Introducing nuts to babies: When and how

Starting solids is a whole new world of mess, recipe-searching, research, fun, and worry all rolled into one for parents. As if life with a baby wasn’t busy enough, you now have to fit in cooking, mealtimes, cleaning up, and extra washing!

We want you to have one less thing on your plate (pardon the pun), so to reduce any concern or confusion about introducing nuts, which is an allergy food and a choking risk, here is everything you need to know about introducing nuts to babies and how to offer them.

Introducing nuts to babies: When and how

Peanuts and tree nuts (such as almonds, coconut, and hazelnuts) are common allergy foods. You can start to offer them when you introduce solids, which is usually around 6 months (and not before 4 months) when they’re developmentally ready. It’s recommended to give your baby these foods before 12 months.

This also applies if your baby suffers from extreme eczema and/or has an existing food allergy, according to the Australasian Society of Clinical Immunology and Allergy (ASCIA) guidelines for infant feeding and allergy prevention. However, before proceeding, speak to your paediatrician or paediatric allergist.

How to introduce allergy foods

Other common allergy foods include egg, wheat, cow’s milk, and shellfish. You can decide which allergy food to start with first (if you choose eggs as your starting point, read When to introduce eggs).

Here are the steps to offering any allergy foods:

1. Start with one allergy food at a time, so that you can observe and monitor your baby for any reactions. If any are present, you’ll know exactly which food is the source.
2. Rub a small amount of food inside your baby’s lip first. It’s not recommended to rub it on their skin as it won’t help to identify a reaction.
3. If there is no allergic reaction after a few minutes, mix a small amount of the food with your baby’s usual food. For instance, you might add a quarter of a teaspoon of smooth peanut butter to your little one’s porridge. Observe your baby for 30 minutes.
4. If your baby doesn’t react, it’s important to keep offering the food regularly (at least weekly) in gradually increasing amounts so that they maintain a tolerance to the food.
5. You can offer a new allergy food each day or two, and if there’s no reaction, continue to offer it once it’s been introduced into their diet.

Time of day to introduce allergy foods

Daytime meals are ideal because it allows you to watch for any signs of a reaction. Reactions are often quite quick, usually within the first 30 minutes, so be prepared to respond if necessary. You might feel less anxious if you have another trusted adult with you for support.

Allergic reaction symptoms and what to do

Mild symptoms include:

• Tingling in the mouth
• Red rash around the mouth
• Hives or red welts (bumps) on the skin
• Tummy pains
• Vomiting
• Swelling of the eyelids, lips, or face

What to do: If your baby has any of these reactions, and you’re understandably concerned, you could speak to a nurse on the healthdirect hotline on 1800 022 222 or phone the Pregnancy, Birth and Baby helpline to speak to a maternal and child health nurse on 1800 882 436.

Avoid giving them that particular food again and see your GP for advice and an accurate diagnosis and management.

More serious symptoms can indicate anaphylaxis, which is rare but requires urgent medical attention:

• Swelling of the tongue
• Hoarse voice
• Tightness of the throat
• Cough or wheeze
• Difficulty breathing
• Collapse or going ‘floppy’

What to do: If any of these symptoms appear, call triple zero (000) and ask for an ambulance or go to your nearest emergency department.

How to safely serve nuts to babies

Whole nuts, nut pieces, and nut butters/pastes are all choking risks. So, generally speaking (as every baby develops on their own timeline), here is how to safely prepare and start introducing nuts to babies:

In the beginning:

• To start with, you could mix smooth natural, unsalted peanut butter or nut paste with water, breastmilk or formula until extra smooth.

Between 6-12 months:

• You can mix it into purees, such as fruit puree, yoghurt, or porridge.
• You could also use finely crushed nuts, such as almond meal, sprinkled on or stirred through your baby’s meals.
• Roll slippery foods in finely ground nuts such as avocado slices, mango, or banana for added grip for little hands.
• You could also use peanut oil to cook food in.
• Add almond meal or nut paste to pancakes, fritters, or smoothies.

From 12 months:

• You can start to spread natural unsalted nut butters on toast or crackers. Avoid large blobs of it, but there’s usually no need to thin it down now.