From the introduction of solids until three years of age the most common allergenic foods are: cow’s milk, egg, wheat, soy, peanuts, tree nuts, sesame, fish and shellfish.
The latest advice in Australia is to not delay the introduction of these allergenic foods, and introduce these common allergy causing foods, in a safe form and one at a time, before your child is 1 year old. Once introduced, these foods should be regularly included in their diet.
Cow’s milk protein allergy is quite common, particularly in young infants. Cow’s milk protein may be found in infant formula, small amounts in breast milk from the mother’s diet, and dairy foods. Advice from an allergist or allergy dietitian will be required if your baby is diagnosed with a cow’s milk allergy. It’s also important to note that an allergy to cow’s milk is different to lactose intolerance. You can read more on lactose intolerance here.
It is recommended to introduce cooked egg to a baby’s diet before 12 months of age (scrambled or hard boiled are great options!). If your child is diagnosed with an egg allergy they will need to avoid egg, so get ready to become an expert in food labels! Many food products sold in Australia are manufactured using ingredients containing eggs, which means you need to read the label and list of ingredients carefully. A dietitian can help teach you the best way to read the food label. When starting your baby on solids, always introduce cooked egg (i.e., scrambled or hard boiled are great options!)
An allergy to the proteins in wheat, which may include ‘gluten’, is another common allergic food in Australia. As soon as a wheat allergy is diagnosed, all products derived from wheat must be eliminated from the diet. Lists of foods containing wheat can be found on reputable sites such as Allergy & Anaphylaxis Australia. Until a diagnosis is made it is recommended gluten be introduced from six months even if there is a family history of allergy. If introduced in conjunction with breastfeeding, your baby may be less likely to develop an allergy or intolerance to gluten.
Soy comes from soybeans. While soy is one of the more common food allergens, it’s not as common as some of the others in this list such as cow’s milk and peanut. Like all food allergies, the primary management is to eliminate it from the diet. Soy can be an obvious ingredient, for example in Soy sauce, or a less obvious ingredient, for example as a vegetable protein source. On a positive note, most children grow out of their soy allergy by the time they reach school age.
Peanut allergy is one of the more common allergies in this list of foods, and only about 20% of children grow out of it. When your doctor diagnoses your child’s peanut allergy, they will also be able to guide your management plan. Like eggs and gluten, peanuts are present in many processed food products not necessarily designed for children. Learning how to read the label to determine if it contains (or may contain) peanuts, and then subsequently avoiding the product, will be key.
Tree nuts are a different plant type to peanuts, they include a variety of different nuts including almonds, walnuts, cashews, macadamia, pine nuts and pistachios, pecans, brazil nut and hazelnut. If your baby has been diagnosed with an allergy to one nut, there may be some cross over with other nuts and you will need to avoid those too. Nuts show up in foods in different formats, as whole nuts, pastes, flours and even oils, so read the ingredients list carefully.
Sesame allergy occurs when your body reacts unnecessarily to what should be a harmless protein. While most children with an allergy to sesame don’t grow out of it, the prevalence is quite low in comparison to the other foods listed in this article. Like all food allergies, avoidance of this food is essential once your baby has been diagnosed. When traveling or eating out, avoid sharing food and utensils with others. Having a backup snack ready in case you can’t find something will help.
A fish allergy is more commonly life-long and occurs in adulthood as opposed to childhood. If your baby is allergic to fish, there is sometimes a cross-over with crustaceans, but not always. Interestingly, there is also some cross-over with crocodile as they have similar proteins to fish. Your doctor will guide you regarding which fish to stay clear of.
Shellfish are split into two groups – molluscs (e.g. oysters, squid and scallops), and crustaceans (e.g. crab, lobster and prawns). If your baby reacts to one crustacean, they are more likely to react to another. With fish and shellfish, there is often cross-contamination due to where it’s sold and stored.
Read more on allergy symptoms here.
For all these common food allergens, the “Allergy & Anaphylaxis Australia” website (allergyfacts.org.au) is a brilliant source of guidance and contains more detailed information.