This resource includes steps to reduce a baby’s risk of developing food allergy. It is intended for babies at increased risk.
What is food allergy?
Food allergy occurs when the immune system mistakes a specific protein (an allergen) in a food as harmful. Once a person has a food allergy, an allergic reaction occurs every time they eat that food.
About 7% of babies and young children have food allergy. Children can outgrow some food allergies.
The foods that most commonly cause food allergy are called common food allergens. They include:
- Milk (and milk products)
- Egg
- Peanut
- Tree nuts (e.g. almonds, cashews, walnuts)
- Soy
- Seafood (fish, shellfish, and crustaceans)
- Wheat
- Sesame
What are some possible symptoms of an allergic reaction?
Symptoms of an allergic reaction to a food can range from mild to severe. Reactions often appear within minutes after exposure to the food. Examples include:
- Hives, swelling, redness or rash
- Stuffy or runny nose with itchy watery eyes
- Vomiting
- Cough
Although less common, vomiting, sometimes together with diarrhea, can also occur hours later.
Severe symptoms of an allergic reaction need immediate attention. Examples include:
- Swelling of the mouth, tongue or throat
- Hives that are spreading
- Any difficulty breathing, repetitive coughing or wheezing
- Difficulty swallowing or hoarse voice or cry
- Pale or blue colour of the face or lips
- Faintness, weakness or passing out
Call 9-1-1 or the local emergency number right away if signs of a severe allergic reaction occur.
If you are concerned a food is causing an allergic reaction, stop giving the food to your baby and talk to your baby's doctor. You can continue to offer other new foods.
Is my baby at increased risk of developing food allergy?
A baby is at increased risk of developing food allergy if:
- A parent, sister or brother has been diagnosed with an allergic condition like food allergy, eczema, asthma or hay fever. Allergic conditions tend to run in families.
- A baby has severe eczema.
Talk to your baby’s health care provider to find out if they are at increased risk of developing food allergy.
What is severe eczema?
Severe eczema is a very bad itchy, dry, oozing or crusted rash that does not go away with the proper use of medicated ointments and daily moisturizing as directed by the baby’s doctor or nurse practitioner.
Having food allergy does not cause eczema. Rather, having severe eczema increases the risk of developing food allergy.
Most babies with eczema do not have severe eczema. If you are unsure if your baby has severe eczema, talk to your baby’s doctor or nurse practitioner.
Steps you can take
What can I do to reduce my baby’s risk of developing food allergy?
If your baby is at increased risk of developing food allergy, there are some steps that you can take that will help reduce your baby’s risk.
Keep your baby’s eczema under good control. If your baby has eczema, try to keep it well controlled. This means keeping the inflammation down. If you need help to control your baby’s eczema, talk to your baby’s doctor or nurse practitioner. They can refer your baby to a pediatric allergist or pediatric dermatologist, if needed.
If you can, breastfeed your baby. Breastfeeding your baby may help prevent the development of food allergy. Since breastfeeding is linked to many other health benefits, Health Canada recommends breastfeeding until 2 years of age and beyond.
Questions you may have:
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Should I avoid certain foods during my pregnancy or while breastfeeding?
There is no need to avoid specific foods during your pregnancy or while you are breastfeeding to prevent food allergy in your baby. In fact, restricting your diet during pregnancy can make it harder to get the calories and nutrients you need to support the growth and development of your baby.
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If I offer formula, can I offer a regular infant formula?
If you offer infant formula to your baby, you can use a regular store bought cow-milk based product. Current research shows that regular formulas do not appear to increase the risk of developing milk allergy compared to modified formulas. Modified formulas include extensively hydrolyzed casein and partially hydrolyzed whey formulas.
Introduce the common food allergens at around 6 months of age.
Introduce the common food allergens when your baby has shown they are ready for solid foods. For most babies this is at about 6 months of age. The risk of developing peanut allergy appears to be much lower in babies who had peanut introduced at about 6 months of age.
After you have introduced a few other solid foods, offer the common food allergens one at a time. There is no research to show that you need to wait a certain number of days between them.
You can start with the common food allergens your family eats often. You do not have to introduce the foods your family does not eat, such as fish if your family is vegetarian. If you have questions about introducing the common food allergens, talk to your baby’s nurse or doctor or a registered dietitian.
Tip:
Consider introducing peanut and egg before the other common food allergens. Introducing peanut and cooked egg (such as hard boiled) at about 6 months of age seems to be especially helpful for reducing the risk of a food allergy developing to these foods. You can introduce them to your baby’s diet before introducing the other common food allergens.
