Preventing Food Allergies

In the last 10 years, there has been a great deal of research to help us understanding how to prevent food allergies in children. The data from the pediatric allergy community are clear: introducing peanuts and eggs "early and often" decreases the risk of developing these food allergies.

Special Considerations

  • Three situations should prompt a discussion with your pediatrician before introducing highly allergenic foods at 4-6 months of life:
    1. Your child has a history of moderate or severe eczema.
    2. Your child developed an allergic reaction to something present in the breast milk or formula.
    3. Your child has a first-degree relative (Mom, Dad, brother, sister) with a severe food allergy.
  • If your child falls into one or more of these categories, be sure to let us know right away.
    • This allows us to determine a safe plan for early introduction to prevent food allergies.


  • Introduce peanut butter and eggs between 4-6 months of life.
  • Breastfed babies:
    • For breastfed babies, we typically introduce solid foods closer to 6 months of life.
      • This encourages as many calories from breastmilk for as long as possible.
    • When you introduce solids, make peanut butter and eggs two of your baby's first foods.
  • Formula-fed babies:
    • We typically introduce solid foods closer to 4 months of life.
    • When you introduce solids, make peanut butter and eggs two of your baby's first foods.


  • Giving peanut butter and eggs at least two times per week makes sure the body never forgets that these foods are safe.
  • Once you introduce an allergenic food to your baby's diet, it's very important you continue giving that food often.
    • At least two times every week.
    • More than twice per week is even better.
  • "Often" is the part many families forget.
    • When we ask you how the allergy foods are going at the 6 or 9 month visit, we want you to say "great, we're doing peanut butter and eggs, and haven't had any problems."
      • Too often we hear "great, we did peanut butter and eggs, and we didn't have any problems."

How To Administer Peanut Butter and Eggs

  • Peanut butter
    • Mix 2-3 baby spoonfuls of peanut butter with baby oat cereal.
    • Give this to your baby at least two times per week.
  • Eggs
    • Soft scramble some eggs (include the egg white and yolk) and puree them in a blender.
      • Start with enough eggs to provide for the whole week, and put the remainder in the refrigerator after you give them to baby.
    • Give 2-3 baby spoonfuls of the egg puree at least two times per week.

Recognizing an Allergic Reaction

  • Keep Children's Benadryl (diphenhydramine) on hand, in case you need it.
    • Introducing these foods at 4-6 months makes a dangerous allergic reaction very unlikely.
      • The body hasn't had a chance to develop a severe allergy yet.
  • Allergic reactions to foods always occur within 2 hours of ingestion.
    • Usually much sooner (5-10 minutes after ingestion).
  • Signs of a mild allergic reaction include:
    • Blotchy, red skin on the face, neck, chest, or around the mouth.
    • An urticarial (hives) rash may also occur.
      • Hives look like small mosquito bites, and are usually itchy.
        • Unlike mosquito bites, they move from place to place within the same area of the body.
    • If you notice blotchy/red skin and/or hives within 2 hours of eating peanut butter or eggs, do the following:
      1. Take a picture of the rash right immediately (these rashes tend to go away quickly after the occur).
      2. Send that picture to us via the Spruce App, so we can review right away.
  • Signs of a dangerous allergic reaction include:
    • Respiratory distress/wheezing.
    • Vomiting, followed by weakness, being very tired, and sometimes pale skin.
      • This is different than normal spit up, gagging on new textures, or even vomiting from a stomach bug.
        • Children feel better after vomiting from these common causes.
    • Severe diarrhea, followed by weakness, being very tired, and sometimes pale skin.
    • If your child has eaten an allergenic food in the last 2 hours and develops respiratory distress, vomiting with weakness, or diarrhea with weakness, please contact us immediately.

Other Allergenic Foods

  • Currently, the most convincing allergy prevention research exists for peanuts and eggs.
    • This is why we focus on introducing these two foods "early and often."
    • As more research comes out, the recommendations may expand to include other common allergy foods.
  • If any first-degree relatives (Mom, Dad, sisters, brothers) have a personal history of severe allergies to other foods, please let us know right away.
    • This allows us to determine a safe plan for early introduction to prevent allergies to these foods.

What About Allergy Powder Products?

  • Several commercial products claim to prevent food allergies by introducing all the allergenic foods at the same time in powder or puff form.
    • The most common example is SpoonfulOne, but there are others popping up all the time.
  • At this time, we do not recommend these products as substitutes for "early and often" introduction of peanut and egg in the manner described above.
    • These products contain much smaller amounts of the allergenic proteins compared to those used in the original scientific studies.