You know Herman, there is nothing quite like the sound of a baby discovering peanut butter for the first time. It is that mix of confusion, sticky realization, and then total commitment.
Herman Poppleberry here, and I have to say, watching Ezra today was a masterpiece of sensory exploration. Daniel was actually showing me the footage earlier, and the way Ezra just went for it with the peanuts, dairy, and egg, it is quite a milestone.
It really is. And it is funny because if we were doing this show maybe fifteen years ago, the advice we would be giving Daniel would be the exact opposite of what we are talking about today. Our housemate Daniel sent us this prompt because he is right in the thick of it with Ezra, and honestly, the science has shifted so dramatically that even parents with older kids might find this unrecognizable.
It is a complete paradigm shift, Corn. We went from a culture of avoidance to a culture of early, intentional exposure. And for good reason. The data is overwhelming.
Exactly. So today we are diving into the science of allergen introduction. We will talk about the order, the timing, how to track it without losing your mind, and most importantly, what the protocol is if things go sideways.
And I have my spreadsheets ready, Corn. You know I have been tracking Ezra's progress in my own side-log just for the pure data of it.
Of course you have. Let us start with the big picture, Herman. Why did everything change? I remember back in the early two thousands, the advice was basically, do not give your kid a peanut until they are three years old. Now, we are seeing babies eat Bamba at six months. What happened?
It was the L-E-A-P study, Corn. The Learning Early About Peanut allergy study, which was published in the New England Journal of Medicine around twenty fifteen. It is one of those rare moments in medical history where a single study basically rewrote the entire rulebook. Researchers in the United Kingdom noticed that Jewish children in London had much higher rates of peanut allergies than Jewish children in Israel.
And the difference was Bamba, right? That peanut puff snack that every Israeli kid basically lives on.
Precisely. In Israel, babies are often given peanut-based snacks as soon as they start solids. In the United Kingdom, they were following the avoidance guidelines. The study took over six hundred infants who were at high risk for allergies and split them into two groups. One group avoided peanuts, and the other group ate them regularly starting between four and eleven months of age.
And the results were staggering, if I recall.
They were incredible. By age five, the group that ate peanuts early had an eighty-one percent lower rate of peanut allergy. Eighty-one percent. That is not just a statistical fluke, that is a massive preventative success. It basically proved that the immune system needs to be trained. If you wait too long, the immune system starts to view those proteins as enemies rather than food. We also saw this backed up by the E-A-T study, or the Enquiring About Tolerance study, which looked at introducing six different allergens early.
It is like an immune system bootcamp. If they do not see the recruit early enough, they assume it is an invader. But Daniel asked specifically about the order. Is there a scientific sequence? Like, do you have to do egg before peanut, or dairy before wheat?
Scientifically speaking, there is no mandatory chronological order for the big nine allergens. The big nine, for those listening, are milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, soybeans, and sesame. Now, sesame is particularly relevant for us here in Jerusalem because it is in everything, like Daniel mentioned. But generally, the recommendation is to introduce them one at a time once your baby is developmentally ready for solids, which is usually around six months, though some start as early as four months if the pediatrician agrees.
So if there is no set order, how does a parent choose? Is it just whatever is in the fridge?
Not exactly. Most pediatricians suggest starting with the more common ones that are easy to prepare. Usually, that is egg or peanut. But the key is the methodology. You want to introduce one new high-allergen food and then wait about three to five days before introducing another one.
Right, because if you give them a peanut and egg sandwich for their first meal and they break out in hives, you have no idea which one caused it.
Exactly. It is a process of isolation. You want to see the reaction, or lack thereof, in a controlled environment. And when we say introduce, we are talking about tiny amounts. A quarter teaspoon of smooth peanut butter thinned with water or breast milk. You do not just hand a six month old a handful of whole nuts, obviously, because that is a major choking hazard.
So, three to five days per allergen. If you are doing the big nine, that is at least a month of focused testing. But I am curious about the frequency. Is it a one and done thing? Like, Ezra passed his peanut test today, is he good for life?
That is a common misconception, Corn. Early introduction is only half the battle. Regular exposure is the other half. The science suggests that once you introduce an allergen and confirm there is no reaction, you need to keep that food in their diet regularly, maybe twice a week, to maintain that tolerance. The immune system has a short memory at that age. If you give them peanuts once and then do not give them again for six months, that window of tolerance could actually close.
That is a lot for a parent to keep track of. You are not just introducing new foods, you are maintaining a rotation of potential allergens. This leads perfectly into the second part of Daniel's question. Tracking. Herman, I know you have thoughts on the spreadsheet versus app debate.
