Can we prevent food allergies in young children?

While there is no miracle cure to prevent food allergies, it’s a good idea to introduce common food allergens frequently when starting solids, especially in infants with eczema or other food allergies

Jun 27, 2025

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Can we prevent food allergies in young children?

While there is no miracle cure to prevent food allergies, it’s a good idea to introduce common food allergens like nuts and eggs frequently when starting solids, especially in infants with eczema or who have other food allergies. Every baby is different, so check with your pediatric clinician or lactation consultant to be sure your baby is ready.

If it seems like more “kids these days” suffer from food allergy, you’re absolutely right. According to one study, emergency room visits due to severe food allergy increased significantly from 2005 to 2014 (see image). Food allergy can range from a mild reaction, like an itchy mouth or small rash, to vomiting, to life-threatening difficulty breathing and need for life-saving adrenaline (epinephrine).

Image: Motosue, et al (2018). National trends in emergency department visits and hospitalizations for food-induced anaphylaxis in US children.

By 2014, US emergency rooms saw 3 times as many children with a severe reaction to peanuts and 4 times as many with a severe reaction to tree nuts, when compared to rates in 2005.

In 1997, the American Academy of Pediatrics (AAP) recommended parents wait until at least age 2 to introduce common food allergens. The thinking was that avoiding early exposure to these foods would prevent the development of allergies. With more information and studies, we now know that delaying introducing common allergens doesn’t prevent allergies.

Does avoiding common allergy-causing foods lead to more allergies?

Food allergies are likely caused by multiple factors, including both genetics and environment. We don’t know all the causes, but one theory is that children become sensitive to these foods from exposure to their skin without another exposure through the mouth and digestive system during the same time period. There are no studies in humans to date, but mouse studies support this model.

This theory is supported by the high rate of food allergies (~20-30%) in children with eczema (atopic dermatitis). Because their skin is often dry and cracked, even with careful skin care, they are more at risk of skin-based exposure to allergens.

What evidence do we have to support early introduction of highly allergenic foods?

Peanuts:

The LEAP study was a randomized controlled trial (RCT) of 640 infants. The authors found that early introduction of peanuts led to a big drop in peanut allergy among children at high risk (those with severe eczema, egg allergy, or both) compared to children who did not have early exposure to peanuts. After this study in 2015, the AAP reversed their recommendation and since then continues to support early exposure. A follow-up of the study participants in 2024 found that these children continued to be either less likely (early introduction group) or more likely (avoidance group) to have peanut allergy at 12 years of age.

Another RCT in 2016 found a group assigned to early introduction of peanuts had fewer food allergies later in life.

Eggs:

Six RCTs showed decreased risk of egg allergy with early introduction, with some studies showing the biggest benefit for babies at high risk of developing allergy (1st degree relative with food allergy, eczema).

Soy, Wheat, Tree Nuts, Sesame, Fish, Shellfish:

There are no RCTs to support early introduction of foods other than peanuts and eggs and there is not enough evidence to support any benefit, but there also does not appear to be any harm in including these ingredients.

What if my child has eczema or already has one food allergy?

Many international allergy and immunology groups agree that early introduction is more important for these children since they are more at risk for food allergy and multiple food allergies, and likely receive the biggest benefit.

For babies at high risk, a pediatric allergist can provide support and lay out next steps if any reactions occur. They can also perform blood or skin tests, or even in-office food challenges.

So you want me to give a baby peanuts?

For infants, it’s not a good idea to give whole peanuts or even peanut butter because they can choke. Some baby-friendly options include peanut powder, peanut “puffs”, or simply watered-down smooth peanut butter. Powder and butter can be given in water, yogurt, or blended into oats or infant rice cereal.

This is not intended to replace calories, just to give a small taste frequently. Introduction of these foods should happen after introducing at least one fruit or vegetable. The allergen should be given frequently; every other day or at least once a week. Babies who had early introduction without frequent exposure could be at risk for more allergies.

A child must be developmentally ready to feed: able to sit, has head and neck control, brings objects to the mouth, and no longer pushes food out with their tongue. For babies fed with human milk, experts recommend waiting until at least 6 months to introduce solids, while formula fed babies could start as early as 4 months. Every baby is different, so check with your pediatric clinician or lactation consultant to be sure your baby is ready!

I still have questions. What should I do?

Check out the links below for further information and always reach out to your pediatric clinician or pediatric allergy specialist to help guide you through the process.

Happy feeding!

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