouth

  • A few isolated hives, mild itching

  • Mild nausea or gastrointestinal discomfort

If you note any of these symptoms, stop feeding the allergen and contact your health care provider for guidance.

More severe reactions may include any of the following, either alone or in combination:

  • Shortness of breath, wheezing, repetitive cough

  • Pale, ashen or bluish skin

  • Swelling of face, lips, or tongue

  • Widespread hives on body

  • Repetitive vomiting

  • Sudden tiredness/lethargy/seeming limp

If your child is having any of the above symptoms or multiple mild symptoms, call 9-1-1/local emergency services immediately and request an ambulance with autoinjectable epinephrine. Do not wait.

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