How to introduce allergens to your baby: a guide by Dietitian Melanie McGrice - Little Étoile
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How to introduce allergens to your baby: a guide by Dietitian Melanie McGrice

Introducing your bub to new foods is an exciting time! You really notice how fast they are growing up. Introducing solids to your young one is one thing, but introducing foods that might cause adverse reactions is another. This can be… a little daunting.

Here we will cover everything you need to know about how to introduce your baby to potential allergens.

What Are Allergens?

Let’s begin with a quick lesson in human physiology. Don’t worry, this part will be quick, but helpful!

Allergens are components of foods that cause allergic reactions, hence the name ‘allergen’. This reaction occurs when the body responds to allergens by triggering an immune response, in order to protect the body from the allergen. This happens because the body recognises allergens as ‘the bad guys’.

In the majority of people, allergens are harmless, but for some people (including infants) allergens can cause terrible symptoms.

Symptoms of an allergic reaction may include:

  • itching,
  • flushing,
  • hives,
  • swelling,
  • vomiting,
  • excessive crying,
  • breathing difficulties (wheezing),
  • and low blood pressure.

Anaphylaxis is the most severe sign of an allergic reaction and requires an adrenaline injection for relief. In an anaphylactic attack, after ingesting the food allergen that your baby is allergic to, the mouth, throat and face swell up blocking the airways and making it difficult to breath. An anaphylactic reaction may be life-threatening, so precautions should be taken to avoid these attacks.

What Foods Contain Allergens

It is important to have an idea of what foods contain allergens. It could be harmful to your baby if you are not fully prepared for a potential allergic reaction.

Some common allergies include:

  • wheat,
  • cow’s milk,
  • eggs,
  • peanuts,
  • tree nuts,
  • and fish.

Is My Baby At Risk Of Allergies?

 

How can you tell if your bub is at a potentially higher risk of having food allergies?  Bubs with one allergy are more likely to react to other allergens. If you or your partner have any allergies your baby has an increased risk. There have also been studies that suggest that if the baby’s older siblings have a peanut allergy, they are 7 times more likely to also have a peanut allergy.

Furthermore, babies who have mild, moderate or severe eczema are more likely to react to allergens in foods. Studies suggest that babies with eczema may benefit from early introduction to allergens through food to develop a tolerance, while skin exposure of allergens may increase likelihood of allergy. So, if your baby experiences eczema, or has a diagnosed peanut or egg allergy, take extra care and consult with a health professional before introducing allergens to your little one.

When And How Should I Introduce Allergens?

In the past, it was recommended to delay introduction of allergens for up to 3 years. This is no longer the case. Let’s look at the guidelines and recommendations for introducing your bub to allergens…

It is recommended to introduce your bub to solids at around 4-6 months, while you are still breast-feeding or formula feeding. When starting solids, it is safest to start with allergen-free foods. When choosing baby foods, look for products which have been rigorously tested for allergens to ensure that your baby is only exposed to allergens in a safe and controlled environment. I recommend the Little  Étoile Organic range as their products are batch tested for the most common allergens and are free from egg, gluten, milk (except in custard), peanut, soy, macadamia, crustacea, almond, hazelnut, sesame, walnut, fish, pistachio, cashew, and lupin.

It is important for baby food products to clearly label potential allergens so that parents can avoid known allergens for their child. If a parent mistakenly gives their baby a product containing an allergen, this can cause a severe and even life-threatening reaction, so it’s important for baby food products to be free from allergens, or at the very least, display the allergen very clearly on the packaging.

Because most pre-packaged baby food contains more than one ingredient, if a parent is relying on pre-made pouches to expose their baby to allergens, it would not be possible to introduce one food at a time as recommended.

So, while parents can use baby food pouches for convenience, allergenic foods should be introduced for the first time using single ingredients. This way the situation can be monitored closely and if a reaction occurs, it is clear which food has caused the reaction.

It is also good to remember that parents should use premade baby food in conjunction with fresh foods. Just like adults, babies will thrive on fresh foods, with the addition of nutritious packaged foods for convenience.

