How to Reduce the Risk for Food Allergies in Children
Food allergies are a scary topic for parents. You want to nourish your baby, and the thought that food could do harm can turn feeding fun into feeding fear! Although food allergies are a serious reality, only approximately 6% of children will experience a true food allergy and some of these allergies can be avoided or outgrown (see Food Allergies: Do Children Outgrow Them? for more information). While certain allergies are unavoidable, there are measures you can take from the time of breastfeeding through the introduction of solid foods to help prevent allergic reactions to foods. Here are the latest guidelines.
The First Six Months
The American Academy of Pediatrics recommends feeding your baby only breast milk for the first four to six months of life. Babies with a direct family history of food allergies, meaning mom, dad, and/or siblings, should be fed only breast milk (or a hypoallergenic formula, if breast feeding is not feasible) for a FULL six months. Mom might also consider steering clear of peanuts and tree nuts while breastfeeding, since these foods contain proteins that can make their way into breast milk. Depending on the severity of food allergies in close relatives, mom might even consider avoiding eggs, cow's milk, and fish while breastfeeding - but, since that could also eliminate a lot of important nutrients, it is best to speak with your doctor about allergy risk before cutting more than one food out of your diet.
How to Introduce Solids
Most of us are familiar with foods that are likely to cause allergies (nuts, cow's milk, eggs, shellfish, soy and wheat) but are less sure of the right time to introduce these foods. When you introduce foods is just as important as what you introduce and how you introduce it! Offering solid foods before your baby is four months old can put him or her at a higher risk for developing a food allergy later on. Introduce new foods slowly--and only offer one new food every 4-5 days. Before you introduce mixed foods, make sure that each component of the mix has been given separately without a reaction. It is best to start with iron-fortified rice cereal mixed with breast milk, which is a less-reactive food for most infants. Then introduce cooked, pureed, and strained fruits and veggies. Cooking makes fruits and veggies less likely to cause an allergic reaction. Introduce cooked versions first (even if the food is able to be mashed raw) - especially for babies at high risk for food allergies. Be particularly watchful of kiwi fruit. Allergic reactions to kiwi are more common lately - but cooking reduces the risk of a reaction. Also make sure that meats are well cooked before offering them to your baby.
See also "Nutrition and Parenting: Children Eating with Family" and "Tips for Feeding Your Baby Only The Best" for further tips.
Common Foods that May Cause an Extreme Allergy
Waiting to introduce cow's milk until age one is a well-established way to prevent milk allergies. But what about the other highly allergenic foods like eggs, peanuts, tree nuts, fish, and seafood? This is not as clear-cut. For kids with a direct family history of food allergy, the American Association of Pediatrics recommends waiting to introduce eggs until age two, and peanuts, tree nuts, and fish until age three. For babies without a family history of food allergies, it's best to wait until the first birthday to introduce more highly allergenic foods.(For further information on peanut allergies see the following article from TheDietChannel: Peanut Allergies: Recognize & Manage A Peanut Allergy.
Do not let feedings stress you or your baby out. Food allergies are a serious issue, but taking the proper precautions enables you to introduce foods confidently. Watch carefully for signs of reactions to foods. If your baby does have a reaction to a food, speak to your doctor (if it is a severe reaction, seek immediate medical attention).
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Muraro A, Dreborg S, Hankel S. Dietary prevention of allergic diseases in infants and small children: Part III: Critical review of published peer reviewed observational and international studies and final recommendations. Pediatr Allergy Immunol. 2004;15:291-307.
American Academy of Pediatrics Committee on Nutrition. Hypoallergenic infant formulas. Pediatrics. 200;106(2):346-349.
Food Allergy: An Overview. U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Allergy and Infectious Diseases. NIH Publication No. 04-5518 July 2004. www.niaid.nih.gov.