Foods for Babies and Toddlers: Choking, Honey and Allergen Introduction

Know the emergency signs first

A baby can have a severe allergic reaction (anaphylaxis) to a new food. The UK National Health Service (NHS) says it starts quickly and can cause breathing problems, a swollen throat or tongue, or a raised, itchy rash, and that it needs urgent treatment. [1] In the United States, MedlinePlus says to call 911 if someone has the symptoms of anaphylaxis. [2] For choking, stay with your baby while they eat. [3] For what happens after a reaction, see When to seek medical help after a food reaction.

This page is general information from official health bodies, not advice for your own child. A pediatrician or health visitor decides what is right for a child with eczema, a known allergy or a family history of allergy.

Honey and babies

MedlinePlus lists infant botulism as a form of botulism that happens when a baby swallows spores of the bacterium from soil or honey, and says all forms can be deadly medical emergencies. [4] The NHS gives the same reason and a clear age limit: honey can occasionally contain bacteria that produce toxins in a baby's intestines, so it advises no honey until a child is over 1 year old. [5] Honey as a skin or home-remedy ingredient is covered in Natural Ingredients.

Choking hazards

The NHS says whole nuts should not be given to children under 5 because they can choke on them. [5] It also advises avoiding hard foods such as whole nuts or raw carrot or apple for babies starting solids, and cutting small round foods such as grapes and cherry tomatoes into quarters. [3] Nut butter on its own is also a choking risk, according to the NHS, which suggests it only be spread onto another food. [5] The NHS separates choking from gagging: gagging is common as babies learn to manage solid foods. [3] Seeds are discussed on chia seeds, which carries its own choking cautions.

Nut allergy and introducing allergen foods

The NHS lists foods that can trigger allergy: eggs, nuts and peanuts, cows' milk, foods with gluten, seeds such as sesame, soya, shellfish, fish and others. It advises introducing them one at a time from around 6 months so a reaction can be spotted. [1] It says evidence has shown that delaying peanut and hen's egg beyond 6 to 12 months may increase the risk of allergy to them. [1] Its advice on form is specific: nuts only crushed or ground and added to food, and peanut butter only spread on food. [5]

Timing guidance for infants at high risk of peanut allergy comes from US allergy-institute guidelines (NIAID). We could not read that page this session, so we do not summarize it here. Ask a pediatrician.

Other foods official bodies say to avoid or limit for young children

• Rice drinks: the NHS says children under 5 should not have rice drinks as a milk substitute because they may contain too much arsenic. [5] See heavy metals in foods.
• Unpasteurized and mould-ripened cheeses: the NHS advises avoiding them for babies because of listeria risk. [5]
• Raw or lightly cooked eggs: the NHS gives a UK egg-quality rule that does not apply in the US, and says untested raw eggs should be avoided. [5]
• Juice: US Dietary Guidelines, as quoted by FDA, say infants under 1 year should not drink juice. [6]
• Shark, swordfish and marlin: the NHS says children under 16 should avoid them for mercury. [5] See fish and mercury.
• Salt and sugar: the NHS advises against added salt and, for children 4 or younger, against food and drink with added sweeteners or sugar. [5]