Allergies And Breastfeeding Or Formula Feeding
Exclusive breastfeeding or first infant formula is recommended for around the first 6 months of life.
If your baby has a cows’ milk allergy and is not being breastfed, talk to your GP about what type of formula to give your baby.
If you’re pregnant or breastfeeding, you do not need to avoid foods that can trigger allergic reactions , unless you’re allergic to them.
How Does An Allergy Develop In Babies
The most common way a baby becomes allergic is when they develop whats called the hygiene hypothesis. This means that your baby isnt exposed to enough germs, bacteria, or allergens while growing up which causes their immune system to overreact when it comes into contact with something new. Some things you can do about this are: make sure your home is clean , give them pets, let them play outside more often and eat healthy foods rich in antioxidants like blueberries. Those actions should help reduce your childs risk of developing allergies.
What Are Food Allergies
No one understands why, but food allergies in children are an increasing occurrence. Some theories: children are exposed to allergens at a later time, they come across less bacteria in everyday life, and parents have more awareness. The foods that cause 90 percent of allergic reactions in the United States are milk, eggs, peanuts, tree nuts, shellfish, fish, soy, and wheat.
“A food allergy occurs when the body responds to proteins in foods that it mistakenly thinks are harmful,” says Katie Marks-Cogan, M.D., co-founder and Chief Allergist of Ready, Set, Food. Whether or not a baby will develop food allergies is partly determined by genes, but other dietary and lifestyle factors may also come into play. Babies with eczema, for example, have a higher likelihood of developing food allergies, says Dr. Marks-Cogan.
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What Foods Most Often Cause Food Allergy
Approximately 90 percent of all food allergies are caused by the followingeight foods:
Eggs, milk, and peanuts are the most common causes of food allergies inchildren, with wheat, soy, and tree nuts also included. Peanuts, tree nuts,fish, and shellfish commonly cause the most severe reactions. Nearly 5percent of children under the age of five years have food allergies. From1997 to 2007, the prevalence of reported food allergy increased 18 percentamong children under age 18 years. Although most children “outgrow” theirallergies, allergy to peanuts, tree nuts, fish, and shellfish may belifelong.
What Do I Do If My Baby Has Allergies
The best thing you can do is start by being aware and alert, look out for severe symptoms of food allergy after your child eats especially for high-risk foods like peanuts because they can be fatal. The second you see signs of an allergic reaction in your baby, its time to seek emergency medical care or the attention of your child’s doctor.
If your baby has weak or mild symptoms of common food allergies, you should stop feeding them potentially highly allergenic foods immediately and seek medical assistance as quickly as possible within twenty-four hours. This way, allergy treatment can be prescribed by the child’s doctor or medical caregiver. It is important to follow their recommendations thoroughly.
After dealing with the allergy symptoms, if necessary by using allergy medicine, it is usually recommended to begin allergy testing. For this, an allergist will likely perform what’s known as a food challenge test. During this test, a small amount of an allergen is given to your child, and then they’re monitored for an allergic reaction.
If a food allergy is diagnosed, to prevent a food intolerance or food allergy reaction your child’s doctor may recommend that you carry a chef’s card when bringing your family out to eat. This printed little card tells restaurant workers what foods your little one has to avoid to prevent a food allergy reaction. This food allergy card is a great way to keep your little one safe and minimize the risk of a food allergy reaction occurring.
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Why Did The Food Allergy Guidelines Change
The American Academy of Pediatrics published guidelines in 2000 recommending that infants not consume milk until they were 1 year old, eggs until age 2, and peanuts, tree nuts, fish, or shellfish until their third birthdays. There was no evidence that delaying those foods prevented eczema and food allergies, so in 2008 those guidelines were changed.
But it was unclear when and how to begin giving those foods to young children. As a result, many parents were confused about how to protect their children and remained cautious. Mothers-to-be cut certain foods out of their diets and left them out as they began nursing. But this prevented kids from getting much-needed nutrients, which is partly why organizations have released new guidelines in recent years.
Expose Your Baby To Dogs And Other Environmental Factors
According to the hygiene hypothesis, exposure to diverse environments and surroundings can also help build up a babys immune system. For example, regular exposure to farm environments, or attendance at a daycare or playgroup, may help protect against food allergies because of the different particles in those environments.
In particular, though, owning a dog may help reduce your babys food allergy risk. Dogs expose babies to more particles from the environmentand owning a dog also gives families a reason to go outside frequently. As reported by the EAT study, living with dogs was associated with a 90% reduction in food allergy risk, and none of the babies who lived with two or more dogs developed a food allergy.
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Prevention Of Food Allergies
The development of food allergies cannot be prevented, but can often bedelayed in infants by following these recommendations:
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If possible, breastfeed your infant for the first six months.
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Do not give solid foods until your child is 6 months of age or older.
