Feeding Baby: How to Avoid Food Allergies by Louise Chang, MD

Starting to feed a baby solid foods is an exciting milestone for parents -- and one that also comes with a lot of new questions and concerns. What’s the best way to avoid food allergies once your baby has mastered single-grain cereals and is ready to move on to new foods? What foods are most likely to cause allergies in babies?

Start Gradually to Identify Any Food Allergies

It’s important to introduce baby to new foods gradually, and one at a time, in case of food allergies. Otherwise, you’ll have trouble tying an allergy to a specific new food. For example, if you give your baby three new foods over the course of a day and she develops an allergic reaction, you won’t know which of the foods provoked it.

It doesn’t matter all that much which foods you introduce to your baby, or which order you introduce them in, as long as the foods you are offering are healthy and well-balanced. But each time you offer a new food, you should wait three to five days before adding another to the menu. Don’t eliminate all the other foods your baby is already eating during that time -- just don’t add anything else new.

Babies and Allergies: The Top 8 Allergenic Foods

With each new food, you’ll want to be on the lookout for allergic reactions. There are more than 160 allergenic foods, but these eight foods and food groups are the culprits 90% of the time. You may want to wait until baby is older to try some of these foods, especially peanuts. In fact, many experts suggest waiting until your child is 3 before trying peanuts. Ask your pediatrician if you have any questions about a food.

* Milk

* Egg

* Peanuts

* Tree nuts (such as walnuts or almonds)

* Fish

* Shellfish

* Soy

* Wheat

Food Allergy Symptoms to Watch for in Your Baby

Food allergy symptoms usually appear very soon after the food is eaten -- within a few minutes to a couple of hours. If you’re introducing a new food to your baby, keep an eye out for these symptoms:

* Hives

* Flushed skin or rash

* Face, tongue, or lip swelling

* Vomiting and/or diarrhea

* Coughing or wheezing

* Difficulty breathing

* Loss of consciousness

Severe Food Allergy Symptoms: When to Call 911

If your baby is having trouble breathing, has swelling on her face, or develops severe vomiting or diarrhea after eating, don’t take time to call your pediatrician. Call 911 immediately. Severe allergic reactions can be fatal very quickly.
 
Dealing With Mild Food Allergies in Baby
 
If you see mild symptoms, such as hives or a rash, contact your pediatrician, who will make an appointment for allergy testing for your child. Once your baby’s specific allergies are identified, the doctor will give you an action plan for managing the allergies (usually, eliminating the food from your baby’s diet) and dealing with accidental exposures.

Remember, just because a baby’s initial allergic reaction to a new food may be mild, it may not stay that way. Talk to your pediatrician about any food allergy symptoms in baby.

Some allergies go away with time. Peanut, tree nut, and shellfish allergies tend to persist, while egg and milk allergies often go away as children get older.

The Family Food-Allergy Connection

Until very recently, the American Academy of Pediatrics recommended that parents wait until age 1 to introduce dairy products, age 2 to introduce eggs, and age 3 to add peanuts, tree nuts, and fish. In early 2008, however, the AAP amended these recommendations, which were based on expert opinion rather than specific evidence.

The new AAP guidelines say that unless there is a significant history of food allergies in a child’s family, there’s no evidence that waiting until after a year to introduce these foods reduces her risk of developing allergies. In fact, there is some evidence that early introduction of some of these foods, such as peanuts, may make your child less likely to become allergic. Ask your pediatrician for guidance.

Protecting Baby Against Food Allergies: Easy Does It

Many pediatricians still recommend waiting until your baby is a bit older -- 9 or 10 months -- before offering these foods. Even if there’s no added risk of causing an allergy, they note that an allergic reaction may be easier to manage in an older baby. And some pediatricians, concerned about the particular severity of allergic reactions to peanuts and shellfish, still suggest staying away from them until your child is up to 3 years old.

Whole cow's milk should not be given to babies younger than 1 year old because the proteins in whole milk can irritate the stomach. Yogurt and soft cheeses are fine, however, because the proteins in these dairy products are broken down and less likely to cause tummy trouble. You should also still wait until at least 1 – some experts say 2 -- to introduce honey, which can cause a potentially serious disease called infant botulism.
 
SOURCES:
 
American Academy of Pediatrics: "Starting Solid Foods."

Rachel Lewis, MD, assistant professor of clinical pediatrics, Columbia University College of Physicians and Surgeons, New York.

American Medical Association: "Allergic reaction: Food allergies increasing, especially among children."

Medline Plus Medical Encyclopedia: "Food Allergy."

Reviewed by Louise Chang, MD on July 08, 2010 WebMD