Currently, in Australia and New Zealand, voluntary “Allergen Free” or “Allergen Friendly” claims are not regulated (apart from gluten-free) under the ANZ Food Standards Code. This means the allergen-free information you find on products is listed at a company’s discretion. Comprehensive allergen testing on baby food products is surprisingly uncommon and standard disclaimers and voluntary warnings on food packaging can be misleading and broad. Companies have the choice to:

  1. Opt to not include allergen-free information on the label;
  2. Use the claim “may contain traces of” (meaning they don’t do not have a strict allergen management plan in place or perform allergen testing);
  3. Have a strict allergen management program in place and invest in batch testing to ensure safety and be able to declare that allergens are not present.

Once solids are introduced, allergens can be introduced one at a time, in small amounts, under your close supervision. Once the allergenic food has been introduced and given there is no adverse reaction, the food should be eaten three times per week to help build up their immune tolerance.

Peanut

Peanuts carry the greatest risk as they are the most common cause of anaphylaxis. Research suggests that introduction of peanuts at 4-6 months may reduce the risks of peanut allergy, compared to leaving it until later in life.

Peanuts should be provided in a smooth texture such as peanut butter, ground whole peanuts, peanut butter powder or peanut flour. Children who are tolerant to peanuts should regularly consume peanut-containing foods. Some studies have suggested that two teaspoons of peanuts (in the forms mentioned above) should be consumed three times per week.

Important note! If your baby has severe eczema or a diagnosed food allergy, introduction to peanuts should take place with medical supervision. Speak to your doctor for more information.

Tree Nuts

Tree nuts include nuts other than peanuts such as almonds, macadamia nuts and walnuts.  Introducing tree nuts at 4-6 months of age in a smooth texture or ‘non-choking form’ is also recommended. This can be achieved by blending nut butter into a couple of tablespoons of fruit puree.

Egg

Again, it is recommended that you introduce your baby to egg at about four to six months of age to reduce risk of allergy. The egg must be heated and cooked, such as scrambled, or hard-boiled and mashed with a fork.

Cow’s Milk

Although early exposure of cow’s milk protein (4-6 months) is again reported to reduce the risk of your baby developing a cow’s milk protein allergy, this has to be weighed against the risks.  Cow’s milk is low in iron and can reduce iron absorption (which is particularly important for infants as they commence solids).  Consequently, it is recommended that breast milk or infant formula (which is fortified with iron) is used as your baby’s primary source of nutrition until he or she reaches 12 months of age.

Small amounts of cow’s milk may be used in cooking, yoghurt or cheese under your supervision, in a controlled manner when your baby commences solids. At 12 months, breast milk or infant formula can start to be weaned and replaced with cow’s milk.  However, daily cow’s milk consumption should not exceed 500mL. It is also important to consider that cow’s milk is lower in zinc and vitamin C than breastmilk and infant formula.

Wheat

There are several ways in which we can have an adverse reaction to wheat. This may be wheat intolerance, wheat allergy, or gluten intolerance (coeliac disease). To date, there has been no evidence that suggests introducing wheat at a certain stage in your baby’s life can reduce the risks of wheat allergy, intolerance or coeliac disease.  However, wheat can be a great source of nutrition, especially fibre. Therefore, it is recommended that wheat-containing foods be introduced with solids at roughly 6 months, in the form of infant cerealsin a controlled manner, under your supervision.

Fish

Did you know that delayed introduction to fish is associated with increased risk of developing allergies?

Fish contains a special type of fat called Eicosapentaenoic acid (EPA). Studies have found that infants with low EPA may actually be at increased risk of allergies. On top of this, EPA is delivered to your bub through breast milk, so fish consumption by mum actually influences EPA levels in bub.

This means that maternal consumption of fish may actually reduce risks of allergy development in your little one. Introducing fish, firstly in the form of fish oil, then as a solid, to your baby in a controlled manner under your watchful eye should occur at 6-10 months of age to reduce risks of allergy.

What Should I Do If My Baby Has A Reaction?

If your baby experiences anaphylaxis-like symptoms (difficulty breathing, swelling of the tongue, becoming pale and floppy), call an ambulance immediately.

If your baby shows mild to moderate allergic reaction symptoms such as hives, vomiting, diarrhea or facial swelling, take them to see a doctor, allergy specialist or pediatric dietitian.

 

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