Allergen Introduction — Including Peanut Risk Groups

THE NINE MAJOR ALLERGENS — INTRODUCE EARLY, ONE AT A TIME, THEN KEEP IN THE DIET

Milk (dairy), egg, peanut, tree nuts, soy, wheat, fish, shellfish, and sesame. Introduce one new allergen at a time, early in the day, in a small amount, with several days before the next, so any reaction is easy to trace. Once tolerated, keep it in the diet regularly — dropping it can undo the protection. For a baby at high risk (severe eczema or existing egg allergy), talk with the pediatrician about how and when to introduce peanut.

CRITICAL — HOW TO INTRODUCE PEANUT SAFELY

Infants do NOT eat whole peanuts, chunks of peanut, or sticky globs of peanut butter. Safe forms include thinned smooth peanut butter (mixed with breast milk, formula, water, or another familiar food into a thin slurry), peanut puffs that dissolve in saliva, or pureed peanut soup. Whole peanuts and chunks are choking hazards and remain so until age 4.

Introduce one new allergenic food at a time. Wait 3–5 days before introducing another new allergen. Watch for a reaction (hives, swelling, vomiting, breathing difficulty) for two hours after each feeding.

A severe allergic reaction to a food introduction — hives, swelling, vomiting, breathing difficulty — is a medical emergency. See Unit 3, Lesson 3.4, for anaphylaxis recognition and response.

Risk-group table (NIAID 2017): Volume 1, Unit 4, Lesson 4.2. High-risk infants follow the clinician’s individualized plan.