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Avoid cow’s milk, wheat, eggs, peanuts, and fish during your child’s first year of life.
Are These Guidelines Safe
“We know that feeding infants allergenic foods is inherently safe,” assures Dr. Marks-Cogan. “Allergic reactions are milder in children than in adults. That’s why we believe that less than 1 year of age is the safest time to be introducing allergenic foods.” That said, you can still follow these safety measures when starting solids:
- Start solids around 4 to 6 months, depending on your baby’s readiness. Introduce new foods one at a time, three to five days apart, to watch for allergic reactions. Symptoms include itchy eyes or mouth, swelling of the tongue and throat, hives, vomiting, diarrhea, abdominal cramps, difficulty breathing, and in extreme cases, anaphylaxis.
- The AAAAI recommends that allergenic foods like eggs and cow’s milk be given for the first time at home, rather than at day care or in a restaurant. They can be introduced after an infant has successfully tolerated a few of the basic complementary foods.
- Peanuts and peanut butter are choking hazards in infants and young children, so rely on peanut butter mixed with warm water or purees instead. Also, a child who has a sibling with peanut allergy does not necessarily need to be tested before eating peanuts because their risk is only slightly higher than the general population.
- Follow your doctor’s advice for starting solids if your little one was diagnosed with asthma, eczema, or a food allergy.
Video courtesy of National Jewish Health
Additional reporting by Nicole Harris.
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Introduce The Worry Foods Early
Step one, as we’ve discussed above, is to bring allergen foods into the equation as early as possible. After babies reach the four- to six-month range, you’ll be able to appropriately examine their reactions to food outside of breastfeeding and/or formula. But what foods does this include exactly?
Foods that may cause an allergic reaction or intolerance are those that are or contain milk, egg, wheat, soy/soybeans, peanut, tree nuts, fish , and sometimes even sesame seeds. “It’s OK for babies to be introduced to these things that are sort of allergens. And it might be even better to have it among the earlier foods they’re introduced to,” Dr. Sicherer says.
Multiple studies and reviews have found that introducing allergens to infants within the beginning of their first year combats the development of allergies to food as the child grows up. It’s also possible that if the process is delayed for too long, then there’s a greater chance that a child can become allergic or more sensitive to common allergy-related foods.
“The introduction of peanut, for example, is generally recommended around six months of age, not before four months,” Dr. Sicherer explains. But, he says, “for babies showing signs of allergy, it might actually be given earlier in that four to six months window of time.” Early attempts can allow parents to see any physical discomfort, and allergies can be spotted and then dealt with quickly .
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Helping To Prevent The Development Of Food Allergy In Infants
Recommendations for the introduction of common allergens to infants has changed over the last few years as research has emerged on ways to help prevent the development of food allergy in babies.
In 2019, the Canadian Paediatric Society released recommendations on the specific timing of early introduction of allergenic foods for high-risk infants. The guidance is to actively offer non-choking forms of foods containing common allergens around 6 months of age, but not before 4 months, as this can be effective in preventing food allergy in some high-risk infants. This specific timing is reinforced, along with other recommendations, in the position statement co-published by CPS and the Canadian Society of Allergy and Clinical Immunology in 2021.
This represents a dramatic shift from previous advice to parents and caregivers regarding the introduction of common allergens in a childs diet.
Infants who are not considered high risk should start to receive complementary foods when they are around 6 months of age and show signs of developmental readiness.
Please scroll below for information on the introduction of allergenic foods to babies. You will find recorded webinars for parents and healthcare professionals, a frequently asked questions document for parents, and other resources for families and healthcare professionals.
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Get Creative When Serving Up Potential Allergen Foods
When getting ready to share these new foods with your baby, it’s best to keep in mind that, “allergens are essentially the same as any other food, they still have to be given in a way that a baby isn’t going to choke on it,” says Dr. Sicherer.
On average, the first foods fed to babies in America are normally ones like grains or oats and pureed food in jars. These are almost always single-ingredient foods or vegetablessuch as oatmeal, squash, peas, or applesauceand can remain the initial solids you decide to give your infant, before stepping into the realm of allergens.
When allergy-related foods come into the picture , Dr. Sicherer recommends smoothing out choking hazardous components into warm water to make a sauce or liquidy paste .
“Tree nuts are real hard,” he explains. But if you’re really adamant about adding them to your infants’ diet as soon as they’re ready, then it’s best to “have it in forms that are going to be baby-safe. That would be made into butters that can be smoothed out, for example, or flours.”
If you’re looking for something simple to start within the allergens family, try some soft cheeses, yogurt, or eggs. “Eggs could be pretty easy,” Dr. Sicherer claims, while “babies should not eat raw egg, you certainly could make scrambled egg and mash it up into small bits.”
Fish Oil To Prevent Allergies In Babies
A number of studies have looked at whether fish oil during pregnancy, breastfeeding and infancy has been able to prevent allergies in babies.
