This information aims to provide practical advice to parents and carers about how to introduce solid foods to babies, based on currently available evidence for food allergy prevention. Whilst this advice can be used for all babies, it is most relevant to those with a parent or sibling with allergies, or babies with severe eczema and/or existing food allergy.
- When introducing foods to your baby include those which may cause an allergy within the first 12 months of life. Studies show that this may reduce the chance of your baby developing a food allergy.
- Start to introduce solid foods around 6 months, but not before 4 months, when your baby is ready.
- If possible continue to breastfeed your baby while you are introducing solid foods.
- Include cow’s milk, egg, peanut, tree nuts, soy, sesame, wheat, fish and other seafood.
- Once introduced, continue to regularly include these foods in your baby’s diet.
- This advice is based on evidence, including research in babies with severe eczema and egg allergy.
- Unfortunately, some babies may still develop a food allergy despite following this guide.
- If your baby has an allergic reaction, stop giving that food and seek medical advice.
How do I know if my baby is ready to start solid foods?
When your baby is ready, at around 6 months, but not before 4 months, start to introduce a variety of solid foods, starting with iron rich foods, while continuing breastfeeding.
Signs that your baby is ready to start eating solid foods include when your baby:
- has good head and neck control and can sit upright when supported;
- shows an interest in food, for example, when they look at food on your plate;
- reaches out for your food;
- opens their mouth when offered food on a spoon.
These signs happen at different times for different babies. If your baby is not eating solid foods by 7 months of age, discuss this with your child health nurse, doctor or dietitian.
Learning to eat
- Learning to eat takes time, so be patient with your baby.
- Offer your baby foods that are the right texture for their developmental stage. For example, babies should move from smooth foods (pureed or mashed) to finger foods (8-9 months) and cut up foods by 12 months.
- Aim for your baby to be eating healthy family meals by 12 months of age where possible.
- Babies with food allergies may take longer to get used to eating new foods and new textures of foods.
- If your baby does not seem interested in eating or trying new foods, wait a few days and try again.
- If your baby is having feeding problems discuss this with your child health nurse, doctor or dietitian.
- There is no particular order in which to introduce solid foods. However, iron rich foods need to be included around 6 months but not before 4 months. Iron rich foods include iron enriched (fortified) cereals, meats, poultry, fish, cooked egg and legumes (such as chick peas).
- Introduce foods one at a time, around 1 or 2 days apart so that you can identify if any foods cause a reaction. Allergic reactions usually occur quickly, within minutes (although they can take up to 2 hours), whilst other reactions to foods may be delayed. It is important to note than minor redness around the mouth is most often due to irritation, and is not usually due to an allergic reaction.
- If a food causes an allergic reaction, stop feeding your baby that food and seek medical advice.
- If there are symptoms of a severe allergic reaction (anaphylaxis) call an ambulance immediately.
- Aim to offer your baby a variety of foods from each food group, including:
- Cereal foods such as bread, crackers, pasta, iron fortified cereals. Offer a variety of grains including wheat, rice, oats, corn.
- Dairy foods such as yoghurt, cheese, cow’s milk on cereal. Cow’s milk should not be given instead of breastmilk or infant formula for babies under 12 months.
- Meat and alternatives such as beef, lamb, poultry, cooked egg, fish, other seafood, legumes, nut butters/pastes, soy (tofu or flour).
- Fruits and vegetables (see advice below on how to feed hard fruits and vegetables to your baby).
- Babies need to learn to eat a variety of foods from each food group so they receive adequate amounts of important nutrients including iron, zinc, fat, protein, vitamins and essential minerals such as calcium. It is therefore important to continue to regularly give foods that you have introduced to your baby so that they are eating a wide variety of foods by 12 months.
Introducing egg and peanut
- All babies should be given foods that may cause a food allergy, including peanut, in an age appropriate form in the first 12 months, such as smooth peanut butter/paste, cooked egg, dairy and wheat products. This includes babies with severe eczema, babies with another food allergy or babies who have a first degree relative with food allergy, even though they may have a higher chance of developing food allergy.
- Babies who are already allergic to a particular food should not be given that food.
- Parents are sometimes worried about giving egg and peanut to their babies, as they commonly cause food allergies. However, it is best to offer your baby cooked egg and smooth peanut butter/paste regularly, starting before 12 months of age, as delayed introduction has been shown to increase the chance of developing food allergy.
