Introducing Allergens to Babies: Singapore Guide
Current evidence says introduce early, not late. Here's the safe protocol for every common allergen - Including the ones common in Singapore cuisine.
What the Evidence Says
The LEAP Study (2015) changed everything. This landmark randomised controlled trial showed that introducing peanuts early - From 6 months - Reduced peanut allergy by 81% in high-risk infants. Subsequent studies confirmed this for other major allergens.
Current guidance (ASCIA, Singapore HPB): Introduce all common allergens from around 6 months, in any order, one at a time. Do not delay beyond 12 months. If baby already has diagnosed food allergy or severe eczema, consult your paediatrician first.
The Top 9 Allergens - How to Introduce
Peanuts
Start: Start with ¼ teaspoonHow: Smooth peanut butter thinned with breast milk, formula, or water
Do not offer whole peanuts - Choking hazard. Crunchy peanut butter is also a risk. Thin peanut butter to a dripping consistency.
Singapore context: Peanuts are common in Singapore cuisine - Satay sauce, Hokkien mee, rojak. Once tolerated, baby can be exposed through family meals naturally.
Eggs
Start: Start with ¼ teaspoon of cooked eggHow: Well-cooked scrambled egg or hard-boiled egg yolk first
Introduce yolk first (lower allergenicity), then whole egg. Raw egg is not appropriate at this age.
Singapore context: Eggs are widely available and versatile. Kaya contains cooked egg - Can be a later vehicle once egg is tolerated.
Tree nuts
Start: Start with ¼ teaspoonHow: Nut butters (almond, cashew, walnut) thinned with water or breast milk
Each tree nut is a separate allergen - Introduce almond, cashew, walnut separately with a 2–3 day gap.
Singapore context: Almond milk is not suitable as a milk replacement. Nut butters are the safest form.
Fish
Start: Start with 1 teaspoon of flaked fishHow: Pureed or very well-flaked white fish - Snapper (ikan merah) or sole
Remove all bones carefully. White fish is lower in mercury than oily fish - Good starting point.
Singapore context: Singapore's access to fresh fish is excellent - Fish porridge (fish congee) is a natural introduction vehicle.
Shellfish
Start: Start with ¼ teaspoonHow: Cooked prawn or crab, pureed or very finely minced
Shellfish allergy is particularly common in Asian populations. Well-cooked only.
Singapore context: Prawns and crab are staples in Singapore cuisine. Prawn is common in laksa, fried rice, and wonton - Once tolerated, exposure is easy.
Wheat / Gluten
Start: Start with a small piece of soft bread or a few pieces of cooked pastaHow: Small amount of plain pasta, bread crust, or wheat-based cereal
Introduce plain wheat first - No added sugar or salt. Wholemeal is fine.
Singapore context: Wheat is everywhere in Singapore - Kway teow, bao, bread. Once tolerated, family meals are an easy vehicle.
Dairy (cow's milk protein)
Start: Start with 1 teaspoon of plain yoghurtHow: Yoghurt (full-fat, plain) or mild cheese - Not cow's milk as a drink
Cow's milk as a drink should not replace breast milk or formula before 12 months. Well-cooked dairy in food (e.g. cheese on congee) is lower allergenicity than raw dairy.
Singapore context: Cheese and yoghurt are available at all Singapore supermarkets. Cold Storage and FairPrice carry full-fat plain yoghurt.
Sesame
Start: Start with ¼ teaspoon of tahiniHow: Tahini (sesame paste) thinned with water, or a small smear of sesame oil in food
Sesame is now classified as a major allergen in many countries. Sesame oil is highly refined and lower allergenicity - Tahini is the best test.
Singapore context: Sesame is common in Singapore food - Sesame oil in Chinese dishes, til paste in Indian sweets. Introducing early provides natural maintenance exposure.
Soy
Start: Start with 1 teaspoon of silken tofu or pureed edamameHow: Plain silken tofu, soft edamame pureed, or a small amount of plain soy milk in food
Soy allergy is distinct from soy intolerance. Introduce plain soy (not soy sauce, which contains wheat and high salt) as the first vehicle.
Singapore context: Tofu is a staple in Singapore hawker food and supermarkets. Silken tofu is the easiest first form - No cooking needed, soft enough to serve directly.
Introduction Protocol
One new allergen at a time
Introduce a single new allergen and wait 2–3 days before introducing another. This allows you to identify which food caused any reaction.
Introduce in the morning
Offer the allergen at breakfast or mid-morning - Not at dinner - So you can monitor for 2 hours during the day when you're alert.
Start with a tiny amount
¼ teaspoon. If no reaction after 15 minutes, offer more. If no reaction after 2 hours, the food was tolerated.
Watch for reactions
Mild: hives (red raised bumps on skin), eczema flare, vomiting. Severe (anaphylaxis): widespread hives, swelling of lips or tongue, wheezing, pale or limp.
Maintain regular exposure
Once tolerated, include that food at least twice a week - Regular exposure maintains tolerance. Stopping completely after introduction may allow sensitivity to develop.
Anaphylaxis: call 995 immediately
If baby has difficulty breathing, becomes pale or limp, has swelling of face or throat - Call 995. For mild reactions (hives only): call your GP or paediatrician.
Common Myth: "Delaying Allergens Prevents Allergy"
This is wrong. The evidence shows the opposite.
The LEAP trial (Learning Early About Peanut Allergy, 2015) was a landmark study. It followed 640 high-risk infants. Those who ate peanut products regularly from 4 to 11 months had an 81% lower rate of peanut allergy compared to those who avoided peanuts.
The EAT trial confirmed similar findings for multiple allergens including egg, milk, sesame, fish, and wheat. Early and regular introduction reduces risk. Delayed introduction does not protect your baby - It may actually increase risk.
Current guidance from HPB Singapore and ASCIA (2024): Introduce all common allergens from around 6 months. Do not wait. The exception is babies with severe eczema or an existing known allergy - Discuss those cases with your paediatrician first.
Where to Get Help in Singapore
If your baby has a reaction, or if you are worried about allergy risk before you start, these are the right places to go.
KKH Allergy, Immunology and Rheumatology Service
Specialist allergy clinic at KK Women's and Children's Hospital. Referral required via paediatrician or GP. They conduct skin prick tests and oral food challenges for confirmed or suspected food allergy.
NUH Paediatric Allergy Clinic
National University Hospital also runs a paediatric allergy service. Referral via GP or polyclinic. Suitable for babies with eczema and suspected food triggers.
Polyclinic GP (first step)
For mild reactions (localised hives, vomiting after a specific food), start with your polyclinic GP. They can assess and refer to a specialist if needed. Polyclinic visits are subsidised under CHAS and Medisave.
Emergency: Call 995
For any signs of anaphylaxis - Difficulty breathing, widespread hives, swelling of face or tongue, baby becomes limp or pale - Call 995 immediately. Do not wait to see if it improves.
More from the Feeding Guide: