Food allergy is an immune system response to a food protein. Food intolerance is a digestive response. Both are real and important, but they are managed differently. This guide focuses primarily on food allergies in Indian babies.
Common Food Allergens in India
The top 8 global allergens are also the most common in India: milk, eggs, peanuts, tree nuts, fish, shellfish, wheat, and soy. In Indian babies, milk protein allergy, egg allergy, and peanut allergy are the most frequently seen. Sesame allergy is also worth knowing about given its widespread use in Indian cooking (til, tahini).
Signs of Food Allergy in Babies
Immediate reactions (within minutes to 2 hours): hives or skin rash, swelling of lips, tongue or face, vomiting, diarrhoea, runny nose, watery eyes, wheezing or coughing. Severe reaction (anaphylaxis — requires emergency treatment): difficulty breathing, pale or blue skin, loss of consciousness, weak pulse, extreme distress. Delayed reactions (hours to days later): eczema flares, loose stools, blood in stool, poor weight gain, colic.
Current Guidance on Allergen Introduction
The LEAP (Learning Early About Peanut Allergy) study and subsequent research has changed the advice dramatically. Current guidance recommends introducing common allergens early — from around 6 months — rather than avoiding them. Early introduction has been shown to significantly reduce allergy risk.
For babies with eczema or a family history of food allergy, consult your paediatrician before allergen introduction. They may recommend supervised introduction or allergy testing first.
How to Introduce Allergens Safely
Introduce one allergen at a time. Give in the morning so you can observe during the day. Start with a very small amount. Wait 3 to 5 days before introducing the next new allergen. If there is no reaction, continue giving the food regularly — regular exposure maintains tolerance. Keep an antihistamine syrup (ask your paediatrician for an appropriate one) at home during allergen introductions.
Cow's Milk Protein Allergy (CMPA)
CMPA is the most common food allergy in infants under 12 months and is often confused with lactose intolerance (which is rare in young babies). Signs include blood or mucus in stool, severe reflux, eczema, colic, and poor weight gain. Diagnosis is by elimination and supervised reintroduction. Most children with CMPA outgrow it by age 3 to 5.