Cow’s milk protein allergy is one of the most common food allergies in infancy and is caused by an immune reaction to proteins in cow’s milk.

It is important to distinguish this from lactose intolerance, which is not immune-mediated and is rare in infants.

Symptoms may include eczema flares, hives, vomiting, diarrhoea, reflux-like symptoms, or blood or mucus in stools. Less commonly, respiratory symptoms can occur.

Cow’s milk can be introduced from around 6 months in age-appropriate forms such as yoghurt, cheese or milk cooked into foods.

Evidence suggests that early introduction may reduce the risk of allergy development.

Many children outgrow cow’s milk allergy during early childhood, but any suspected reaction should be medically assessed.

Wheat allergy is distinct from coeliac disease and may cause hives, vomiting, abdominal pain or respiratory symptoms shortly after ingestion.

Wheat can be introduced in the first year of life once solids are established, commonly through wheat-based cereals, bread softened with liquid, or pasta prepared in soft textures.

Current evidence shows no benefit in delaying wheat introduction to prevent allergy.

Egg allergy is common in babies and toddlers, particularly during the first year of life.

Egg contains several proteins that can trigger an immune response. Some children react only to lightly cooked egg, while tolerating egg baked into foods such as muffins or pancakes — because heat alters the protein structure.

Regular exposure to tolerated forms of egg is associated with improved tolerance over time.

Egg allergy is often temporary, with many children outgrowing it as their immune system matures.

Sesame is an increasingly common cause of food allergy in Australia and is now recognised as a priority allergen.

Sesame is found in foods such as tahini, hummus, breads, crackers and baked goods.

Sesame should be introduced in infancy in small amounts, for example tahini mixed into purée or yoghurt.

Sesame allergy can cause severe reactions, including anaphylaxis, so any suspected reaction requires prompt medical assessment.

Regular inclusion is recommended once tolerated.

Peanut allergy is one of the most significant food allergies due to its potential severity and persistence into adulthood.

Strong evidence shows that introducing peanut in infancy significantly reduces the risk of peanut allergy, including in higher-risk children.

Peanut should be introduced in the first year of life in a smooth, diluted form, such as smooth peanut butter mixed into purée, yoghurt or porridge.

Whole peanuts and thick spoonfuls of nut butter are choking hazards and should never be offered to infants.

Once peanut is tolerated, regular inclusion is important to maintain immune tolerance.

Tree nuts include almonds, cashews, walnuts, hazelnuts, pistachios and others.

Allergy may occur to one or multiple tree nuts, and tolerance to one does not guarantee tolerance to others.

Whole nuts are a significant choking risk and should not be offered to young children.

Tree nuts should be introduced as finely ground nut meal or smooth nut butter mixed into food.

Reactions can range from mild skin symptoms to anaphylaxis.

Early introduction in safe forms is encouraged, and ongoing exposure is important if tolerated.

Soy allergy is less common but may occur, particularly in children with other food allergies such as cow’s milk allergy.

Soy is found in foods like tofu, soy yoghurt, soy flour and many processed foods.

Soy can be introduced safely during infancy in age-appropriate forms such as mashed tofu or soy-based yoghurt.

Most children with soy allergy outgrow it during childhood, but reactions should be assessed by a healthcare professional.

Fish allergy can cause rapid reactions including hives, vomiting or breathing difficulties.

Fish should be introduced during the first year of life as well-cooked, deboned fish that is finely flaked or mashed into meals.

Early introduction may reduce allergy risk and provides important nutrients, including omega-3 fatty acids essential for brain development.

Unlike some other food allergies, fish allergy is less commonly outgrown and should be taken seriously.

Shellfish includes crustaceans (such as prawns, crab and lobster) and molluscs (such as scallops and mussels).

Shellfish allergy often develops later in childhood but can occur in infancy. Reactions can be significant and may persist into adulthood.

Shellfish should be introduced only when a child is developmentally ready, in well-cooked, finely chopped or mashed forms.

Initial exposure should be in small amounts with careful observation.