HomeEarly introduction of allergens: Recommendations from the Canadian Paediatric Society and the Canadian Society of Allergy and Clinical Immunology

Early introduction of allergens: Recommendations from the Canadian Paediatric Society and the Canadian Society of Allergy and Clinical Immunology

January 24, 2019

Updated as of April 2022

In 2019, the Canadian Paediatric Society (CPS) released recommendations on the timing of early introduction of allergenic foods for high-risk infants. This specific timing is reinforced, along with other recommendations, in the position statement co-published by CPS and the Canadian Society of Allergy and Clinical Immunology (CSACI) in 2021. Here’s what you need to know:

  • The guidance is to actively offer non-choking forms of foods containing common allergens (e.g. peanuts, egg) around 6 months of age, but not before 4 months, as this can be effective in preventing food allergy in some high-risk infants. This is a shift from CPS’ prior guidance which said that there was no need to delay the introduction of common allergenic foods beyond 6 months of age. To learn more, visit our early introduction page where you’ll find an overview of the recommendations, webinars with leading allergists, parent resources, like our “Eat Early. Eat Often.” mini-booklet, and more.
  • The CPS recommendations follow the Addendum Guidelines for the Prevention of Peanut Allergy, released in 2017.

As always, we recommend you consult with your physician to inquire further about early introduction of allergenic foods.

Positive step forward: Highlights the need for continued education and greater healthcare support

CPS’ and CSACI’s updated recommendations are a great step forward in providing consistent guidance to families around how they can potentially help prevent food allergy in their children. Having consistent guidance used by all healthcare providers is essential to ensuring patients have access to the best medical advice and potential interventions for their children, especially if it means preventing a life-threatening food allergy.

However, there is still a significant amount of education and public healthcare support required to shift the mindset in adopting these recommendations in both parents and healthcare professionals.

  • A recent U.S. survey of new or expecting caregivers of infants younger than 1 year of age found that only 31% were willing to introduce peanut before or around 6 months of age.1 Another survey to Canadian healthcare professionals found that a significant portion of family physicians recommended introduction of allergenic solids at age 1 year or more.2 These examples illustrate the need for increased education.
  • To help reassure and guide parents through early introduction, we also require a public healthcare system that can support executing these recommendations. For instance, having a system that can identify and triage high-risk infants across all levels of healthcare, so they are given priority access to medical professionals and have the best chance possible of preventing this medical condition.

We are committed in our advocacy with Health Canada and the healthcare sector to recognize that food allergy is a public health concern, and to make food allergy a public health priority. It’s only with greater support and resources that prevention and other interventions can be properly and effectively addressed.

We will continue to keep you updated on our advocacy efforts in this area and others.

1 Greenhawt M, Chan ES, Fleischer DM, Hicks A, Wilson R, Shaker M, Venter C, Stukus D. Caregiver and expecting caregiver support for early peanut introduction guidelines. Ann Allergy Asthma Immunol. 2018;120(6):620–5.
2 Abrams EM, Singer AG, Soller L, Chan ES. Knowledge gaps and barriers to early peanut introduction among allergists, pediatricians, and family physicians. The Journal of Allergy and Clinical Immunology: In Practice 2019;7(2):681-684.
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