Dr. Mona's Mom Blog

All about food allergies! How to introduce allergenic foods, signs of a food allergy, and FAQ

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Let’s talk about food allergies! Introducing foods can be scary, but in this post we go over the top 9 food allergens and how to safely introduce them to your baby whether you’re BLW or puree feeding. We also discuss potential signs of an allergy and what to do. Let’s dive in!

What are the most common food allergies?

In the U.S., the top nine allergenic foods are milk, wheat, eggs, sesame seeds, tree nuts, soy, fish, shellfish, and peanuts.

Can children develop other food allergies?

Yes, of course. We can be allergic to over 150+ foods. But the nine mentioned are most common.

When can I introduce allergenic foods into my child’s diet?

If your child has moderate to severe eczema, discuss the introduction of allergenic foods with your child’s clinician. In some cases, they may recommend allergy testing prior to introduction. If your child does not have moderate to severe eczema, you can introduce allergenic foods whenever you start solids. For these top allergens, start with introducing these items individually at least three times before mixing with other foods. If no allergy is noted, then combine with other foods you have introduced. Food allergies can happen at any time, but 2-3 exposures is good before combining with other foods.

How can I reduce my child’s risk of developing food allergies?

Early introduction of allergenic foods in a repetitive and consistent basis can help. This doesn’t mean giving peanut powder once and not doing it again. Be consistent in exposure. Remember if they don’t like it, continue to offer it. Try giving that food two or three times a week for consistent exposure.

How to introduce the top nine allergenic foods

  • Cow’s Milk
    • Puree Feeding: Yogurt or cheese in puree form
    • BLW: Yogurt or cheese on a pre-loaded spoon
  • Wheat
    • Puree Feeding: Wheat infant cereal
    • BLW: Lightly toasted wheat bread in strips; cooked pasta with butter
  • Eggs
    • Puree Feeding: Powdered mix-ins in cereal. avocado, or veggies; minced scrambled eggs (can add breastmilk or formula to make smooth)
    • BLW: Hard boiled egg cut in wedges; omelet strips; mix-ins in yogurt on pre-loaded spoon
  • Sesame Seeds
    • Puree Feeding: Hummus or tahini (with sesame)
    • BLW: Hummus or tahini on a pre-loaded spoon
  • Tree Nuts (almonds, cashews, hazelnuts, macadamia nuts, pecans, pistachios, and walnuts)
    • Puree Feeding: Powdered mix-ins to cereal or yogurt; or slightly watered down nut butters (can use water, breastmilk, or formula); ground nuts in yogurt
    • BLW: Nut butters VERY thinly spread on strips of toast, nut butters in yogurt on a pre-loaded spoon, or nut butters alone on a preloaded spoon; ground nuts in yogurt on pre-loaded spoon
  • Soy
    • Puree Feeding: Yogurt made out of soy milk
    • BLW: Tofu sticks; soy yogurt on a pre-loaded spoon, edamame cut for safety
  • Fish (low-mercury fish include salmon, rainbow trout, canned light tuna)
    • Puree Feeding: Pureed fish (may not taste great, so consider BLW)
    • BLW: Strips of well-cooked fish (season as you would)
  • Shellfish (shrimp, crab and lobster – mussels and oysters are usually raw so save for later or cook and mince)
    • Puree Feeding: Pureed fish (may not taste great, so consider BLW)
    • BLW: Crab cakes, sliced shrimp, lobster cakes
  • Peanuts
    • Puree Feeding: Powdered mix-ins to cereal or yogurt; slightly watered down nut butters (can use water, breastmilk, or formula)
    • BLW: Creamy peanut butter in yogurt on pre-loaded spoon; creamy peanut butter on pre-loaded spoon; powdered mix-ins in yogurt on pre-loaded spoon; Bamba (peanut puffs for babies); thin spread of nut butter on strips of toast

Remember that globs of nut butters are a choking hazard, so make sure to use a thin spread and/or liquify with water, breastmilk, or formula.

Signs of a food allergy

Mild Symptoms

  • NOSE: Itchy/running nose, sneezing
  • MOUTH: Itchy mouth
  • SKIN: A few hives/itching
  • STOMACH: Nausea/discomfort

If your child has ONE of any of these mild symptoms after eating a food, monitor for repetitive reactions to that food. If your child has MORE THAN ONE of any of these mild symptoms after eating a food, speak to your child’s clinician.

Severe Symptoms

  • LUNGS: Short of breath, wheezing, repetitive coughing
  • HEART: Pale, faint, light-headed
  • THROAT: Tight, hoarse, difficulty swallowing
  • MOUTH: Swelling of the tongue and/or lips
  • SKIN: Many hives over the body
  • STOMACH: Repetitive vomiting or severe diarrhea

If your child has any of these severe symptoms, they should be seen in the emergency room right away.

Check out my conversation with Dr. Shreya Patel, an Allergist and Immunologist on the PedsDocTalk podcast where we talk about food allergies and FPIES.

P.S. Did you know I have a YouTube channel? Watch this episode where I discuss the importance of early-introduction of allergenic foods!

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All information presented on this blog, my Instagram, and my podcast is for educational purposes and should not be taken as personal medical advice. These platforms are to educate and should not replace the medical judgment of a licensed healthcare provider who is evaluating a patient.

It is the responsibility of the guardian to seek appropriate medical attention when they are concerned about their child.

All opinions are my own and do not reflect the opinions of my employer or hospitals I may be affiliated with.