Infant Food Allergies

Every parent wants to minimize the potential risk that their child may develop food allergies. But while it may “feel” right to delay introduction out of an abundance of caution, you may be surprised to discover that such advice is outdated.

Previous Recommendations

For many years, it was thought that the best way to fight food allergies was to avoid peanuts or other highly allergenic foods for the first years of life. In fact, guidelines issued by the American Academy of Pediatrics (AAP) in 2000 recommended avoiding potential allergens such as peanuts, until the age of 3. But in 2008, this advice was amended as studies didn’t show enough support for this approach. Most recently, as newer evidence suggested that avoiding allergens may actually increase risk, especially among high risk infants[1][2], experts have altered their thinking and updated the AAP guidelines as related to peanuts.

Here are the latest evidence-based recommendations you need to consider with your health care provider when it comes to introducing your little one to potential food allergens during each step of their food journey. Of course, every baby is different, so be sure to talk with your pediatrician about any specific concerns you have, especially if you have a family history of food allergies.

Step 1. Consider Your Diet During Pregnancy and Breastfeeding.

According to the American Academy of Allergy, Asthma, and Immunology, restricting your own diet during pregnancy and breastfeeding is no longer routinely recommended for moms-to-be, as it has not been proven to be effective in reducing the risk of allergies in infants. And breastfeeding during the first 4-6 months may also reduce a baby’s risk of early eczema, wheezing and cow’s milk allergy[3].

Step 2. Talk with your Pediatrician Before The First Spoonful.

While the AAP recommends introducing peanut-containing foods even to “high risk” infants early on in life[4], when you’re finally ready to take that exciting step of introducing your baby to solids, talk with your pediatrician about what’s best for your baby. If you have a family history of food allergies or if your child is already displaying signs of allergy, your pediatrician may recommend that you hold off introducing certain foods or meet with a specialist to develop a personalized plan that’s right for your little one so you can continue your family’s food journey with confidence.

Step 3. Start Early. Start Small.

When offering a new food, start with a small amount, and watch for any signs of an adverse reaction from your baby. It’s a good idea to introduce these foods at home, rather than in a daycare or a restaurant setting. The AAP recommends that you wait at least 3-5 days when offering a new food before offering something else new, so that you can watch for any potential allergic reactions. The Earth’s Best® brand Suggested Infant Feeding Schedule can provide some ideas on introducing your baby to solid foods.

Once your baby has mastered a menu of simple, single ingredient foods (think Stage 1 foods such as rice, oatmeal cereal, vegetables , lean meats or fruits) that do not typically cause allergic reaction, the newest AAP guidelines state that complementary foods, including potential allergens, can be offered to healthy infants after 4-6 months of age[5] (as long as the child has not already shown signs of food allergies, or doing so is not recommended for your child). And it’s important to remember to make sure the foods you offer are age and stage appropriate, and in a consistency that is safe for your baby to enjoy.

[1] Du Toit G et al. Randomized trial of peanut consumption in infants at risk of peanut allergy. New England Journal of Medicine DOI: 10.1056/NEJMoa1414850 (2015). Consensus Communication on Early Peanut Introduction and the Prevention and the Prevention of Peanut Allergy in High Risk Infants. Pediatrics. http://pediatrics.aappublications.org/content/136/3/600

[2] Pediatrics, Volume 136, number 3, September 2015. Consensus Communication on Early Peanut Introduction and the Prevention of Peanut Allergy in High-risk Infants. http://pediatrics.aappublications.org/content/pediatrics/136/3/600.full.pdf.

[3] American Academy of Allergy Asthma & Immunology. “Prevention of Allergies and Asthma in Children.” https://www.aaaai.org/conditions-and-treatments/library/at-a-glance/prevention-of-allergies-and-asthma-in-children.aspx

[4] Pediatrics, Volume 136, number 3, September 2015. Consensus Communication on Early Peanut Introduction and the Prevention of Peanut Allergy in High-risk Infants. http://pediatrics.aappublications.org/content/pediatrics/136/3/600.full.pdf

[5] American Academy of Pediatrics. “What you need to know about the new guidelines for the diagnosis and management of food allergy in the U.S.” http://www2.aap.org/sections/allergy/allergy_guidelines_final_1.pdf