Early Allergen Introduction: Q&A with Chief of Pediatrics Dr. Matthew

Dr. Andrew Matthew, Los Robles Medical Center's Chief of Pediatrics, answers your most-asked questions about introducing your baby to food allergens.

In your 40 years of experience, have you witnessed any trends with respect to food allergies?  

When I finished my residency in pediatrics in 1979, food allergies were rare and there was very low awareness. Now, 1 in 13 children suffer from food allergies (in California, it’s 1 in 11) and I’ve seen that same trend in my own practice. In addition, my 1 year old grandson suffers from multiple food allergies, and I’ve seen the toll it takes on the entire family.  

How can parents of young infants prevent food allergies?

The American Academy of Pediatrics and NIH are now recommending that parents introduce highly allergenic foods as early as 4-6 months of age, with recent studies supporting that early introduction can help decrease the risk of allergy to that specific food by 67-80%.  

I think it’s important for any parents with infants to understand:

  • Starting at 4-6 months of age, earlier introduction can be more effective at preventing allergies. Studies suggest that delaying introduction may put your child at a greater risk for developing food allergies.
  • Studies also suggest sustained exposure is just as important as early introduction, meaning parents must continue introducing allergens many times a week for several months.  

Why do you recommend Ready, Set, Food! at every 4 month visit?   

I tell parents that the most important thing is for them to introduce food allergens early and frequently, but since most families find that difficult to do on their own, I recommend Ready, Set, Food! because it is:

  • Easy to use - Introducing through a bottle makes it easy for parents to follow the study guidance and start as early as 4 months.  
  • Evidence-based - With doses based directly on the clinical trials to help reduce the risk of developing food allergies by up to 80%
  • Organic and All Natural - Contains only organic peanut, egg, and milk with no additives, preservatives, or added sugar.  

Do your recommendations change if the baby has eczema?

Babies with eczema are the highest risk population, with more than a 3x increased risk of developing food allergies. Two of the three recent clinical studies specifically focused on infants with eczema, and the new NIH guidelines recommend peanut introduction for infants with eczema to help reduce the risk of peanut allergies.

If the baby has mild to moderate eczema, I still recommend introducing potential allergens at 4 months. However, if they have severe eczema, I always refer them to an allergist for skin-prick testing. If their allergist clears them for allergies, then I recommend early allergen introduction as supported by the new FDA recommendations.  

Do you think eating allergenic foods while breastfeeding is enough to prevent allergies?   

There has not been conclusive evidence that eating allergenic foods while breastfeeding has a protective effect, however, eating them also doesn’t increase the risk of developing an allergy.  According to the recent studies, early allergen introduction in infants has been proven to be the most effective at preventing food allergies.  

While it's not recommend to give infants under 1 cows milk, how is it safe to introduce milk starting at 4 months of age? 

That's a great question and a common misconception.  It's true that infants under 1 year shouldn't have a large quantity of cow's milk because then it will replace formula or breastmilk and potentially lead to iron deficiency.  But there is absolutely no problem with a small amount of cow's milk, which is why yogurt is often one of a baby's first foods. However, if you're still concerned about introducing milk as early as 4 months of age, Ready, Set, Food! offers a safe and trusted solution since their dosage only has 1.5 g of cow's milk per day.  That's one of the many reasons that I recommend Ready, Set, Food! at every 4 month visit.  

Do you have any advice for parents that are nervous about introducing allergenic foods?   

It’s very common for parents to be anxious about feeding their babies potentially allergenic foods, but in the three clinical trials that started early introduction as early as 4 months with over 2,000 babies, there weren’t any cases of anaphylaxis or hospitalizations. I recommend that parents start with the smallest amounts possible of each food before increasing to larger amounts, similar to the approach taken by Ready, Set, Food! If they show any signs of sensitivity (e.g. rash, itching), I tell them to stop immediately and consult their allergist for testing.

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About the author:

Andrew M. Matthew M.D. is a Board Certified Pediatrician and a member of the American Academy of Pediatrics. He is a native Californian who graduated from UCLA in 1972 with a degree in Psychology. He then attended UCLA Medical School, graduating in 1976. He finished his residency in Pediatrics in 1979, his last year serving as Chief Resident, and started his own practice in Agoura Hills in 1981 (moving to Oak Park in 1983). He served as Chief of Pediatrics and Chief of Staff at Westlake Hospital, and as Chief of Pediatrics at Los Robles Regional Medical Center (last in 2010). He is a member of the scientific advisory board for Ready, Set, Food! In his spare time, Dr. Matthew can be found competing in local triathlons or attending a UCLA sporting event. He is a husband to Sandy, proud father to three children, and grandfather to Emma, Henry, Gabriel, Nathan, Sadie, Abe, and Lily.



All health-related content on this website is for informational purposes only and does not create a doctor-patient relationship. Always seek the advice of your own pediatrician in connection with any questions regarding your baby’s health.

These statements have not been evaluated by the Food and Drug Administration. Products are not intended to diagnose, treat, cure or prevent any disease.  If your infant has severe eczema, check with your infant’s healthcare provider before feeding foods containing ground peanuts.