When do I start eggs, nuts and the other allergens?

Starting the common allergens early, around six months, is better than waiting.

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Handing her an egg or a peanut for the first time is frightening, especially when the family says to wait till she is one. But the advice has changed. Waiting does not protect her from a peanut or egg allergy, and starting early in a small, watched way is safer.

1What an allergy actually is

A food allergy is her immune system reacting to a harmless food protein. A rash, tummy upset, or loose motion that has nothing to do with a food is a different thing. Most babies who try a top allergen have no reaction at all. Food allergies are not common in Indian children. There are nine common ones: egg, peanut, tree nuts, cow's milk, fish, shellfish, soya, wheat and sesame. Every food page flags them, so there is nothing to memorise.

2Why starting early helps her

A major study of peanut found that babies who started it early were far less likely to develop a peanut allergy. Studies of egg showed the same protection. That is why the advice changed. Waiting does not protect her.

3The one calm pattern to follow

For a new allergen's first taste, pick a calm daytime slot at home, never her last feed before bed.

Mix just a small taste into a food she already takes well. Thinned peanut butter stirred into her banana works nicely.

Watch her for a few hours afterwards, then leave a few days before you try the next new allergen.

Once a new allergen has agreed with her, keep offering it about once a week, since regular exposure keeps her used to it.

Never try two new allergens in the same sitting, and never wait it out at home if she shows a severe sign, below.

If she has severe eczema that keeps coming back, or has had a quick reaction to a food, it is worth checking with her paediatrician before you start.

4Myths around starting egg, nuts and other allergens

Nuts and the other allergens do not need to wait until after her first birthday.

The worry is that nuts are heavy to digest, but digestion and allergy are different things. The IAP simply lists nuts among the ordinary foods to offer, with no wait attached. Offer them finely ground and watched, with the method on the almond page.

Egg, peanut and the other allergens are not 'heaty' foods to avoid.

You will not find 'heaty' in any doctor's advice, so there is no reason to hold these foods back. If someone at home still worries, you can simply give these foods earlier in the day.

The whole egg, both yolk and white, fully cooked, is fine from six months.

Holding the white back does not lower her risk, and it may even raise it, so there is no reason to keep them apart. You may still hear the old yolk-first advice, and it has changed.

Good to know: Most reactions show up quickly, within minutes or several hours of that first taste.

5 Questions moms ask

What about that forwarded list of foods to avoid?

Those long forwarded lists usually name more foods than a doctor actually flags, and they rarely tell you what to do about any of them. Every food that can cause an allergy is already marked on its page here, and the page shows you how to start it.

Can I give her milk and egg together?

Yes, you can. The worry about mixing milk and egg is an old belief about digestion, and it is one you can set aside. Once each is settled in on its own, milk foods like curd or paneer can share a meal with egg.

If she does react, is it forever?

Most egg, milk, wheat and soya allergies fade by around age five. Peanut and tree-nut allergies often do not. Only about a fifth of peanut allergies and a tenth of tree-nut allergies go away on their own. Either way, a real reaction is one to talk through with her paediatrician rather than guess at home.

Someone at home says wait till she is one for eggs and nuts. What do I say?

This comes from real care, and many of us grew up hearing the very same thing. You can say gently that the doctor told us starting early is safer now, so we are giving a tiny bit at a time and watching her.

6If she has a bad reaction

A few isolated hives, mild itching, or being sick once after a new food means you stop that food and call her doctor. Trouble breathing, swelling of her lips, face or tongue, or hives spreading across her body means calling for help right away.

Call for emergency help straight away. Do not wait to see if it settles on its own.

Never wait it out at home once you see a severe sign, and never give the food again just to check if it happens twice.

Call 112 or 108

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Written by Anu · a mom of one.

Sources: AAP, ICMR-NIN, WHO, NHS and IAP ›

Educational only, and never a replacement for your paediatrician. Read the full note ›