Introducing Allergens
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 8 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.
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.
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