Oh, you know I do. Daniel mentioned a Google Sheet, and honestly, my heart sang a little. But let us look at the pros and cons. A spreadsheet, like a Google Sheet, is infinitely customizable. You can have columns for the date, the food, the amount, the time of day, and any observations like stool changes, skin rashes, or mood.
But is that practical for a tired parent who is also trying to clean mashed sweet potato off the ceiling?
It depends on the person. If you are someone who already lives in your browser, a spreadsheet is great because it is searchable. Ten months from now, you can search peanut and see exactly when he first had it. However, the baby care apps, things like Solid Starts or Huckleberry, have really stepped up their game. They often have built-in databases of foods, so you just tap peanut butter and it logs it. Some of them even have timers for that three-day waiting period.
I think the advantage of the apps is the visual component. A lot of them show you a checklist of the big allergens so you can see at a glance what you have not tried yet. It gamifies it a little bit, which might help with the mental load. But I will say this, an app is a walled garden. If the app goes out of business or starts charging a subscription, your data might be hard to export. A spreadsheet is yours forever.
Very true. And for parents who find the manual prep too daunting, there are even systems like Ready Set Food or Lil Mixins that provide pre-measured powders you mix into a bottle or puree. They essentially automate the tracking for you. But regardless of the tool, the important thing is the consistency of logging. You want to record the exact time of ingestion because most allergic reactions happen within minutes to two hours. If you log that Ezra ate eggs at ten in the morning and he gets a rash at four in the afternoon, it is less likely to be the eggs and more likely to be something else.
That is a great point. The timing is a huge piece of the puzzle. Now, let us get to the part that actually keeps parents up at night. The reaction. Ezra has been fine so far, which is wonderful. But what if he had not been? What is the protocol if a baby has a reaction?
This is where we need to be very clear. There are mild reactions and there are severe reactions, which we call anaphylaxis. A mild reaction might be a few hives around the mouth, a slight rash, or maybe some mild tummy upset. If that happens, you stop the food immediately and call your pediatrician. They might recommend an over the counter antihistamine like Cetirizine or Diphenhydramine, but you should never give those without a doctor's specific dosage for an infant.
And what about the severe stuff? What are the red flags that mean stop everything and call emergency services?
Anaphylaxis in babies can look a bit different than in adults. You are looking for things like difficulty breathing, which might look like wheezing, a barky cough, or their chest pulling in deeply with every breath. Swelling of the lips, tongue, or throat is a major one. You might see a sudden drop in blood pressure, which in a baby looks like they are becoming very pale, limp, or lethargic. Or even widespread hives that cover the whole body.
I have also heard that repetitive vomiting can be a sign of a severe systemic reaction in infants, right?
Yes, exactly. If a baby eats something and then vomits multiple times in a row, that is not just a spit-up. That could be a sign of anaphylaxis or something called F-P-I-E-S, which is Food Protein-Induced Enterocolitis Syndrome. If you see any of those severe symptoms, that is a call to emergency services immediately. In Israel, that is one zero one. In the United States, it is nine one one. You do not wait to see if it gets better.
And for parents of high-risk babies, doctors often prescribe an epinephrine auto-injector, like an EpiPen Junior.
Right. Epinephrine is the only treatment for anaphylaxis. It reverses the symptoms by constricting blood vessels and opening up the airways. If you have been prescribed one, you should have it within arm's reach every single time you introduce a new food. Most reactions happen on the second or third exposure, not necessarily the first, because the body needs that first exposure to create the antibodies that then trigger the reaction later.
That is a really important nuance. A baby might be fine with peanuts on Monday, but on Thursday, their body says, okay, I recognize this now, let us fight it. So you cannot let your guard down after just one successful feeding.
Exactly. It is a marathon, not a sprint. And I think it is worth mentioning the emotional side of this. It is incredibly stressful for parents. You are essentially feeding your child something that you are worried might hurt them. But the science tells us that the risk of waiting is actually higher than the risk of introducing early. By doing this, Daniel and Hannah are giving Ezra the best possible chance of a life without food allergies.
It is about changing the odds. You are moving from a state of fear to a state of proactive management. And speaking of management, Herman, what about the environment? Should Daniel be doing these tests at home, or in the parking lot of a hospital, as some nervous parents joked about?
For most babies, home is perfectly fine. You want a calm environment where you can observe them for at least two hours afterward. Do not do it right before a nap, because you want to be able to see their behavior and their skin. If the baby is considered high-risk, meaning they already have severe eczema or an existing food allergy like a milk allergy, then the pediatrician might actually recommend doing the first peanut introduction in the doctor's office.
