From the Research
Introducing tree nuts to an infant when the mother has a tree nut allergy should be done under the guidance of a pediatrician and possibly an allergist, with the goal of introducing allergenic foods like nuts to babies around 4-6 months of age to potentially prevent food allergies. The most recent and highest quality study on this topic is from 2025, which found that oral immunotherapy (OIT) for food allergy, including tree nuts, is safe and feasible in infants and toddlers in a real-world setting 1. When introducing tree nuts to an infant, it is essential to:
- Have someone without nut allergies prepare the nuts in an appropriate form for the baby, such as smooth nut butter thinned with breast milk or formula, or finely ground nuts mixed into other foods.
- Prepare the nuts in a separate area to avoid cross-contamination.
- Avoid direct contact with the nuts and consider wearing gloves when feeding the baby.
- Introduce one type of nut at a time, waiting 3-5 days between new foods to monitor for allergic reactions.
- Have antihistamines available and know the signs of an allergic reaction in infants, which include hives, swelling, vomiting, or difficulty breathing. This approach allows for safe introduction of nuts to the baby while protecting the mother from allergic exposure. It is also important to note that previous reaction severity is a predictor for home epinephrine-treated reactions during OIT, and that walnut and hazelnut OIT may have a higher rate of such reactions compared to other foods 2. However, the benefits of introducing tree nuts to infants at a young age, as supported by the 2025 study, outweigh the potential risks, and consulting with a pediatrician and possibly an allergist is crucial to determine the best approach for each individual case.