- Introduce cooked egg and peanut during day time so that you can watch your baby and easily respond if they have an allergic reaction.
- Introduce well cooked egg and smooth peanut butter/paste in small amounts to start with. For example, mix a small amount (¼ teaspoon) of hard-boiled egg or peanut butter/paste into your baby’s usual food (such as vegetable puree), and gradually increase the amount the next time if your baby is not having any allergic reactions, for example ½ teaspoon the next time.
- Never smear or rub food on your baby’s skin, especially if they have eczema, as this will not help to identify possible food allergies.
- You can rub a small amount of the food inside your baby’s lip as a starting point. If there is no allergic reaction after a few minutes, you can start giving small amounts of the food as described above.
- If you notice any swelling of the lips, eyes or face, hives or welts, vomiting, or any change in your baby’s well-being (becoming very unsettled) soon after giving a new food, your baby could be having an allergic reaction, so you should stop feeding your baby that food and seek medical advice.
- If there are symptoms of anaphylaxis (difficult/noisy breathing, pale and floppy, swollen tongue) call an ambulance immediately.
- Information about the signs and symptoms of mild to moderate and severe allergic reactions (anaphylaxis) is on the ASCIA website: www.allergy.org.au/patients/about-allergy/anaphylaxis
Do not give hard pieces of food
- Prevent babies from choking on food by grating, cooking, pureeing or mashing hard fruits or vegetables.
- Do not give babies foods with small hard pieces such as raw apple or carrot, whole or chopped nuts.
- Use nut flours, pastes or smooth butters/pastes when introducing nuts to babies.
- Suitable finger foods for babies include steamed vegetables, roasted vegetable wedges, strips of meat, fish or chicken, bread or toast and crackers, soft fruits.
- Always supervise babies and young children and ensure they are seated while they are eating.
- Breast milk or formula will continue to provide important nutrients once your baby is eating solid foods.
- As your baby eats more solid foods they will need less milk and will demand fewer feeds.
- Take care not to replace milk feeds too quickly with solid foods.
- Water, breast milk, cow’s milk based formula or other infant formula can be offered from a cup from 8 months.
What should I do if my baby already has food allergies?
- Make sure you have appropriate medical advice so that you have an accurate diagnosis and management plan. It is recommended that babies with cow’s milk, wheat or multiple food allergies are also seen by a dietitian for individual assessment and advice.
- If your baby already has food allergies, it is important to replace that food with nutritionally equivalent foods. For example:
- If your baby is allergic to wheat then wheat alternatives such as white or brown rice, corn, quinoa should be included in their diet.
- Babies who are allergic to cow’s milk should continue to be breastfed, or given an appropriate cow’s milk free baby formula in their diet.
What should I do if other members of the family have food allergies?
If other members of the family have food allergies, it is still important to introduce that food to your baby whilst keeping the family member safe. To keep the family member with food allergies safe, you can:
- Give the food to your baby whilst they are in a high chair.
- Wash your and your baby’s hands and baby’s face after giving the food.
- Thoroughly wash all utensils that have been in contact with the allergenic food in warm soapy water.
- Give the food when the food allergic family member is not at home.
- Discuss how to introduce a sibling’s or parent’s allergen to your baby with your dietitian and/or a patient support organisation (Allergy & Anaphylaxis Australia or Allergy New Zealand).
ASCIA guidelines for infant feeding and allergy prevention - www.allergy.org.au/patients/allergy-prevention
ASCIA food allergy information - www.allergy.org.au/patients/food-allergy
Allergy & Anaphylaxis Australia - phone 1300 728 000 or visit www.allergyfacts.org.au
Allergy New Zealand - phone 0800 34 0800 or visit www.allergy.org.nz
© ASCIA 2017
ASCIA is the peak professional body of clinical immunology/allergy specialists in Australia and New Zealand
Postal address: PO Box 450 Balgowlah NSW 2093 Australia
This document has been developed and peer reviewed by ASCIA members and is based on expert opinion and the available published literature at the time of review. Information contained in this document is not intended to replace medical advice and any questions regarding a medical diagnosis or treatment should be directed to a medical practitioner. Development of this document is not funded by any commercial sources and is not influenced by commercial organisations.
Content updated 2017