Early introduction

Recommendations for the introduction of common allergens to infants has changed over the last few years as research has emerged on ways to help prevent the development of food allergy in babies.

Asian baby boy eating blend food on a high chair

Helping to prevent the development of food allergy in infants

Recommendations for the introduction of common allergens to infants has changed over the last few years as research has emerged on ways to help prevent the development of food allergy in babies.

  • In 2019, the Canadian Paediatric Society (CPS) released updated recommendations on the specific timing of early introduction of allergenic foods for high-risk infants. The new 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.
  • In 2017, guidelines were released in the U.S. by the National Institute of Allergy and Infectious Diseases (NIAID) on prevention of peanut allergy. The guidelines are based on the groundbreaking LEAP Study, recommended introducing peanut to high-risk infants around 4-6 months of age to help prevent the development of peanut allergy.

This represents a dramatic shift from previous advice to parents and caregivers regarding the introduction of common allergens in a child’s diet.

Infants who are not considered high risk should start to receive complementary foods when they are around 6 months of age and show signs of developmental readiness.

Please scroll below for information on the introduction of allergenic foods to babies. You will find recorded webinars for parents and healthcare professionals, a frequently asked questions document for parents, and other resources for families and healthcare professionals.

Healthcare professionals:

Visit our section created exclusively for you. You’ll find patient information sheets on food allergy-related topics, additional medically-reviewed materials, and more.


Canadian Paediatric Society’s updated guidance on the early introduction of allergens to babies

In 2019, the Canadian Paediatric Society (CPS) released updated recommendations on the specific timing of early introduction of allergenic foods for high-risk infants. These recommendations provide consistent guidance to families around how they can potentially help prevent food allergy in their children.

For parents: Recorded webinar on the updated guidance on the early introduction of allergens

We hosted a webinar in April 2019 on the CPS’ updated recommendations on the early introduction of allergenic foods for high-risk infants.

The webinar was presented by Canadian paediatric allergist Dr. Elissa Abrams who is an Assistant Professor in the Department of Paediatrics, Section of Allergy and Clinical Immunology at the University of Manitoba; and a co-author of the newly released CPS practice point on the introduction of allergenic foods. She is also Vice Chair of the Anaphylaxis and Food Allergy Section of the Canadian Society of Allergy and Clinical Immunology; and President of the Allergy Section of the CPS.

You can view a recording of the webinar below, which includes a question and answer period.

For healthcare professionals: Recorded webinar on the early introduction of allergens and food allergy prevention

We hosted a webinar tailored for healthcare professionals in June 2019 on the CPS’ updated recommendations on the early introduction of allergenic foods for high-risk infants.

This webinar is presented by Canadian pediatric allergist Dr. Edmond Chan who is a UBC Clinical Associate Professor and Head of the Division of Allergy & Immunology in the Department of Pediatrics at BC Children’s Hospital; and a co-author of the newly released CPS practice point on the introduction of allergenic foods.

You can view a recording of the webinar below, which includes a question and answer period.


NIAID Guidelines for the introduction of peanut to babies

In 2017, the Addendum Guidelines for the Prevention of Peanut Allergy in the U.S. (a report from the National Institute of Allergy and Infectious Diseases (NIAID)) was released, and it remains a positive step forward in preventing the development of peanut allergy.

The guidelines represent a dramatic shift from previous advice to parents and caregivers regarding the introduction of peanut in a child’s diet. It is critical that health providers including allergists, pediatricians, and general practitioners share consistent information, based on the recommendations, so that parents can make an informed decision.

Here are some highlights:

  • The recommendations are based on the ground-breaking LEAP study which found that early introduction of peanuts to babies (4-11 months) identified as high risk for peanut allergy (based on an existing egg allergy and/or severe eczema), helped to prevent the development of peanut allergy.
  • The guidelines provide specific advice for when to introduce peanut-containing foods to babies and how. They also include advice about introducing solids first, avoiding foods that can be choking hazards (e.g. whole peanuts), and specific instructions for babies considered to be “high risk”. There are three guidelines for when to introduce peanut-containing food –
    • Guideline 1: As early as 4-6 months for those at high risk (severe eczema and/or egg allergy). Evaluation with testing is strongly recommended to determine if peanut should be introduced and the preferred method. Parents are advised to consult with their physician.
    • Guideline 2: Around 6 months for those with mild to moderate eczema.
    • Guideline 3: When age-appropriate, introduce freely in diet with other solid foods in accordance with family preferences and cultural practices.
  • You can download the guidelines and summaries for parents/caregivers and clinicians on the NIAID website.

As always, we advise parents to speak with their physician if they have any concerns.

For parents: Recorded webinar on the new guidelines for the introduction of peanut to babies

We hosted a webinar in March 2017 with the Canadian Society of Allergy and Clinical Immunology (CSACI) on the new guidelines for the introduction of peanut to babies.

The webinar was presented by Canadian allergist Dr. Julia Upton who is on staff at Toronto’s SickKids Hospital in the Immunology and Allergy Department. She is an Assistant Professor in the Department of Paediatrics at the University of Toronto and is the Section Chair of Food Allergy and Anaphylaxis with the CSACI.

You can view a recording of the webinar below, which includes a question and answer period.

Parent resource: Frequently Asked Questions

Below is an FAQ document which includes the most common questions by parents, answered by Canadian allergists. Please click on the document to view.

For healthcare professionals: Recorded webinar on the new guidelines and additional resources

We hosted a webinar tailored to healthcare professionals in June 2017 with the Canadian Society of Allergy and Clinical Immunology (CSACI) on the new guidelines for the introduction of peanut to babies.

This webinar was presented by Canadian pediatric allergist Dr. Edmond S. Chan who is the Head of the Division of Allergy & Immunology in the Department of Pediatrics, and Clinical Associate Professor at the University of British Columbia. He sees patients in the Allergy Clinic at B.C. Children’s Hospital. He is also a Clinical Investigator at the B.C. Children’s Hospital Research Institute, and runs a large research program dedicated to multiple aspects of pediatric food allergy and eosinophilic esophagitis. He is on the Board of Directors at the Canadian Society of Allergy and Clinical Immunology (CSACI) and he is on the Executive of the Allergy Section within the Canadian Paediatric Society. He is also the co-author for the U.S. NIAID (NIH) Food Allergy Guidelines on Prevention of Peanut Allergy recently published in January 2017.

You can view a recording of the webinar below.

Please see below for the five handouts that were available during this webinar:

  1. NIAID summary for clinicians
  2. NIAID complete addendum guidelines
  3. CSACI editorial on NIAID guidelines
  4. NIAID summary for parents and caregivers
  5. NIAID parent instructions for home feeding infants at low risk