Tomatoes for babies: when to start, safe cuts and mouth rash

Tomatoes can be offered from around 6 months, once your baby has started solids. None of the Australian, UK or US guidance we checked sets a later age for them. Three things are worth getting right: cutting cherry tomatoes so they're less likely to block the airway, knowing that a red ring around the mouth after tomato is usually skin irritation, and keeping tomato sauces free of added salt.

This guide covers when to start, cooked versus raw, how to prepare tomatoes at each stage, choking safety, mouth rash and allergy, sauces and salt, and when to get help.

When can babies eat tomatoes?

From around 6 months, once your baby shows the signs of being ready for solids described in starting solids.

The ASCIA guide to introducing solid foods, from Australia's allergy body, says iron-rich foods should be offered at around 6 months and other solid foods can be introduced in any order. Australia's Pregnancy, Birth and Baby, which lists the national Infant Feeding Guidelines among its sources, includes cooked or raw vegetables and fruit among foods to introduce before 12 months. The NHS guide to feeding from around 6 months includes vegetables and fruit from the start. The CDC's foods and drinks for 6 to 24 month olds says babies can start foods other than milk around 6 months, and its solids guide names tomatoes among small round foods to cut into small pieces.

Is there any reason to wait?

Not for allergy. The AAP's starting solids page says there's no evidence that waiting to introduce baby-safe foods beyond 4 to 6 months prevents food allergy. Tomatoes aren't on ASCIA's list of the most common allergy foods.

Should tomatoes be cooked or raw for babies?

Either can work, and the sources lean slightly differently.

• AAP (US). Apart from mashed banana, most fruits and vegetables should be cooked until soft for first foods, with no added salt or seasoning.
• NHS (UK). Soft ripe fruit can be mashed with a fork or given as finger food, and harder fruit needs cooking to soften it.
• Pregnancy, Birth and Baby (Australia). Cooked or raw vegetables before 12 months, but small hard foods, such as uncooked hard vegetables, are a choking risk.

Cooked tomato is soft, its skin slips off easily, and it mashes smoothly, so it suits the first weeks. Ripe raw tomato is soft too, but the skin is chewy. New Zealand's Ministry of Health, in its choking advice for early learning services caring for children aged 1 to 6, says fruit skins such as tomato skin are difficult to chew and can seal a child's airway, and suggests finely chopping tomato. Peeling or finely chopping raw tomato for babies follows the same idea.

How do I prepare tomatoes for my baby?

1. Wash and core. Rinse tomatoes under running water and cut out the hard core where the stalk joined.
2. Cook or chop. For first tastes, simmer chopped tomato until soft, then slip off the skin.
3. Shape it for your baby's stage using the table below.
4. Skip the salt. The AAP says to cook fresh foods with no added salt or seasoning.

Around 6 months. The NHS suggests cooking vegetables to soften them, then mashing or blending them, or offering them as finger food. Tomato's sharp taste goes well mixed into milder vegetables, lentils or pasta.

8–9 months. Small, soft pieces suit babies who are learning to pick food up. The AAP's choking-prevention advice suggests pieces no larger than half an inch (about 1 cm) for infants and young children.

12 months and beyond. ASCIA says to aim for your baby to be eating soft, cut-up or roughly mashed family meals by 12 months. Keep quartering cherry tomatoes and cooking your baby's portion without salt. For how textures progress overall, see food textures.

How should I cut cherry tomatoes for my baby?

Always into quarters, lengthways. The CDC's choking hazards list includes uncut cherry or grape tomatoes. The NHS guide to preparing food safely says to cut small round fruits, including cherry tomatoes, into quarters (4 small pieces), and the NHS first solid foods guide says the same. That means cutting in half from stalk to base, then in half again. The NHS advice is quarters, not halves.

Keep doing it for years, not months. The AAP says to keep high-risk foods from children until 4 years of age or older, depending on their development, and that round, firm foods can be served if completely chopped into tiny pieces.

Set every meal up the same way. The CDC says to keep your child sitting up while eating, watch them the whole time, and avoid eating in the car or pram. Gagging is common while babies learn; choking vs gagging explains the difference.

These steps follow the NHS choking first-aid guide, which also says to get medical help afterwards even if the food came out. The Royal Children's Hospital Melbourne in Australia says anyone caring for young children should do a children's first-aid course, and the AAP recommends a certified CPR and first-aid course. An infant first-aid course before or soon after starting solids lets you practise.

Is the red rash around my baby's mouth a tomato allergy?

