To think parents used to be advised to delay allergen introduction to their babies until over the age of one, even 18 months!
That advice has been turned on its head. Turns out, we need to get the allergens into the diet before the age of twelve months.
The basis for this change in advice included the LEAP study in London in 2015 (1). This landmark study found that infants and young children who started eating peanuts from under the age of twelve months (4-11 months) and kept eating peanuts at least 3 times per week were 80% less likely to develop peanut allergy by the age of 5 than those who were provided with the standard information to avoid peanuts.
These findings, along with some other randomized controlled studies (2, 3, 4) and meta-analyses (5) on food allergy prevention leading to changes in infant feeding advice for food allergy prevention worldwide.
It should be noted that a small number of babies will go on to develop food allergies following this advice.
A key outcome from the LEAP (1) study and a follow-up study (3) is that peanut should continue to be fed regularly for at least 5 years.
Keeping Up the Allergens to your Baby
Introducing these foods before the age of one and continuing to provide on a regular basis helps your baby's immune system to recognise these proteins as being friendly and not a danger to mount a defence against.
Knowing how much to keep in the diet and how often has not been specifically determined, although a secondary analysis of the Enquiring About Tolerance (EAT) randomized controlled trial suggested the following (4, 6):
Providing Egg for your Baby for ongoing tolerance
A dose of about 2 g of egg white, the equivalent of approximately one small boiled egg is likely an amount that would be tolerated in infancy although further research is required and it is possible that smaller amounts may be effective as well.
Aim to provide this 3-4 times per month, or once a week (4, 6).
Providing Peanut for your Baby for ongoing tolerance
A dose of about 2 g of peanut protein, the equivalent of approximately the equivalent of approximately 1 1/2 tsp peanut butter is likely an amount that would be tolerated in infancy although further research is required and it is possible that smaller amounts may be effective as well.
Aim to provide this 3-4 times per month, or once a week (4, 6).
A note on nuts: introduce peanuts but also tree nuts as well In a form that baby can tolerate such as a paste or very finely ground up and mixed into foods.
Other Allergens: tree nuts, dairy, soy, sesame, fish
Specific information is not available, just keep in the diet as a baby serve on a regular basis until the age of five.
Try to avoid periods of time when the allergens are not provided Especially for egg and peanuts, try to avoid having out of the diet for a period of time as this can encourage IgEallergies to develop. It does not matter if a week passes without the allergen, but aiming for a few times in a month is a good idea.
Nip Allergies In. The Bub Website
The Nip Allergies in the Bub website (7) provides loads of information on introducing nuts, eggs, dairy, and wheat in your baby's diet and different forms of these foods depending on how how many months Bub is.
It also gives important information on allergy reaction symptoms if your baby does react to any foods, and what symptoms require medical attention.
The best thing for baby to help minimise risk of allergies developing is to introduce allergenic foods before turning one in an acceptable form and keep up in the diet 2-3 times per week.
REFERENCES
Du Toit et al. Randomized Trial of Peanut Consumption in Infants at Risk for Peanut Allergy. N Engl J Med 2015; 372:803-813DOI: 10.1056/NEJMoa1414850
Perkin M.R., Logan K., Tseng A., Raji B., Ayis S., Peacock J., et al. Randomized trial of introduction of allergenic foods in breast-fed infants. N Engl J Med. 2016;374:1733–1743. doi: 10.1056/NEJMoa1514210. [DOI] [PubMed] [Google Scholar]
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Perkin M.R., Logan K., Marrs T., Radulovic S., Craven J., Flohr C., et al. Enquiring About Tolerance (EAT) study: feasibility of an early allergenic food introduction regimen. J Allergy Clin Immunol. 2016;137:1477–1486.e8. doi: 10.1016/j.jaci.2015.12.1322. [DOI] [PMC free article] [PubMed] [Google Scholar]x
Boyle R.J., Ierodiakonou D., Khan T., Chivinge J., Robinson Z., Geoghegan N., et al. Hydrolysed formula and risk of allergic or autoimmune disease: systematic review and meta-analysis. BMJ. 2016;352:i974. doi: 10.1136/bmj.i974. [DOI] [PMC free article] [PubMed] [Google Scholar]
Natsume O, Kabashima S, Nakazato J, Yamamoto-Hanada K, Narita M, Kondo M, et al. Two-step egg introduction for prevention of egg allergy in high-risk infants with eczema (PETIT): a randomised, double-blind, placebo-controlled trial. Lancet. 2017;389:276–86.
Nip Allergies in the bud. Accessed from: https://preventallergies.org.au Accessed on: 16/9/18.
ASCIA Guidelines - infant feeding and allergy prevention. Accessed from: https://www.allergy.org.au/hp/papers/infant-feeding-and-allergy-prevention. Accessed on 21/2/25.
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