New Guidelines For Introducing Allergenic Foods

Throughout my entire childhood (which I bid a fond farewell to roughly a decade ago), I can remember one person I knew with a food allergy—a boy at summer camp who was so allergic to peanuts we couldn’t serve peanut butter in the dining hall. Back then banning peanut butter felt like a foreign concept; today it seems common. I’ve often wondered if the apparent rise in food sensitivities is all in my head. Whether I was just oblivious to friends and classmates who couldn’t eat eggs, nuts, wheat, or other allergenic foods, and whether I’m simply more aware of food allergies now, working at Parents. That doesn’t appear to be the case. According to Food Allergy Research and Education, food allergies are on the rise: The number of people with a food allergy rose 18 percent between 1997 and 2007, and today 1 in 13 kids is affected, or roughly two in every classroom. What if there was a way to stop this trend in its tracks? A recent study from the American Academy of Allergy, Asthma & Immunology suggests parents may be able to do just that, by introducing the most common allergenic foods—cow’s milk, eggs, soy, wheat, peanuts, tree nuts, fish, and shellfish—around the time you start solids, generally between 4 and 6 months. “Food allergies have increased in the last 10 years, and it’s possible that delaying the introduction of allergenic foods has contributed to that,” says study coauthor David Fleischer, M.D., an associate professor of pediatrics at National Jewish Health, in Denver, Colorado. “There’s a window of tolerance for preventing food allergies.”

Before now there haven’t been any updated guidelines on how to give these foods to a child, and some parents may still follow the recommendations from 13 years ago, which advised against offering your child cow’s milk until age 1, eggs until age 2, and nuts and fish until age 3. But after looking over past research, Dr. Fleischer says it’s safe—and beneficial—to introduce these foods earlier, with a couple exceptions. Children with moderate to severe eczema, which puts them at higher risk for food allergies, and those who’ve already had a reaction to an allergenic food should see an allergist before trying any of the above (and below!) mentioned foods.

Now, without further ado, the most recent advice for introducing cow’s milk, eggs, soy, wheat, peanuts, tree nuts, fish, and shellfish:

  • Do not offer your child one of these highly allergenic foods as the first solid. Begin with rice or oat cereal, vegetables, or fruit to see how your child handles them. Once you’ve successfully introduced a few of these foods, you can begin to offer foods like fish, eggs, and yogurt.
  • The first time you introduce an allergenic food, give it to your child at home, rather than at day care or a restaurant. If there is no apparent reaction—including hives, a rash, swelling, breathing problems, vomiting, or diarrhea—continue to offer the food to your child, gradually increasing the amount.
  • Offer one new food every 3 to 5 days if you don’t see any reactions.
  • Continue to avoid whole cow’s milk until age 1, but not because of allergy risk—it can lead to kidney complications and may affect iron levels in the body. Cheese, yogurt, and milk-based formulas are fine to offer.
  • Peanuts and tree nuts pose a choking risk, so should not be offered before age 1, but nut butters are safe. If you have an older child with a nut allergy, see an allergist before offering peanut butter to your younger child—he’s at an increased risk for developing a peanut allergy.

 

Image: Spoon and jar of peanut butter

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  1. by Sarah

    On March 16, 2013 at 11:07 am

    Or you could just NOT introduce solid foods for the first year and exclusively breastfeed… That way your baby tastes everything through your breastmilk and reduces their risk of food allergy. Why is this other alternative not mentioned as an effective method as opposed to filling bellies w/rice cereal which is not as nutritious as breastmilk???

  2. by Melody Fisher

    On March 16, 2013 at 11:11 am

    I would love to see if this works .. In my opinion more children are allergic than ever and they are from before birth. I am a midwife and I have never seen so many nursing mothers have to restrict their diet so their child does not have allergic responses.. I personally think it has more to do with GMOs and introducing foreign things into our typical diets and changing the way our body responds to the food we eat. Are these foods able to assimilated into our body and digested completely or are they causing leaky gut syndrome and increase in allergies?? Time will tell

  3. by Hazel

    On March 16, 2013 at 11:18 am

    What about chocolate?? My oldest was given a couple licks of chocolate ice cream around 7 months old and got a rash all over her torso but now at 5 years old she can eat it no problem. Is there any suggestions for introducing chocolate?

  4. by Kristy

    On March 16, 2013 at 1:33 pm

    To the first comment. That’s a good idea if you can breastfeed, but not all women can. I’m a cancer survivor and had a double mastectomy. I will not be able to breastfeed, so these guidelines are great.

