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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.
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
Introduce small amounts (e.g., sprinkle of ground nuts on oatmeal) the first few times
Then gradually increase amount over time
Introduce single-ingredient foods and allergens one at a time so that if there is a reaction you can identify the culprit
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
~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
Symptoms begin within minutes to an hour after ingestion. The most common signs are in red bold:
Vomiting (common milk allergy symptom)
Diarrhea
Nausea
Hives (red spots)
Swelling
Eczema (itchy dry rashes)
Sneezing
Wheezing
Throat tightness or itchiness
Pale skin
Light-headedness
Loss of consciousness
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.
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
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
