Making a Smart Start on infant food allergies

Australia has one of the highest rates of food allergies in the world, with over half a million Australian’s having a diagnosed food allergy and one in ten children developing a food allergy before their first birthday.

The good news is that recent results from a tool developed to better identify food allergies in infants – SmartStartAllergy – suggests there is a shift in infant feeding practices that may help to reduce the occurrence of infant food allergies in Australia.

What is a food allergy?
A food allergy is the body’s immune system response to a food protein that the body mistakenly believes is harmful.

The most common food allergens include:

  1. Eggs
  2. Peanuts
  3. Tree nuts (such as cashews, pistachios, walnuts, pecans and hazelnuts)
  4. Cow’s milk
  5. Wheat
  6. Fish
  7. Shellfish
  8. Sesame
  9. Soy

While most allergic reactions to these foods are mild or moderate, some people can have severe allergic reactions or anaphylaxis. These severe symptoms include:

  • Difficult or noisy breathing.
  • Swelling of the tongue and throat (e.g. drooling, difficulty swallowing).
  • A change in voice or cry and/or difficulty vocalising.
  • A persistent cough, wheezing or stridor.
  • Collapse or fainting.
  • Paleness and floppiness (in young children).

Anaphylaxis can be life threatening, so if your child is showing any signs of a severe allergic reaction, please seek urgent medical assistance.

This video produced by Allergy & Anaphylaxis Australia shows how to recognise the signs and symptoms of an allergic reaction>>

Infant food allergies
Food allergy has been on the increase in Australia in recent years, with one in ten infants now having a confirmed allergy. Between 1997 and 2001, food allergies in children increased by 50% and around 2% of children now have a peanut allergy. This is of some concern as while most food allergies resolve with age, peanut allergy persists.

It is believed that the medical advice in the 1990s and early 2000s to avoid feeding allergenic foods to young children may have contributed to this increase in allergies, with studies showing that around 70% of children during that time had not eaten peanut by 12 months of age. What we now know is that the delayed introduction of allergenic foods increases the risk of food allergies.

Preventing food allergies in Australia
To help reduce the risk of food allergies developing, the Australian Society of Clinical Immunology and Allergy (ASCIA) introduced new guidelines in 2019 which recommend introducing solid foods to infants between four to six months of age and introducing the common food allergens by 12 months of age.

It is also recommends that breastfeeding mothers continue to breastfeed their infant while solid foods are first introduced, to help reduce the risk of food allergies developing.

SmartStartAllergy data shows shift in feeding practices
Recent data from SmartStartAllergy suggests the change in ASCIA’s infant feeding guidelines has helped to shift infant feeding practices in Australia with respect to introducing common food allergens. The data suggests that most infants now receive peanut during their first year of life, consistent with ASCIA guidelines.

It is hoped that this shift may help to reduce the occurrence of infant food allergies in infants in Australia.


SmartStartAllergy is a collaboration between SmartVax, the National Allergy Strategy (NAS), with funding from the Australian Government Department of Health and the Perth Children’s Hospital Foundation.

It uses automated SMS technology to send a text message to parents when their baby is 6, 9 and 12 months old to find out if they have introduced solid foods (including peanut). Some parents will only receive a text message at 12 months. Subsequent messages ask if the child has had an allergic reaction to any introduced foods.

Parents also receive a brief questionnaire to find out about any allergic reactions, family history of allergy, or if their child has eczema.

SmartStartAllergy is currently used at 69 sites across Australia and has reached the parents and carers of around 16,000 infants to date.

The data collected through SmartStartAllergy will continue to provide important information about infant food allergies in Australia and helps to support the National Allergy Strategy Food Allergy Prevention Project.

To find out more, visit SmartStartAllergy or speak to your GP.

If you have any concerns regarding infant food allergies, make a booking with one of our GPs. Bookings can be made online or by contacting us on (08) 9208 6400.

For more information on this topic, visit: