Module 18

Allergen Introduction Schedule

Early, regular exposure to top allergens between 4-11 months significantly reduces allergy risk — here's the evidence-based timeline

The LEAP, EAT, and PETIT trials demonstrated that early introduction of allergenic foods (starting at 4-6 months) reduces the risk of developing food allergies by up to 80% for peanut and 50-70% for egg. The old advice to delay allergens until age 1-3 has been reversed. Introduce early, introduce often.

Before You Start

Baby is at least 4 months old and showing readiness signs

Offer allergens when baby is well (not sick or fussy)

Give new allergens early in the day so you can monitor for reactions

Have infant-appropriate antihistamine dose confirmed with your pediatrician

If baby has severe eczema or known egg allergy, discuss with allergist before peanut introduction

Introduction Schedule (Weeks 1-10)

Week	Allergen	How to Introduce	Dose	Frequency After Intro
Week 1	Peanut	Thin peanut butter mixed into puree, or Bamba puffs dissolved in breastmilk	Start 1/4 tsp, build to 2 tsp	2-3x per week ongoing
Week 2	Egg	Well-cooked scrambled egg — start with yolk, then whole egg	Start 1/4 egg, build to 1 egg	2-3x per week ongoing
Week 3	Cow's milk (cooked)	Full-fat yogurt, cheese melted into food, milk in pancake batter	Start 1 tsp yogurt, build to 1/4 cup	Daily (yogurt or cheese)
Week 4	Tree nuts	Thin almond or cashew butter mixed into puree (never whole nuts)	Start 1/4 tsp, build to 1 tsp	2-3x per week, rotate varieties
Week 5	Wheat	Soft toast strips, pasta, or wheat cereal cooked in breastmilk	Start 1 Tbsp, build to normal portion	Regular meals
Week 6	Soy	Soft tofu cubes, edamame (mashed), soy yogurt	Start 1 tsp, build to 2 Tbsp	2-3x per week
Week 7	Sesame	Thin tahini mixed into puree, hummus	Start 1/4 tsp, build to 1 tsp	2-3x per week
Week 8	Fish	Flaked salmon or cod, mashed sardines, fish mixed into puree	Start 1 tsp, build to 2 Tbsp	2-3x per week (DHA bonus)
Week 9	Shellfish	Well-cooked shrimp pureed or finely minced	Start 1/2 tsp, build to 1 Tbsp	1-2x per week
Week 10	Remaining review	Cycle back through all introduced allergens to confirm tolerance	Regular servings	Maintain exposure for ALL allergens

Important

CRITICAL: Introduction alone is not enough. You must maintain regular exposure — at least 2-3 times per week for each allergen — for the protective effect to hold. Infrequent exposure after introduction can actually INCREASE allergy risk. Put it on the weekly meal plan.

Reaction Severity Guide

Severity	Symptoms	Action
Mild (common, usually not allergy)	Small rash around mouth (contact irritation), minor stool change, slight fussiness	Monitor. Reintroduce in 2-3 days. Contact rash from acidic foods is NOT allergy.
Moderate (possible allergy)	Hives (raised welts away from mouth), vomiting within 2 hours, significant swelling of face/lips, worsening eczema	Give antihistamine (pediatrician-approved dose). Do NOT reintroduce. See allergist.
Severe (anaphylaxis — EMERGENCY)	Difficulty breathing, wheezing, throat tightness, widespread hives, pale/blue color, limp/unresponsive	Call 911 immediately. Use epinephrine auto-injector if prescribed. Lay baby flat with legs elevated.

Make It Easy

Mix peanut butter or tahini into oatmeal, stir egg yolk into sweet potato puree, blend tree nut butter into yogurt. You don't need separate allergen meals — layer allergens into foods baby is already eating.