“Although the LEAP study and subsequent guidelines have helped forward the narrative that early introduction of allergenic solids is safe and effective at preventing certain food allergies, how to optimally advise and implement this is still uncertain in many areas. These areas include which allergens to focus on as a priority for early introduction, how often to advise allergenic solid foods are fed, how much quantity of allergen to feed, and how long feeding is required for a full preventive effect?”

Figuring out how to incorporate tolerated allergens felt really daunting and really important. We absolutely want to give Julia any allergens she tolerates to try to mitigate the development of other allergies, but the information on how best to do so is hard to come by.

So much of the guidance for feeding allergens is extrapolated from the LEAP study on peanuts. The LEAP study recommends children predisposed to developing peanut allergies ages 4 months to five years old eat 6 grams of peanut protein a week. 6 grams of protein translates into about 3 teaspoons of peanut butter over three or more meals a week.

If you take this quantity/frequency ratio and apply it to all the common food allergens (the 8 non cashew/pistachio tree nuts and the 8 other common food allergens) you are talking about trying to give a baby 48 teaspoons of common allergen food each week. At six months Julia was eating about 6 teaspoons of food total a week, so this goal was very far beyond reach (not to mention she hadn’t been introduced to most of the allergens at that point). At 7.5 months (as of writing this) she’s eating more, but she’s still nowhere close to actually ingesting 48 teaspoons a week.

So taking the reality of our baby, we have come up with this plan for keeping tolerated allergens in regular rotation in her diet:

• Monday, Wednesday, Friday: Peanut Butter, Almond Butter, Sesame & Dairy days

• Tuesday, Thursday, Saturday: Hazelnut butter, Macadamia Butter, Egg & Wheat days

We hope to keep these regularly in her diet until she is at least five (hopefully longer) just mirroring the guidance from LEAP. Hopefully she won’t decide she hates these foods as a toddler.