By Gina Shaw. Reviewed by Amita Shroff, MD
Starting to feed a baby solid foods is an exciting milestone for parents. However, it comes with a lot of questions and concerns, especially about food allergies. What foods are most likely to cause allergies in babies? How do you avoid them?
Emerging research has shown that introducing multiple foods together is safe, and may help the immune system have a lower risk of developing food allergies, but more studies are needed. Check with your doctor for what’s best for your baby.
Start Gradually to Identify Any Food Allergies
It’s most important to introduce a baby to new foods gradually, one at a time, in case of food allergies. If not, a parent may have trouble tying an allergy to a specific new food. For example, if you give your baby three new foods over the course of a day and they develop an allergic reaction, you won’t know which of the foods provoked it.
The type of food or the order in which food is introduced is not much of a concern, as long as the foods you are offering are healthy and well-balanced for the baby. Each time you offer a new food, you should wait three to five days before adding another new item to the menu. Don’t eliminate the other foods your baby is eating during that time; you already know these are safe because the child has not had any food reactions up until now. Just don’t add anything else new.
Babies and Allergies: The Top 8 Allergenic Foods
With any new food, you’ll want to be on the lookout for any allergic reactions. There are more than 160 allergenic foods; certain foods may be more allergenic than others. The following eight foods and food groups are known to possibly cause problems with allergic reactions possibly up to 90% of the time.
- • Cow’s milk
- • Eggs
- • Fish
- • Peanuts
- • Shellfish
- • Soy
- • Tree nuts (such as walnuts or almonds)
- • Wheat
New nutrition guidelines from the American Academy of Pediatrics (AAP) say it’s okay to introduce these allergy-causing foods when your baby is ready to eat solids. There is no evidence that waiting until the baby is older prevents food allergy. If you believe your baby has an allergic reaction to a food, such as diarrhea, rash, or vomiting, talk with your child’s doctor about the best choices for the diet.
Within a few months of starting solid foods, your baby’s daily diet should include a variety of foods, such as breast milk, formula, or both; meats; cereal; vegetables; fruits; eggs; and fish.
Food Allergy Symptoms to Watch for in Your Baby
Food allergy symptoms usually appear very soon after the food is eaten -- within a few minutes to a couple of hours. If you’re introducing a new food to your baby, keep an eye out for these symptoms:
- • Coughing or wheezing
- • Difficulty breathing
- • Face, tongue, or lip swelling
- • Flushed skin or rash
- • Hives or welts
- • Loss of consciousness
- • Vomiting and/or diarrhea
Severe Food Allergy Symptoms: When to Call 911
Severe allergic reactions can be fatal very quickly. If your baby is having trouble breathing/wheezing, has swelling on their face/lips, or develops severe vomiting or diarrhea after eating, immediately call an ambulance. You can inform your pediatrician at a later time.
Dealing With Mild Food Allergies in Baby
If you see mild symptoms, such as hives or a rash, contact your pediatrician for further evaluation. The doctor might refer you to an allergist (allergy specialist doctor), who will ask more questions and do a physical exam. The allergist may order diagnostic tests such as:
- A skin test. This test involves placing liquid extracts of food allergens on your child’s forearm or back, pricking the skin, and waiting to see if reddish raised spots form within 15 minutes. A positive test to a food only shows that your child might be sensitive to that food.
- Blood tests to check the blood for IgE antibodies to specific foods
Remember, just because a baby’s initial allergic reaction to a new food may be mild, it may get worse upon following exposures. Talk to your pediatrician about any food allergy symptoms in your baby.
Some allergies go away with time. Egg and milk allergies often go away as children get older, but peanut, tree nut, and shellfish allergies tend to persist. That said, research shows that in the case of peanut allergies, peanut immunotherapy drops administered under the tongue are safe and effective as treatment for peanut allergy, even in children as young as 1. They were also found to help significantly desensitize the patients to peanuts.
The Family Food-Allergy Connection
If there is a history of family food allergies, your baby has an increased risk of also developing allergies, although it is not a certainty. If you have the allergies, the odds are 50-50 for them to have them as well.
It’s best to introduce the 8 allergens gradually, at one-to-two-week intervals over time so that you can recognize if an allergy develops.
Protecting Baby Against Food Allergies: Easy Does It
In a reversal of earlier policy, the AAP is now recommending that potential allergens be introduced to your infant earlier rather than later. In doing so, the move may actually help prevent them from developing allergies to those foods.
Breastfeeding your baby for 4-6 months is the best way to prevent a milk allergy. Remember that breast milk or formula is higher in nutrition. When you begin to introduce whole milk, you should do so under a doctor’s supervision. Yogurt and soft cheeses are fine, because the proteins in these dairy products are broken down and less likely to cause tummy trouble.
The AAP now advises that, in the case of infants who are at high risk of allergies, peanuts should be introduced between 4-6 months. Infants at highest risk of developing peanut allergies are those with eczema or egg allergies or both. It was originally believed that introducing your baby to the foods when they are older might make any reactions more manageable.
Other potential allergens such as tree nuts and fish should be introduced over a period of time as you introduce your baby to solid foods, between 6 and 9 months
You should wait until at least age 1 (some experts say age 2) to introduce honey, which can cause a potentially serious disease called infant botulism. Ask your pediatrician for guidance.
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