food allergies

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Introducing food allergens to babies

Food allergies can cause anxiety for some parents when introducing solids. Allergies only affect a small minority of children, but are common enough that it's important to know about them and what to do if your child has a reaction. What is a food allergy? A medical condition in which exposure to a food protein known as an allergen triggers the immune system to overreact. How common are they? 5-8% of children under age 5 have food allergies. Some children with an allergy may tolerate a small amount of the food (e.g., milk or egg cooked into a baked good) while others do not. Most children outgrow them, but some allergies can be lifelong.

how to introduce allergens

Early in your solids journey

Start solids with low-risk foods (e.g., veggie, fruit)

If baby is tolerating these well, introduce allergens soon thereafter

For cow's milk (an allergen), offer via yogurt or cheese

small amounts

Introduce small amounts (e.g., sprinkle of ground nuts on oatmeal) the first few times

Then gradually increase amount over time

One at a time

Introduce single-ingredient foods and allergens one at a time so that if there is a reaction you can identify the culprit

early in the day

Serve early in day to give you time to observe your child while they and you are not sleeping and so you can contact the doctor if needed


Once a food is ruled out as an allergy for your child, offer it frequently and regularly, such as weekly

top allergenic foods

~90% of food allergies are caused by 8 foods:

(Key: Allergen ~% children affected | notes)

Cow's milk ~2-3% | ~75% outgrow it

Peanuts ~2-2.5% | 20% outgrow it

Eggs ~1-2% | >70% outgrow it

Tree nuts ~1-2% | <10% outgrow it

Soy ~0.4% | most outgrow it

Wheat <1% | 65-70% outgrow it

Shellfish ~2% | many (~60%) don't discover allergy until adulthood

Fish ~1% | many (~40%) don't discover allergy until adulthood

Signs of an allergic reaction

Symptoms begin within minutes to an hour after ingestion. The most common signs are in red bold:

stomach symptoms

Vomiting (common milk allergy symptom)



skin symptoms

Hives (red spots)


Eczema (itchy dry rashes)

breathing symptoms



Throat tightness or itchiness

circulation symptoms

Pale skin


Loss of consciousness

A note on milk and soy allergies

In young infants, crying & gassiness, eczema, or poor growth can signal cow's milk or soy allergy, but these symptoms are also common in general. Discuss with your pediatrician to identify the root cause.

What to do?

Before introducing solids:

Talk to your pediatrician for guidance on how and when to start based on your own baby's health, development, and readiness signs

If your baby has eczema, ask your pediatrician for guidance as some studies show this increases the risk of allergic reaction

If baby shows signs of allergic reaction to formula, breastmilk, or solid food:

Keep note of what foods were served prior to the reaction and any other patterns you have noticed

Consult your pediatrician about how to proceed

Treatment is generally to avoid the trigger foods (no medication can prevent food allergies)

If a cow's milk allergy is suspected, formula-fed babies may be directed to switch formulas

For children with multiple food allergies, a registered dietician can help ensure they get a complete nutritious diet

For severe reactions, pediatricians or allergists may prescribe epinephrine (EpiPen)


American Academy of Pediatrics (AAP); Food Allergy Research & Education (FARE); Johns Hopkins Medicine; Center for Disease Control (CDC); Nemours KidsHealth

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