Usually not. The Sydney Children's Hospitals Network fact sheet on fruit and vegetable allergy, from Australia, says some children get a rash around the mouth after acidic foods like tomatoes, oranges and strawberries. It calls this perioral contact dermatitis, and says it doesn't mean you need to remove the food from your child's diet.

ASCIA agrees that a mild rash limited to the area around the mouth (redness or contact hives), appearing during or just after eating, without other allergy signs, may not be an allergic reaction.

To reduce redness, ASCIA suggests a barrier cream without perfume or food ingredients on the face and chin before meals, and offering food on a spoon directly into the mouth. Offering tomato mixed into other food also means less acidic juice on the skin. ASCIA says never to rub food on your baby's skin to "test" for allergy.

If redness keeps appearing, note whether the tomato was raw or cooked, whether it touched your baby's face, and when the redness started and faded. A photo helps a doctor more than a description.

Can babies be allergic to tomatoes?

They can, though tomato isn't one of the common allergy foods. Australia's Sydney Children's Hospitals Network says fruit and vegetable allergy can develop at any age, with signs such as hives, vomiting, tummy pain, and tingling or swelling of the mouth, lips, face or eyes. It lists tomato among foods more likely to cause problems for children with latex allergy, and among foods linked to grass pollen allergy. The NHS food allergy page says pollen food syndrome, an itchy mouth after raw fruit or vegetables, is not usually serious, and that well-cooked fruit and vegetables can help.

The CDC suggests one new single-ingredient food at a time, with 3 to 5 days between new foods, and ASCIA says reactions usually happen within minutes to two hours. Introducing allergens covers egg, peanut and the other common allergens.

These steps follow the ASCIA first aid plan for anaphylaxis from Australia, which says to hold young children flat, to give the adrenaline device if in doubt, and to start CPR if your baby is unresponsive and not breathing normally. For hives beyond the mouth, swelling of the face or eyes, or vomiting with normal breathing, stop the food, stay with your baby and get medical help today.

Can my baby have pasta sauce and other tomato sauces?

Homemade, yes; many shop-bought sauces are too salty. The NHS salt guide says babies under 1 year should have less than 1 g of salt a day and children aged 1 to 3 no more than 2 g, because a baby's kidneys can't process much salt. It names ketchup among sauces that can be high in salt. The NHS foods to avoid page says not to use stock cubes or gravy in your baby's food, and to avoid salty foods such as ready meals and takeaways.

The CDC's foods to avoid or limit says some canned foods are high in salt, so choose low-sodium or no-salt-added versions, and check labels for sodium and added sugars. It also says infants and young children shouldn't have added sugars.

A simple baby-friendly tomato sauce:

1. Soften onion or other vegetables in a little oil.
2. Add chopped fresh tomatoes or no-added-salt canned tomatoes.
3. Simmer until thick and soft, then mash or blend to suit your baby.
4. Take your baby's portion out before adding salt, stock or seasoning for the family.

Takeaway pizza and pasta count as takeaways, which the NHS lists among salty foods, and it's worth checking the label on anything ready-made, such as tomato soup. Foods to avoid covers salt in more detail.

How do tomatoes fit into my baby's meals?

The CDC's iron page lists tomatoes among vitamin C-rich foods, and says pairing them with plant sources of iron helps babies absorb it. Tomato makes an easy partner for the foods in first foods and iron:

• mashed lentils or beans cooked with tomato
• soft pasta with a homemade tomato and minced meat sauce
• quartered cherry tomatoes alongside soft tofu or egg

When should I get help?

Call your local emergency number (000 in Australia, 999 in the UK, 911 in the US) now if your baby:

• can't breathe, cough or cry because food is stuck, turns blue or becomes unresponsive
• has sudden swelling of the lips, tongue or throat after eating
• has difficult or noisy breathing, a wheeze or a persistent cough after eating
• becomes pale, floppy or drowsy, collapses, or has a hoarse or weak cry

ASCIA classes lip swelling on its own as mild to moderate, while the NHS urgent-help guide lists swollen lips, tongue or throat with difficulty swallowing among reasons to call an ambulance, so this guide treats sudden lip swelling as an emergency.

Get medical help today if your baby:

• has hives or welts beyond the mouth, or swelling of the face or eyes, and is breathing normally
• vomits after eating tomatoes
• needed back blows or chest thrusts, even if they now seem well
• has blood or red streaks in their poo that aren't tomato skin

Talk to your GP or child-health nurse if:

• mouth redness keeps happening and you're unsure whether it's irritation or allergy
• your baby has a latex allergy or hay fever and you'd like advice on tomatoes
• you'd like to offer tomatoes again after a reaction