How to Introduce Common Allergens Like Peanuts and Eggs Safely
Current evidence strongly supports early allergen introduction. Here is how to do it safely at home in Singapore, and when to seek specialist help.
Why Early Introduction Is Now Recommended
For many years, parents were advised to delay introducing allergenic foods. This guidance has been reversed. Multiple large studies now show that early introduction reduces allergy risk, particularly for peanut allergy.
The LEAP Trial (Learning Early About Peanut Allergy)
This landmark UK trial found that introducing peanuts to high-risk infants (those with eczema or egg allergy) between 4 and 11 months reduced peanut allergy by 81% compared to avoidance. The follow-up LEAP-On trial showed that this protection lasted even after stopping regular peanut consumption.
Based on this evidence, allergy guidelines around the world, including those used in Singapore, now recommend introducing allergenic foods from around 6 months of age, not avoiding them.
For babies with mild-to-moderate eczema, the HPB and Singapore allergy specialists advise introducing peanuts and eggs early while managing the eczema. For severe eczema, speak to an allergist at KKH or NUH before introducing high-risk foods at home.
The Big 8 Allergens and Singapore-Specific Risks
| Allergen | How to Introduce to Baby | Singapore Notes |
|---|---|---|
| Cow's milk | Small amount of plain yoghurt or cheese. Not milk as a main drink until 12 months. | Common. Many babies tolerate dairy products even if they react to milk as a drink. |
| Eggs | Well-cooked scrambled egg or hard-boiled yolk first. Must be fully cooked. | Common allergen. Introduce early and maintain regular exposure. |
| Peanuts | Smooth peanut butter thinned with water or breastmilk. Never whole nuts (choking hazard). | Prevalent. High-risk babies (eczema, egg allergy) should introduce early under guidance. |
| Tree nuts | Smooth nut butters (almond, cashew) thinned with water. Never whole nuts. | Introduce one at a time, not all at once. |
| Wheat | Small amount of soft wheat bread or pasta cooked very soft. | Less common than in Western countries but still worth introducing early. |
| Soy | Silken tofu is a natural first soy food for Singapore babies. | Common in the local diet. Good to introduce early given how frequently it appears in food. |
| Fish | Steamed white fish, fully deboned, pureed or flaked. | High prevalence of fish allergy in Singapore. Introduce one species at a time. |
| Shellfish (prawns, crab) | Small amount of soft, well-cooked prawn pureed finely. Introduce at home, not at a restaurant. | Very high allergy prevalence in Singapore. Prawns are a particularly common trigger. Introduce carefully. |
How to Introduce Each Allergen Safely
Following a safe protocol at home reduces risk and ensures you can respond quickly if a reaction occurs.
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1
Introduce one new allergen at a time. Do not introduce two allergens on the same day.
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2
Do it in the morning at home, not the day before daycare or before bedtime. You want to be able to observe your baby for 2 hours after eating.
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3
Start with a very small amount. For peanut butter, a quarter of a teaspoon thinned with water. Wait 10 minutes, then give a little more if there is no reaction.
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4
If tolerated, continue offering the food regularly (2 to 3 times per week) to maintain tolerance. Do not introduce it once and then not again for months.
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5
Keep an antihistamine such as Zyrtec or Piriton syrup (check dosing for age with your pharmacist) at home during the introduction period.
Emergency Signs: When to Call 995
Mild reactions (a few hives around the mouth, slight redness) are usually managed with antihistamine. Anaphylaxis is a severe, life-threatening reaction requiring immediate emergency care.
Signs of Anaphylaxis - Call 995 Immediately
- Hives spreading rapidly across the body
- Swelling of the lips, tongue, or throat
- Vomiting combined with hives
- Difficulty breathing, wheezing, or stridor (high-pitched breathing sound)
- Baby going pale, limp, or losing consciousness
If your child has been prescribed an EpiPen (adrenaline auto-injector), use it immediately and call 995. EpiPens can be prescribed at KKH Allergy Clinic, NUH, or by a private allergist. They are available at hospital pharmacies with a prescription.
Families with a history of severe allergies or a baby with severe eczema should see an allergist before doing home allergen introductions. A supervised oral food challenge at KKH or NUH may be recommended first.