Fish oil is rich in the omega-3 fats eicosapentaenoic acid and docosahexaenoic acid . In most of the research into fish oil and allergies, participants were given a high-dose EPA/DHA fish oil supplement.
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So far the research has not produced consistent results, with some studies showing a possible benefit and others showing no effect. For the studies that have shown positive effects, EPA/DHA supplementation has reduced the incidence of eczema and sensitisation to specific foods, particularly egg .
While we are yet to see consistent results for the prevention of allergies, fish oil also provides other benefits during pregnancy and breastfeeding especially good amounts of DHA, which supports the development of the babys brain, eyes and nervous system.
If you enjoy seafood, try to incorporate 2-3 servings of fish into your meals each week, including oily fish like salmon, sardines, trout and tuna.
An EPA/DHA supplement may also be suitable. Learn more about omega 3s, fertility and pregnancy in my blog post here!
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How Should We Counsel Families On Food Introduction
The recent statement from the American Academy of Allergy, Asthma and Immunology provides practical advice for families around complementary food introduction.20 It recommends that new foods be introduced at a rate of no more than one new food every three to five days in an age-appropriate manner . In addition, the statement suggests starting with typical complementary foods and introducing one of the highly allergenic foods once a few complementary foods have been well tolerated. The highly allergenic foods should be given at home , and the guideline reiterates that reactions can occur with first known ingestion. If there is no reaction, it is recommended that the food in question be gradually increased in amount over a few days duration. As stated in the Canadian Pediatric Societys guideline, regular ingestion of tolerated foods is important for maintenance of tolerance.21 Once a highly allergenic food is tolerated, it should be consumed regularly .
Food Additives That Can Provoke Allergies
Formula-fed babies are exposed to different ingredients than exclusively breastfed babies. Because of this, some babies end up developing food allergy symptoms from food additives in their formula. These common allergens include soy, palm oil, different metals, sulfites, sodium benzoates, food coloring, and sugar.
If you take a look at many baby formula ingredients lists, you’ll often find soy milk lecithin. This additive is commonly used as an emulsifier . The problem with this ingredient is that it’s been known to cause mild adverse reactions in babies such as mouth itching, mouth swelling or even causing an itchy rash.
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Yet another problematic additive found in baby formula is sulfites or sulfate agents. These are used to prevent or delay food spoiling. While the extended shelf-life of baby formula can be seen as a plus, when it’s added to the formula at a concentration of more than 10 mg/kg, that’s when unwanted side effects start happening. At this concentration, sulfites can cause severe eczema and other symptoms of a food allergy in children and babies.
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Include Allergenic Foods In Your Diet
Pregnant and breastfeeding mothers should eat a healthy, balanced diet, including allergenic foods. Cutting allergenic foods out will not prevent food allergy in your infant. There is some evidence that omega-3 fatty acids during pregnancy and breastfeeding may help prevent eczema in early life, so try to include up to 3 serves of oily fish per week.
When It Comes To Your Maternal Diet:
In a systematic review of maternal diets, researchers found that a Mediterranean diet pattern and diets high in fruits, vegetables, fish, and foods containing vitamin D was associated with lower risk for allergies in children. Diets associated with a higher risk of food allergies included vegetable oils, margarine, nuts, and fast food.
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When You Find One Allergy The Clock Really Is Ticking And The Window Of Opportunity Starts Closing George Du Toit
Du Toit says it is important for parents to be aware that there is a “window of opportunity” to establish tolerance, between 4-11 months.
Parents should start weaning their children on to as many different foods as possible, especially if they have eczema, he says.
“It’s rare to be allergic to just one food where you find one food allergy, you usually will find others,” says Du Toit. “When you find one, the clock really is ticking and the window of opportunity starts closing. Ideally, you want to be weaning onto other common safe food allergens.” By the time the baby reaches 12 months, it’s often too late as the allergies are already established, he says.
“A lot of allergies go together because they share common proteins, especially shellfish,” says Nadeau. “So if you’re allergic to shrimp, you’re more likely to be allergic to other items that have an exoskeleton like lobster.”
Therefore it is important to introduce infants to a wide range of food in the first year of their life, she says.
Is being ‘too clean’ really a problem?
One of the most discussed topics when it comes to allergies is whether cleanliness is to blame for rising allergies.
The theory is contentious and many scientists disagree with it, arguing that good hygiene is vital to protect against disease and that there is no good evidence showing that cleanliness is responsible for the development of allergic diseases.
Amish children raised on traditional farms have a particularly low incidence of allergies
What Is Food Allergy
Food allergy occurs when the immune system mistakes a specific protein in a food as harmful. Once a person has a food allergy, an allergic reaction occurs every time they eat that food.
About 7% of babies and young children have food allergy. Children can outgrow some food allergies.
The foods that cause food allergy most often are called common food allergens. They include:
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