• Mix powders / ground nut meal into a previously tolerated puree or roll a piece of previously tolerated finger food such as avocado into the powder/ ground nut
  meal
• Start with 1/4 teaspoon of powder / ground nut meal on exposure 1, increase to 1/2 teaspoon on exposure 2 and increase to 1 teaspoon on exposure 3
• Three initial exposures should be carried out over 3 consecutive days or 3 days in one week (such as Monday, Wednesday, Friday)
• Always introduce a new food / potential allergen in the first half of day with time before next nap to watch for any adverse reactions
• Each sachet contains approximately 15 teaspoons of the powder / ground nut meal so it can be used to keep up exposure for at least a few more weeks

While it is not essential to do over three consecutive days, we encourage you to do in one week so this may mean offering every second day, such as Monday, Wednesday and Friday.

This way you can get the three initial exposures in and provided there is no reaction, move on to ‘maintenance’ where you continue to offer the potential allergen twice weekly as part of your little one’s regular diet.

The most recent update to the USDA Dietary Guidelines (2020-2025) recommends introducing nutrient-dense complementary foods to infants at about six months. It is recommended to give age-appropriate allergenic foods along with complementary foods from about 6 months. This recommendation is in line with Australian recommendations from the Australian Society of Clinical Immunology and Allergy (ASCIA).

If your baby has severe eczema, egg allergy, or both (conditions that increase the risk of peanut allergy), age-appropriate, peanut containing foods should be introduced into the diet
as early as age 4 to 6 months. This will reduce the risk of developing peanut allergy.

Early exposure refers to the introduction of potential food allergens, at around 6 months (not before 4 months) of age when introducing solid foods.

It is now widely accepted, that early food introduction has a role in the prevention of food allergy, especially in higher-risk infants. This is thanks to the results of the Learning Early About Peanut (LEAP) study which was the first randomized controlled trial to demonstrate a significant (81%) relative risk reduction in the development of peanut early with early (aged 4-11 months) versus delayed (aged 5 years) peanut introduction.

There is no hard and fast rule with regards to the order in which you introduce the allergens, however the most evidence and guidance is around egg, peanut and milk. If your child is on a cow’s milk-based formula, this would count as their introduction to cow’s milk.
Current recommendations advise introduction of the common allergens along with complementary foods ~6 months (and not before 4 months).

Generally, egg and peanut (as well as cow’s milk) are encourage earlier (closer to 6 months) however this is largely because there is the most evidence relating to these. While there is little guidance with regards to the other allergens, the mechanism of sensitization is thought to be similar and therefore it is generally considered there is no harm to early introduction.

Consequently, current guidelines agree that all potential food allergens should be introduced by a child’s first birthday. From a practicality point of view, it is best to introduce the foods in the order in which they are consumed within your household, ie. Those foods-which are more readily consumed, should be prioritized over those less frequently eaten.

Increasing evidence is also supporting the need to continue to offer these foods, at least weekly, provided they are tolerated, in order to maintain tolerance.

There is still no definitive volume of food you need to offer in order to keep up this
tolerance to the allergen, so start by adding a teaspoon of the potential allergen, twice weekly and increase, as appropriate as your child begins to eat more.

Once your baby has tried a potential allergen causing food, without reaction, it is important to keep offering it to them, ideally around twice per week. Ultimately, your little one will be
eating family meals, so that means if you don’t eat a food, they are unlikely to eat it either.

Therefore, if there is a food your household does not eat, you may decide not to introduce that food, as they are unlikely to be exposed to eat at home. You may wish to discuss this
further with your doctor, paediatrician or a dietitian specialising in allergies.

Recommendations around cow’s milk introduction can be a little confusing. As cow’s milk
protein is a potential food allergen and the current advice recommends introducing all food
allergens before your child is one, it is important to introduce cow’s milk to your child by
their first birthday (which is why it is in our allergen pack). Cow’s milk is found in cow’s milk-
based formulas, which is how many babies will be first exposed to it! It is also found in
yoghurts, cheese and butter, among other things. Cow’s milk can be offered to your child in
any of these forms and even in small amounts in the form of dairy, for example in porridge
or cereal or baked in a muffin, however a bottle of cow’s milk must not displace breast milk
or formula until your child is the age of 1. This is because it does not provide the appropriate
balance of nutrients for baby’s optimal growth.

Allergic reactions usually take place within minutes, up to 2 hours after a food is ingested.
Allergic reactions are considered either mild to moderate or severe (anaphylaxis). A mild to
moderate reaction may include hives or welts, vomiting, significant changes in wellbeing or
swelling of the lips, eyes or face.
A more severe reaction, known as anaphylaxis, may involve wheezing or persistent cough,
difficulty breathing, swelling of the tongue, swelling in throat, change in voice or cry and/or
pale and floppy/collapsing.

If you notice any of the above signs that suggest your child may be having an allergic reaction, stop feeding the food immediately and seek medical attention. If they are showing
signs of a mild reaction, continue to monitor for signs of a severe reaction. You may wish to take your child into the doctor immediately.

If your child is having a severe reaction, lay them flat in your arms. DO NOT allow them to walk or stand upright. Call 911 immediately.