Tree nuts are one of the top 8 allergens here in the United States, as well as around the world. That means that we want to introduce them early and often once our babies start foods. But just how should you introduce them and what should you watch out for when you do?
What is Classified as a Tree Nut?
Before we get any further, just what exactly is a tree nut? Tree nuts include, but are not limited to, almonds, cashews, hazelnuts, pecans, pistachios, and walnuts. These six tree nuts make up the majority of tree nut allergies reported in both adults and kids.
Peanuts are not considered nuts, even though nut is in their name. They are from the legume family, and are more closely related to peas and lentils than to tree nuts.
When to Introduce Tree Nuts to Babies
Based on newer research, introducing highly allergenic foods to your baby early on in their solids journey can be protective against food allergies. Most of this research has been done with eggs and peanuts. Experts agree, though, that it can be extrapolated to all other food allergens.
Because of this, the recommendation is to introduce tree nuts once your baby has started other foods. This usually occurs around that 6 month mark. Aim to serve them a couple of times a week once you have introduced them, although there is no need to be regimented about it.
How to Introduce Tree Nuts to Babies
Nuts, in general, are choking hazards for babies. It is not safe to give them in whole form to babies. The safest way to serve them is as a nut butter stirred into something like yogurt or spread thinly on toast, or ground up into a sand-like texture and sprinkled on things.
It is no longer the recommendation to serve single foods for multiple days to check for an allergic reaction. Experts in this field generally agree that introducing multiple foods at a time is fine, as well as multiple new foods a day. It is preferable, however, to introduce only one of the top 8 allergens at a time. For more in-depth information on introducing allergens, check out the Starting Solids course!
Which Tree Nuts Should You Introduce to Babies
One of the more common questions parents and caregivers have is if you need to introduce all tree nuts, or if you can just treat it as a general category and introduce one or a few of them only. While there isn’t much documented research on introduction of different tree nuts and prevention of allergies, we do have knowledge about cross reactivity of different tree nuts.
Some tree nuts come from the same or a closely related plant family, like cashews and pistachios or walnuts and almonds. For these, introducing one of the pair will likely have a similar effect as introducing both.
Outside of those, there are some cross-reactive proteins found in various tree nuts, but in general they are their own food. Meaning that introducing several different kinds of tree nuts is not a bad thing. Especially if you focus on the main six tree nuts listed above. At a minimum, I recommend introducing any tree nuts that you consume in your house to your baby.
If your baby does develop a tree nut allergy, your allergist may recommend that you avoid all tree nuts. You can always have a discussion with them about their reasoning. Many people will be allergic to one or a few tree nuts, but often not all of them.
What A Tree Nut Allergy Looks Like
Tree nuts can cause one of the more severe allergic reactions in the form of anaphylaxis, but not all allergic reactions will present this way. When introducing tree nuts to your baby, some signs of an allergic reaction to look out for are:
- Difficulty breathing
- Loss of consciousness
- Pale or blue skin
- Repetitive cough, wheezing
- Hives, redness or itching
- Diarrhea or vomiting
- Swelling of lips or tongue
- Itchy/runny nose, sneezing
For more minor symptoms like an itchy or runny nose, it is generally okay to contact your doctor about them and wait for an appointment. If your baby shows signs of a severe reaction, such as difficulty breathing or loss of consciousness, call 911 and seek immediate treatment.
Only about 10% of kids with tree nut allergies tend to outgrow their allergy. Many kids (around 30%) with peanut allergies also are allergic to tree nuts. If you suspect that your child has developed a tree nut allergy, be sure to talk to your healthcare professional and ask for a referral to an allergist.
The thought of your baby developing a food allergy can understandably be daunting. Know that there are many resources out there to provide support and help you through it if your baby does develop an allergy, though.
Understanding how to best prevent a food allergy and how to keep your baby safe if they show signs of an allergy is the best thing that you can do for them!
American College of Allergy, Asthma, and Immunology, Tree Nut Allergy
Food Allergy Canada, Tree Nuts
American Academy of Allergy Asthma and Immunology, Everything You Need to Know About Tree Nut Allergy