Ah nuts! Food allergies and children part 2

Kristin Johnson, Pediatric Registered Dietitian
CentraCare Health

Food allergy recommendations have rapidly evolved. So what does this mean for parents? What should parents be doing?

Baby feeding tips to help prevent food allergies in children:

• Mothers should not avoid allergenic foods during pregnancy or breastfeeding, unless she has an allergy herself.
• Breast feed your infant! Exclusive breastfeeding for at least 4-6 months may reduce the risk of allergies in the baby, along with providing many other health benefits, including a stronger immune system. Continue to breastfeed until at least 1 year of age.
• If you can’t breast feed, feed your baby a hydrolyzed infant formula, which delays the introduction of intact cow’s milk or soy proteins until the baby is old enough to consume these proteins in foods.
• Do not offer any food until the baby is 4-6 months of age and developmentally ready.
• Begin with single-ingredient foods only. If your baby is breastfed, baby food made with meat, which has easily absorbed sources of iron and zinc, provides the extra nutrition your infant needs. Baby cereals are another common choice, although there is no medical evidence that introducing solid foods in any particular order has an advantage for your baby. However, a highly-allergenic food should not be one of the first foods given.
• Introduce each single-ingredient food for at least 3-5 days before starting another food. After each new food, monitor for allergic reactions, such as diarrhea, rash, or vomiting. If these occur, stop the food and consult with your child’s doctor.
• Highly-allergenic foods refer to the top 8 food allergens: cow’s milk, soy, egg, wheat, peanut, tree nut, fish and shellfish. These foods can be introduced after a few other foods are tolerated. Keep in mind:
  • Give an initial taste at home, rather than at day care or a restaurant.
  • Reactions typically occur on the first or second try. If there not an obvious reaction, the food can be introduced in slowly increasing amounts for a few days before starting another new food.
  • Liquid cow’s milk should still be delayed until 1 year of age as babies still need the nutrition from breast milk or formula. Other dairy foods, like plain yogurt and cheese, can be introduced in this manner.

Parents should check with the child’s doctor or allergist before introducing a highly-allergenic food when:

• The baby has already had an allergic reaction to a food. (Children with an underlying food allergy are at risk for having other food allergies).
• The baby has persistent atopic dermatitis or eczema.
• The baby has had a positive blood or skin testing to a food.
• The child has a sibling with a peanut allergy or there is a strong prevalence of atopic diseases (asthma, eczema, food and/or environmental allergies) amongst siblings and/or parents.

If parents have any questions regarding food allergies or introduction of baby foods, it is always best to speak to your child’s doctor, allergist or dietitian to get the latest information and recommendations that are individualized to your infant.

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