  5. by Sarah Jane

    On March 16, 2013 at 2:59 pm

    To the first commenter, exclusively breastfeeding your child until they’re a year old might be fine for you, but please keep an open mind for those of us who have offered our children solids before age 1. I am not criticizing your choice, it is yours to make, but my nearly 10 month old daughter has been expressing interest in “people food” since she was about 5 months old. She watches me eat lunch and she watches her father and I eat dinner and has a clear desire for what we have. Not every parent fills their babies bellies with rice cereal. She currently eats baby fruits with her oatmeal and veggies cooked, puréed, and frozen (by myself) 2 times a day. She still nurses 3-4 times a day and the breast is always offered before meals, because it is more important. Every parent and every situation is different, but keeping an open mind is most important. We live in a world where so many women try to out-mommy one another and judge their choices. I really think its time for this to stop.

  6. by Michele

    On March 16, 2013 at 4:04 pm

    I don’t see where the first commenter was making a judgement about other mothers. She simply raised a valid point based on what was said in the article. It is an option that some parents have and thus could have been presented. The article suggested the rice cereal and it is not as nutritious as breast milk. That doesn’t mean it can’t be given, it is just a matter of fact. Like you Sarah Jane, I have introduced solids because of our daughther’s interest and use the baby-led weaning method. She has never had commercial baby food, but foods I hand pick and cook for her. She is still nursed 4-5 times a day and she is 9 months old. I think what needs to stop is the idea that every time someone speaks about the benefits of breastfeeding, others feel judged, threatened or possibly insecure in their own choice. And yes, I fully support breastfeeding and everything about it AND giving my child table food when she’s ready.

  7. by Kaytee

    On March 16, 2013 at 4:20 pm

    Once I gave my son a piece of tomato and he got a slight rash, but I fear that maybe it had been in contact with other food. Would it be wise to try again? If so, how long after?

  8. by SarahRL

    On March 16, 2013 at 5:22 pm

    @Sarah – The title of this article is New guidelines For Introducing Allergenic Foods… Im fairly certain that’s why she didn’t go into detail about the many, very well known benefits of ebf. I, for one, am happy to see this. Some one was all over me about how I couldn’t give LO peanut butter for a long time, which I thought sounded absurd, knowing thatno one in my, or his fathers family, has any kind of food allergy.

  9. by wendy

    On March 16, 2013 at 7:04 pm

    I’ve often wondered why allergies were on the rise .I belive you’re both correct in your educated guesses: less breastfeeding for those that are able and our American gotta-have-it-now diet of convenience. I grew up in the 70′ssystem in Illinois and we lived on pb &j sandwiches scrambled eggs and cream of wheat or farina etc. I think the difference was our moms breastfed when able introduced solids appropriately not through enlarged nipples of bottles too soon so they could sleep and their then our food wasn’t processed and chemicalled when wasn’t necessary or as a steady diet. Just my humble opinion…

  10. by tj

    On March 16, 2013 at 7:36 pm

    I have 2 boys – both breastfed and both have food allergies. The younger showed symptoms hours after birth. The other was diagnosed at nearly 4 years old. Because of my infants immediate reaction, I’m certain there must be a genetic component. He vomited on my milk hours after birth and every feeding after. Doctors were convinced it was reflux, colic, and just bring a “spitty” baby. 9 months later after a reaction to a food with trace ingredients of milk, we learned of several food allergies. When avoidance was used, all the symptoms presenting since his birth disappeared. So, my advice would be to be very careful when offering solids, many of the baby foods are blended and include byproducts with milk, eggs, soy,etc. Symptoms of a reaction can emerge quickly, so talk to your doctor before offering foods and be aware and prepared in the event of a reaction.

  11. by Nikki

    On March 16, 2013 at 9:01 pm

    My son is 10months and eats everything I introduced some food after 6months when his teeth started coming in like fruit and veggies by 9months when he started day care he started eating chicken noodle spaghetti now when I cook he eats a whole bowl or plate of whatever were eating by the 7 month he had been introduced to all the allergen food except peanuts in fear of him choking but he did taste a lttle peanut butter his doctor was always in favor of introducing food and other things like pets early to help avoid allergies

  12. by Swati

    On March 18, 2013 at 4:53 am

    Thanks mother for all the lovely suggestions…Nikki we should be thanking God for blessing our kids with no allergies and my full support ti TJ who has struggled bit by bit and come out in flying colors… Saraj jane I truely agree with your ideology that we shouldnt be devil’s advocate but it is I guess in female genes or maybe till now I used to think it is in Indian female gene. One suggestion, Just try to give everything home made atleast for the first year to your child and If you are working and practically not possible to cook so often then try only prescribed baby foods and fruits. pLUS THE NON-VEG SHOULD BE REALLY COOKED PROPERLY BEFORE OFFERING THE INFANTS. (By western stds I will guest a over-cooking on fire )

  13. by where can I find hair chalk

    On April 9, 2013 at 1:42 am

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