Learn when and how to introduce potential allergens to your baby, and what steps to take if your child develops a food allergy.

If it seems like every other tot you know is allergic to something, there’s a good reason. Though the exact cause remains unclear, researchers are sure about one thing: food allergies in children are on the rise.

Since allergies tend to run in families, if either you or your spouse — or both — have an allergy (including pollen, mold, or pets), your baby or toddler may have an elevated risk of developing allergies too.

Is it possible to reduce your child’s risk of developing a food allergy? How can you determine if your baby or toddler has a food allergy? And how should you treat an allergic reaction? Keep reading to find answers to these questions and more about food allergies in children.

What Causes Food Allergies in Babies and Toddlers?

Food allergies occur when a baby’s or toddler’s immune system mistakenly treats a specific food as a threat. This exaggerated immune response leads to an allergic reaction, which can range from mild to severe.

If your little one has skin, stomach, or breathing issues, a food allergy might be the culprit. Around 8 percent of children in the U.S. are affected by food allergies, according to a study published by the American Academy of Pediatrics (AAP) in its journal Pediatrics.

This is an increase from a decade ago when only about 5 percent of U.S. children had food allergies, as per a study by the Centers for Disease Control and Prevention (CDC).

What Are the Symptoms of Food Allergies in Babies and Toddlers?

Symptoms of food allergies in babies and toddlers are rarely subtle, and they often appear within minutes of eating the allergenic food. Signs of a food allergy typically emerge between 30 to 120 minutes (one to two hours) after exposure, although in rare cases, symptoms may develop after as long as four to six hours or even longer. Common symptoms include:

• Hives (red spots that look like mosquito bites)
• Itchy skin rashes (eczema)
• Itchy, watery, or swollen eyes
• Skin swelling
• Lip and/or tongue swelling
• Sneezing
• Wheezing
• Throat tightness
• Difficulty swallowing
• Nausea
• Vomiting
• Stomach pain
• Diarrhea

Severe symptoms — such as trouble breathing, lightheadedness, or loss of consciousness — are rare, but if you notice them, call 911 immediately.

High-Allergy Foods for Babies

While any food can trigger an allergic reaction in babies, toddlers, and children, some foods are more likely to cause issues. These eight foods are responsible for 90 percent of food allergies:

• Milk
• Eggs
• Peanuts
• Tree nuts (including almonds, Brazil nuts, cashews, chestnuts, filberts, hazelnuts, hickory nuts, pecans, pistachios, and walnuts)
• Soy
• Wheat
• Fish
• Shellfish (such as crab, lobster, and shrimp)

The most common high-allergy foods in a baby’s first year include cow’s milk, peanuts, and eggs. Certain foods, such as peanuts (which are actually legumes), tree nuts, and seafood, are more likely to cause severe allergic reactions.

Approximately 30 percent of children with peanut allergies are also allergic to tree nuts, so it’s a good idea to consult your pediatrician before introducing peanut butter or tree nuts to your baby’s diet.

Introducing Food Allergens to Your Baby

For a while, it was common advice to delay giving babies dairy foods until age 1, eggs until age 2, and seafood and nuts until ages 1 to 3. However, recent evidence suggests there’s no need to wait.

The AAP now recommends introducing foods like peanuts as early as 4 to 6 months to potentially prevent peanut allergies, especially in babies at high risk for allergies.

If your baby doesn’t have severe eczema or other food allergies (and is not considered at increased risk), you can start introducing foods like eggs, fish, and peanut-containing products after a few solid foods have already been tolerated without signs of an allergy.

When it’s time to introduce solid foods, begin with less allergenic solids (like fruits, vegetables, and infant cereal).

Each time you introduce a new, single-ingredient food, wait two to three days before introducing another one, and watch closely for potential allergic reactions such as diarrhea, rashes, or vomiting. If everything seems fine, you can gradually add more allergenic foods to your baby’s diet.

Always introduce new foods at home, not at daycare or a restaurant, and observe your baby for allergic reactions one to two hours after eating.

If your baby seems perfectly fine, you can rest easy. But if you notice any symptoms of a food allergy, call your pediatrician immediately. If the reaction is severe and life-threatening, such as difficulty breathing or passing out, dial 911 and seek medical care right away.

For safety, always ensure that allergenic foods are introduced in age-appropriate forms and sizes. For example, when introducing peanuts, use a thin layer of creamy peanut butter or a peanut puff snack. Avoid whole peanuts or chunky peanut butter, as these can pose a choking hazard.