If your baby has severe eczema or egg allergy, talk to your baby’s doctor or nurse practitioner. Babies with severe eczema or egg allergy may benefit from having peanut introduced to their diets as early as 4 to 6 months of age. This may be the best age for reducing their chance of developing peanut allergy. Talk to your baby’s doctor or nurse practitioner before you offer peanut. Ask them to consider referring your baby to a pediatric allergist.
Offer tolerated common food allergens regularly. Offer the common food allergens your baby tolerates several times a week, or more often if you like. This will help your baby maintain tolerance to these foods (prevent a food allergy from developing).
How should I offer the common food allergens when I try them for the first time?
- Blend some of the common allergen into prepared infant cereal. See the recipes below for details.
- Offer your baby just a taste of the recipe (about a quarter of a baby spoonful).
- Wait about 10 to 15 minutes before offering more.
- During this time, watch your baby to see if they show symptoms of an allergic reaction. You can offer other foods to your baby while you wait.
- If after the 10 to 15 minutes wait your baby hasn't shown any symptoms of an allergic reaction, you can offer more of the common allergen along with other foods.
Recipes
These recipes are suggestions of how to prepare peanut, tree nuts and egg for your baby, when your baby is about 6 months of age and ready for solid foods.
| Peanut butter | Add 15 mL (1 tablespoon) of warm water to 15 mL of smooth peanut butter. Blend until smooth and no lumps. Stir into 30 mL (2 tablespoons) of infant cereal prepared according to package instructions. |
| Almond, cashew and hazelnut butter | Add 15 mL (1 tablespoon) of warm water to 15 mL of smooth tree nut butter. Blend until smooth and no lumps. Stir into 30 mL (2 tablespoons) of prepared infant cereal according to package instructions. You can also stir the nut butter, water blend into 30 mL (2 tablespoons) of fruit puree, such as banana or apple. |
| Hard-boiled egg | Blend or mash a hard-boiled egg with a fork. Add a few teaspoons of water to moisten as needed. |
Other Recipes
These recipes are suggestions of how to prepare peanut, tree nuts and egg when your baby is older and ready for more textures. Avoid offering whole peanuts and tree nuts or globs of peanut butter. They are choking hazards for children until about 4 years of age.
| Peanut butter and tree nut butter on toast | Spread 15 mL (1 tablespoon) of smooth peanut butter or tree nut butter thinly on a piece of toast. Cut into strips. |
| Scrambled egg | Beat together an egg and a small amount of water. Scramble in an oiled pan, until egg is completely cooked. Mash larger pieces of scrambled egg with a fork before offering to your baby. |
| French toast | Beat together an egg, 30 mL (2 tablespoons) of milk and some cinnamon. Soak a slice of bread in the egg mixture. Fry each side of the bread in an oiled pan until the egg is completely cooked. Cut into cubes. |
What other foods should I offer my baby?
In addition to the common food allergens, offer your baby other foods, especially foods rich in iron. Offer iron rich foods 2 or more times each day. Examples include:
- Well-cooked meat, poultry and fish
- Cooked egg, lentils, beans and tofu
- Iron-fortified infant cereal
Some common food allergens are also sources of iron. These include peanut, tree nut and sesame seed butters.
Yogurt and cheese are recommended for your baby starting at 6 months of age. To help your baby maintain good iron status, delay offering milk to drink until 9 to 12 months of age.
Additional Resources
For information and advice based on your specific food and nutrition needs and preferences, call 8-1-1 and ask to speak to a HealthLink BC dietitian.
For additional information, see the following resources:
- HealthLink BC - Get medically approved non-emergency health information.
- Dietitian Services Fact Sheets - Available by mail (call 8-1-1) or visit www.healthlinkbc.ca/healthy-eating
- HealthLink BC File #69c Baby’s First Foods
- HealthLinkBC File #69d Helping Your 1 to 3 Year Old Child Eat Well
- Baby's Best Chance
- Toddler’s First Steps
- Public Health Agency of Canada - The Sensible Guide to a Healthy Pregnancy https://www.canada.ca/en/public-health/services/health-promotion/healthy-pregnancy/healthy-pregnancy-guide.html
Last updated: December 2018
©2017 Province of British Columbia. All rights reserved. May be reproduced in its entirety provided the source is acknowledged. This information is not meant to replace advice from your medical doctor or individual counselling with a health professional. It is intended for educational and informational purposes only.
