While it can feel scary and overwhelming, especially if you have a family history of food allergies, most babies will tolerate allergen foods.
Previously the recommendations were to delay the introduction of allergens whereas more recently the recommendation is to NOT delay the introduction of allergens. The Australasian Society of Clinical Immunology and Allergy (2018) recommend that infants should be given allergenic solid foods including peanut butter, cooked egg, dairy and wheat products in the first year of life. There is currently minimal research regarding an ‘optimal time’ to introduce different allergens. Recommendations may continue to change as more research and clearer evidence is provided in this space (continue reading for current information regarding allergies and intolerances).
The following resource is written with the intention to provide you with current (at the time of writing this) and evidence-based guidelines to consider when introducing your baby to the top food allergens. It is not intended to act as or replace medical advice. If you are worried or concerned about your baby at any time it is imperative that you seek appropriate medical advice and support.
BEFORE YOU START:
- Some babies experience food allergies and this is often unpredictable. Some babies experience food allergies even when you introduce your baby to allergen foods in line with current research. If you notice your baby reacts to food, stop serving the food immediately and seek medical support.
- If you have a family history of food allergies or are worried about your baby, please discuss this with your health care provider and consider implementing an introduction plan that everyone feels comfortable with.
- It can be helpful to check that your phone is charged and you have someone home with you when introducing allergen foods, in the rare case of a reaction.
WHAT ARE THE TOP FOOD ALLERGENS?
- Milk
- Eggs
- Peanuts
- Tree Nuts (almonds, cashews, walnuts etc)
- Fish
- Shellfish
- Soy
- Wheat
- Sesame
As we've personally experienced, children can have allergies to other foods. However, these are less common.
WHEN SHOULD YOU INTRODUCE ALLERGEN FOODS?
Current evidence-based research is still inconclusive as to the perfect time to introduce food allergens to minimise the risk of allergies. Current research suggests:
- Exclusion of foods during pregnancy (unless the mother herself is allergic) is not recommended.
- Breastfeeding is recommended for the first 6 months of a baby's life and for as long as a mother and child wish to continue thereafter. If breastmilk is not possible, infant formula can be given.
- Foods should be introduced around 6 months of age and not before 4 months of age.
- Introduce allergen foods before 12 months of age. Studies show that this may reduce the chance of developing food allergy in babies with severe eczema or egg allergy.
- Introduce earlier in the day to monitor for reactions.
- Introduce allergen foods one at a time to assist with identifying trigger foods.
- Once a portion of food is introduced and tolerated, continue to offer regularly as starting and stopping may result in a food allergy developing.
- If baked egg/milk has been tolerated but a reaction occurs to straight egg/milk products, current guidelines suggest continued exposure of the baked product (seek guidance from your specialist).
- Smearing food on the skin of a child with eczema may increase the risk of the child developing an allergy to that food.
- Children with eczema as an infant are considered higher risk for egg and nut allergies.
WHAT MIGHT A REACTION LOOK LIKE?
An allergic reaction to food often occurs in minutes, whereas intolerances may be delayed.
- Swelling (mouth, eyes, face)
- Vomiting
- Hives or welts
- Difficult/noisy breathing and/or swollen tongue (indicates anaphylaxis reaction)
If your baby presents with the above symptoms stop feeding your baby immediately and call an ambulance.
WHAT DO YOU DO IF THERE IS A REACTION?
- Stop feeding the food to your baby immediately.
- Call an ambulance immediately and a health line (such as 13 HEALTH) if necessary for advice.
- If your baby is presenting with anaphylaxis symptoms, keep your baby in a reclined position.
- Seek advice from a SPECIALIST such as an immunologist or allergy specialist for a detailed management plan moving forward. You can request a referral from your family doctor.
REFERENCES:
Australasian Society of Clinical Immunology and Allergy (2016)
https://www.allergy.org.au/patients/allergy-prevention/ascia-guidelines-for-infant-feeding-and-allergy-prevention Website accessed on 23 January 2019.
Infant Feeding and Allergy Prevention Clinical Update (2018). https://www.allergy.org.au/hp/papers/infant-feeding-and-allergy-prevention-clinical-update Website accessed on 7 September 2020.
This article is written for inspiration only. It is not intended to replace medical advice.
