Food Allergies in Infants & Toddlers—Nothing to Sneeze at  

As you begin moving your child to solid foods, you might notice an unusual reaction within minutes. Although it shouldn’t be ignored, an allergic reaction to food is not uncommon. It’s estimated that 1 in every 13 children in the United States has food allergies.^1,2 So, be alert when introducing new foods to your child, and look for the allergy symptoms noted below. 

Many foods can trigger an allergic reaction, and symptoms of food allergy vary among children. Some food allergies will go away as a baby grows older and some could be lifelong. If you suspect that your child may be experiencing symptoms of a food allergy, speak to your child’s healthcare professional.

Although many concerned parents avoid giving their babies foods with potential allergens until late infancy or toddlerhood, this may not be the best idea. . For example, there is evidence that delaying the introduction of egg and/or peanuts does not reduce the incidence of food allergies but may possibly increase them—particularly in high-risk infants.^3,4 That’s why experts generally recommend not delaying the introduction of any food category. Consult with your pediatrician for specific recommendations for your child.

Most parents love when their babies fall in love with fruits. But sometimes fresh fruits can trigger a reaction that may seem alarming at first glance. However, most of the time it’s nothing to worry about. 

Take the strawberry, for example. Fresh strawberries may cause some children to develop a rash around their mouth. Most of the time this rash is an “irritation” reaction and not due to pollen-food allergy syndrome. It can happen with other fresh fruits and berries, too.

Pollen-food allergy syndrome (PFAS), previously called oral allergy syndrome, is a type of food allergy that occurs because certain proteins in fruits and vegetables are very similar to proteins found in pollens. If your child has shown to have seasonal allergies to pollen, their immune system may mistake certain foods for that pollen, so when they eat the food, their body thinks it is seeing the pollen allergy and can react.

Symptoms usually happen within minutes of eating the food and are typically limited to the mouth and throat: itchy mouth or lips, tingling of the tongue, mild swelling of the lips, mouth, throat, scratchy throat. For most children, symptoms are mild and go away quickly, and many children can tolerate the food when it is cooked. However, a small number of children can experience more significant reactions; if these happen, they should receive emergency medical care immediately.

If you suspect pollen-food allergy syndrome, contact your child's doctor.

Allergic reactions to foods may appear within a few minutes to several hours or even days after eating, and symptoms can take many forms. Typical food allergy symptoms in infants include: 

• Skin rash, flushed skin, or hives 
• Blood and/or mucus in the stool 
• Runny nose or sneezing 
• Swelling of the face, tongue, or lips 
• Excessive spit-up, vomiting, or diarrhea   

If you see an unusual reaction in your baby when you add a new food, call your healthcare professional. If your baby is having difficulty breathing or loses consciousness, call 911 immediately.   

Visit the Tummy Trouble Tool to troubleshoot a feeding issue.   

• When you introduce a new food to your baby, start with simple, single-ingredient foods and introduce just one new food at a time. Wait at least a day before trying another new food. This way, a reaction to a specific food can be easier to identify, and you can discuss it with your baby’s doctor.
• Begin with a small taste, then gradually offer more if your baby wants. If your baby eats the food without problems, continue offering it regularly as part of their usual diet, as regular exposure may help maintain tolerance to food.
• Keeping a food journal of successfully introduced foods and ones that caused minor reactions can help you accurately communicate with your child’s pediatrician.
• If you think your baby is allergic to a food you have fed them, contact your baby’s healthcare provider. 

Remember that most infants do not develop food allergies. Infants who are allergic to cow’s milk, wheat, soy, and eggs may eventually develop a tolerance, though very few infants grow out of peanut allergies. Current evidence supports introducing complementary foods around 6 months.

Peanut and egg should be introduced around 6 months (not before 4 months), and be offered regularly as part of a diverse diet, because diet diversity may help support food allergy prevention.³

Seek guidance from your child’s healthcare provider to determine an appropriate plan for the introduction of peanut products.

Babies should not be given whole peanuts due to the risk of choking. Be sure to use infant-safe forms of peanut such as thinned peanut butter or peanut powder mixed in age-appropriate foods. 

Peanut allergy tends to begin early in life and persist through adulthood. Allergic reactions to peanuts can range from mild to severe and even life-threatening. To avoid these reactions, people with peanut allergy must be vigilant about the foods they eat and the environments they enter.

National Institute of Allergy and Infectious Diseases Addendum Guidelines for the Prevention of Peanut Allergy in  the United States.

Here’s a helpful resource on peanut allergy prevention(PDF, 0.25 MB) from the National Institute of Allergy and Infectious Diseases (NIAID).

Call your healthcare professional if your baby: 

• May have had an allergic reaction to a food, even if the symptoms are mild
• Is crying excessively and you have ruled out hunger, wet diaper, exhaustion, being overly warm or cool, or external pain 
• Is younger than 2 months old and has a rectal temperature higher than 100.4°F 
• Refuses food for longer than is normal for them

Listen to your instincts and talk to your child’s healthcare professional about any food allergy concerns.

References: 1. Allergy facts. Asthma and Allergy Foundation of America website.
https://aafa.org/allergies/allergy-facts/#:~:text=In%202021%2C%20approximately%2081%20million,(14%20million)%20of%20children.&text=Seasonal%20allergic%20rhinitis%20is%20an,trees%2C%20grasses%2C%20and%20weeds  2. Allergies. Centers for Disease Control and Prevention website. https://www.cdc.gov/nchs/fastats/allergies.htm 3. Soriano VX, et al. Pediatrics. 2023;151(2):e2022058380. 4. Venter C, et al. Prevention of food allergies. In: Health Professional's Guide to Nutrition Management of Food Allergies. Venter C, Groetch Marion editors. Academy of Nutrition and Dietetics 2023:204-243.