That makes sense. Controlled environment for the high-risk cases. Now, let us talk about the second-order effects of this. If a child does develop an allergy, it is not the end of the world like it used to be. There is oral immunotherapy now, right?
There is. We are living in an era of incredible breakthroughs. Oral immunotherapy involves giving the child tiny, escalating amounts of the allergen under medical supervision to desensitize their immune system. It is not necessarily a cure, but it can raise the threshold of how much they can accidentally ingest without having a life-threatening reaction. It provides a safety net.
It is amazing how much the field of immunology has evolved. We went from avoidance to exposure, and now to active desensitization. It really shows the power of large-scale clinical trials like the L-E-A-P study.
It really does. And for the listeners who want to go deeper, I highly recommend looking up the guidelines from the National Institute of Allergy and Infectious Diseases. They have very specific charts for different risk levels. But for the average parent, the takeaway is simple: start early, start small, and keep it up.
And keep a log. Whether it is Herman's dream spreadsheet or a flashy app, having that data is your best defense against uncertainty.
Absolutely. I actually have a template I built for a friend last year. Maybe I should send that to Daniel. It has a pivot table that shows the diversity of protein sources over a thirty-day rolling window.
Herman, I think Daniel just wants to know if he should buy more Bamba or not. A pivot table might be overkill for a Tuesday morning.
There is no such thing as an overkill pivot table, Corn. It provides clarity. It provides peace of mind.
Only for you, brother. Only for you. But honestly, this topic is so vital because it affects the daily life of almost every family. It is about more than just food; it is about how we interact with the world and how we prepare our kids for it.
Well said. And since we are talking about community and sharing knowledge, I should mention that we have covered some adjacent topics in the past. If you are interested in how technology is changing the way we parent, you might want to explore our archive at myweirdprompts.com, where you can find episodes on the ethics of tracking and datafication of childhood. It pairs quite well with this discussion on tracking allergens.
That was a good one. I remember we got a lot of feedback on the ethics of tracking every diaper change. It is a fine line between being informed and being obsessed.
I prefer the term highly engaged, Corn.
Of course you do. Well, I think we have given Daniel a lot to chew on, pun intended. To recap: the order does not strictly matter but isolation does. Three to five days between new foods. Keep it in the diet twice a week once it is clear. And if you see trouble, do not hesitate to call for help.
And if you are using a spreadsheet, make sure you have a column for the specific brand of the product. Sometimes the additives or the manufacturing environment can play a role, especially with cross-contamination.
See, this is why we have you, Herman. The details that most people would miss. Before we wrap up, I want to say thanks to everyone who has been sticking with us. We have built an incredible community around My Weird Prompts, and we are grateful for your support.
It really is. We love hearing from you, and it is your questions that keep us diving into these rabbit holes. If you have a moment and you are enjoying the show, leaving a review on Spotify or Apple Podcasts really does help others find us. It is the best way to support the show.
It genuinely is. And you can always find our full archive and a way to get in touch with us at our website, my weird prompts dot com. We have an R-S-S feed there too if you want to make sure you never miss an episode.
Thanks to Daniel for sending this in. It was great to see Ezra doing so well. I am looking forward to seeing the data from the sesame introduction next week.
I will be sure to tell him to keep the pivot tables to a minimum.
Good luck with that.
Alright, that is it for this one. Until next time, I am Corn.
And I am Herman Poppleberry.
Thanks for listening to My Weird Prompts. We will catch you in the next one.
Bye everyone.
So, Herman, what is the first thing you would put on your allergen spreadsheet if you were starting today?
Oh, definitely a timestamped entry for the ambient temperature of the room. You know, heat can sometimes exacerbate skin reactions.
I should have known. I really should have known.
Data is life, Corn. Data is life.
Let us go see if there is any Bamba left in the kitchen.
I already checked. Daniel finished the bag during the recording.
Typical. Alright, see you later.
See you.
Just one more thing for the listeners, because I know someone will ask. If you are worried about the mess of peanut butter, those little puffs are a godsend. They dissolve in the mouth, so the choking risk is much lower.
Excellent practical tip. Science and snacks, the perfect combination.
Exactly. Okay, now we are really going.
Goodbye!
Bye.
Wait, Corn, did you mention the website?
Yes, Herman, I mentioned my weird prompts dot com.
Good. Just making sure.
We are done!
Okay, okay. Signing off.
Seriously, go.
Going.
Is he gone? I think he is finally gone. Anyway, thanks again for listening. It means the world to us. We will be back soon with more weird prompts and deep dives. Take care of yourselves and your little ones.
I can still hear you!
Go away, Herman!
Leaving now!
Unbelievable. Every time. Alright, see you guys.
