Abbie Tomson
Midwife MSc, BSc, Yoga Teacher, Project Lead at All4Birth
@enevlorel @All4Birth
Summary
Introducing solid foods to your baby is an exciting milestone, but it can also be a time of concern, especially when it comes to potential food allergies. In recent years, research has significantly shifted our understanding of how to manage food allergies during weaning. The early introduction of allergenic foods, once thought to increase the risk of allergies, is now encouraged as a way to reduce it. Here’s what you need to know to navigate this important phase confidently.
The Science Behind Early Allergen Introduction
Traditionally, parents were advised to delay the introduction of common allergenic foods like peanuts, eggs, and dairy until after the first year of life. However, recent studies have shown that introducing these foods earlier, typically between 4 and 6 months of age, may actually help prevent the development of food allergies.
The LEAP (Learning Early About Peanut Allergy) study, conducted in the UK, found that early introduction of peanuts significantly reduced the incidence of peanut allergy in high-risk infants. Similar research has supported the early introduction of other allergens, such as eggs.
When and How to Introduce Allergenic Foods
- Timing: Start introducing solid foods around 6 months, but not before 4 months. Consult with your healthcare provider to determine the best timing for your baby, especially if there’s a family history of allergies.
- Start Slow: Introduce one allergenic food at a time and wait 3-5 days before trying a new one. This allows you to monitor for any signs of a reaction.
- Common Allergens to Introduce:
- Peanuts: Peanut butter (smooth) is a good option. Mix it with breast milk or formula to thin it out.
- Eggs: Start with well-cooked eggs, either scrambled or hard-boiled.
- Dairy: Offer small amounts of plain yoghurt or cheese.
- Wheat: Try offering small amounts of bread or wheat-based cereal.
- Fish and Shellfish: Start with well-cooked fish like salmon.
- Monitor for Reactions: Signs of an allergic reaction can include hives, swelling, vomiting, or difficulty breathing. If any of these occur, stop feeding and seek medical attention immediately.
- Be Persistent: If your baby tolerates an allergenic food, continue offering it regularly as part of their diet to maintain tolerance.
Strategies for Managing Potential Reactions
– Have a Plan: Discuss with your health visitor or similar professional what steps to take if your baby has a reaction. They may advise keeping antihistamines or an epinephrine auto-injector on hand.
– Know the Signs: Mild reactions might include a rash or stomach upset, while severe reactions (anaphylaxis) can involve breathing difficulties, swelling, or a drop in blood pressure. Severe reactions require immediate emergency care.
– Introduce in a Safe Environment: Try new foods at home, rather than at a nursery or a restaurant, so you can closely monitor your baby.
The Role of Breastfeeding
Breastfeeding is another crucial element in allergy prevention. Exclusive breastfeeding for the first 4-6 months, followed by continued breastfeeding alongside the introduction of solid foods, may help protect against the development of allergies..
Links to other resources
Books
BooksThe Allergy-Free Baby & Toddler Cookbook by Fiona Heggie & Ellie Lux
What Mummy Makes by Rebecca Wilson
The Pediatrician’s Guide to Feeding Babies and Toddlers* by Anthony Porto, MD, and Dina DiMaggio, MD
Film Audio and Podcasts
Film Audio and PodcastsBaby Buddy app, created by the Best Beginnings Charity
The Weaning Podcast by SR Nutrition
Allergy Kids by Dr. Katie Allen Podcast
The Milk Allergy Mom Podcast
Websites and Guidelines
Websites and Guidelines– British Society for Allergy & Clinical Immunology (BSACI)
– National Institute for Health and Care Excellence (NICE)
References
- Du Toit, G., Roberts, G., Sayre, P. H., Plaut, M., Bahnson, H. T., Mitchell, H., … & Lack, G. (2015). Randomized trial of peanut consumption in infants at risk for peanut allergy. New England Journal of Medicine, 372(9), 803-813. https://doi.org/10.1056/NEJMoa1414850
- Natsume, O., Kabashima, S., Nakazato, J., Yamamoto-Hanada, K., Narita, M., Kondo, M., … & Ohya, Y. (2017). Two-step egg introduction to prevent egg allergy in high-risk infants with eczema (PETIT): A randomised, double-blind, placebo-controlled trial. The Lancet, 389(10066), 276-286. https://doi.org/10.1016/S0140-6736(16)31418-0
- Greer, F. R., Sicherer, S. H., & Burks, A. W. (2019). The effects of early nutritional interventions on the development of atopic disease in infants and children: The role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas. Pediatrics, 143(4), e20190281. https://doi.org/10.1542/peds.2019-0281
- Muraro, A., Halken, S., Arshad, S. H., Beyer, K., Dubois, A. E. J., Eigenmann, P. A., … & Roberts, G. (2014). EAACI food allergy and anaphylaxis guidelines: Primary prevention of food allergy. Allergy, 69(5), 590-601. https://doi.org/10.1111/all.12398
- Perkin, M. R., Logan, K., Marrs, T., Radulovic, S., Craven, J., Boyle, R. J., … & Lack, G. (2016). Enquiring About Tolerance (EAT) study: Feasibility of an early allergenic food introduction regimen. Journal of Allergy and Clinical Immunology, 137(5), 1477-1486.e8. https://doi.org/10.1016/j.jaci.2015.12.1322