One way to introduce peanut butter is to thin it out and mix it with yogurt or cereal, or spread it very thinly on bread. Whole peanuts should not be served to children until they’re about 4 years old, as this is when they can generally chew them safely.

If your baby has mild or moderate eczema, they may be at higher risk for peanut allergies, so it’s recommended that they try peanut products around 6 months old. Speak with your pediatrician before introducing these foods.

Testing for Peanut Allergy

For babies with severe eczema or egg allergies, peanut allergy testing may be recommended. It’s a good idea to discuss this with your doctor around the 2- or 4-month check-up, as the ideal time to introduce peanut products is by 6 months old.

How Is a Food Allergy Diagnosed in Babies and Toddlers?

If you suspect your baby or toddler has a food allergy, consult with your pediatrician.

If your doctor suspects a food allergy, they may refer you to a pediatric allergist. The allergist may recommend a blood test (to detect allergy antibodies) or a skin-prick test (where a small amount of the allergen is introduced to the skin to check for a reaction).

However, a positive test result doesn’t always mean there is a food allergy or indicate how severe a reaction may be. It may only suggest sensitivity to a particular food.

Food Allergy vs. Food Intolerance in Babies

How can you tell if your baby has a food allergy or a food intolerance? With food intolerance, your baby may experience gas or an upset tummy after consuming a larger amount of a certain food, like milk after the age of 12 months. But with a food allergy, even a small amount of the food can trigger a reaction that affects various parts of the body.

Food allergies are an immune system response, where the body attacks a substance (like food) that it mistakenly identifies as a threat. The immune system releases histamine, causing symptoms like swelling and itchiness.

Food intolerance, on the other hand, relates to the digestive system and occurs when the body lacks an enzyme to properly break down certain foods, leading to stomach upset, gas, or bloating.

The symptoms of food allergies and intolerances can overlap. If you’re unsure whether your child is allergic, a pediatric allergist can help with a proper diagnosis using blood or skin tests.

Can Kids Outgrow Food Allergies?

Will your child always be allergic to certain foods? Not necessarily. The majority of babies and toddlers with milk, egg, wheat, or soy allergies outgrow them by the time they’re 5 years old.

About 20 to 25 percent of children with peanut allergies, once thought to last a lifetime, outgrow them by around age 8. However, allergies to shellfish, fish, and tree nuts tend to persist into adulthood.

Never try to test if your child has outgrown an allergy on your own. Always consult your pediatrician or pediatric allergist, who can conduct a supervised feeding test to make the diagnosis.

How to Treat an Allergic Reaction in Babies and Toddlers

It’s nearly impossible to control everything your baby or toddler consumes. That’s why, if your child has a food allergy, check with your pediatrician about remedies and medications to keep on hand.

Your doctor may recommend children’s antihistamines (like Benadryl), although these are not suitable for children younger than 2 years old unless approved by your doctor.

For severe reactions, your pediatrician may prescribe an epinephrine auto-injector, a device that can reverse anaphylaxis by opening airways and increasing blood pressure. There are smaller epinephrine auto-injectors for babies and toddlers weighing between 16.5 to 33 pounds.

Always know where the injector is and how to use it. If you ever need to use it, take your child to the emergency room right away for follow-up care, as allergy symptoms can return.

Will My Baby Need Allergy Shots?

Here’s the good news: food allergies aren’t treated with allergy shots. These are reserved for environmental or seasonal allergies in children aged 5 and older.

The unfortunate news: the only way to manage food allergies is to avoid the foods that cause reactions. This means you’ll need to become an expert at ensuring your child avoids allergic foods, whether at home or when dining out.

Tips for Keeping a Baby or Toddler with Food Allergies Safe

Worried about navigating the challenges of being a parent to a child with food allergies? Here are some tips to make things smoother:

• Ensure all of your child’s caregivers are aware of their allergies, know how to identify symptoms of an allergic reaction, and understand what to do if your child is exposed to an allergen.
• Always have safe food on hand, especially when you’re out and about.
• Become a pro at reading food labels, as milk, eggs, and other common allergens are often listed under different names.
• Consider consulting with a registered dietitian to help you create safe and nutritious meals for your child.

Having a child with food allergies can be overwhelming. As a parent, the key is preparation: recognize the signs of an allergic reaction, manage your child’s allergies carefully, and know when to use epinephrine and call for medical help.