Babies and Food Allergies
About 7% of babies and young children have food allergy. Peanut allergy is one that can cause anaphylactic reactions and has led to banning peanuts in elementary schools across the country. According to the randomized control trial Learning Early About Peanuts, LEAP, done back in 2015, early introduction of peanuts at 6 months of age to high risk infants cut risk of allergy by 81%. If parents can adopt the new recommendations for early introduction to common allergens, the incidence of peanut and other food allergens will decrease. Peanuts are a healthy, high protein food, rich in iron, magnesium, zinc, folic acid and good fats and are an important food to include in a healthy diet.
Old Infant Feeding Guidelines:
Nutrition guidelines for introducing solids and common food allergens have changed significantly over the years. In the past it was recommended to delay the introduction of potential allergenic foods such as eggs, fish and milk products to 12 months and to delay peanuts, tree nuts, sesame seeds and shellfish to 2-3 years of age. The thought was that delaying the introduction allowed the digestive tract to mature. We now know that allergy is through the skin not the GI tract and that the digestive tract trains the body to tolerate allergens.
Current Guidelines for Feeding your Infant:
-Breastfeed exclusively for the first 6 months in addition to 400IU liquid vitamin D supplement. If breastfeeding is not possible commercial formula is recommended.
-At 6 months of age, when the baby can sit, hold it’s head up and doesn’t push food out with it’s tongue it is ready for solid foods. Offer a variety of foods, particularly those high in iron and including potential allergens. Iron rich foods including soft, minced or ground meats, fish or poultry, iron fortified infant cereal, mashed cooked egg, lentils or beans or tofu. Other healthy foods to offer include vegetables, fruit, whole grains and milk products such as yogurt and cheese. Offer sips of water in an open cup. Pasteurized whole (3.25%) cow milk can be offered at 9-12 months of age in an open cup. Lower fat milk and coconut, rice, nut or seed milks are not nutritionally adequate.
This year, the Canadian Pediatric Society and Food Allergy Canada made the new recommendations for high risk infants official.
For high-risk infants, and based on their developmental readiness for food, consider introducing peanut at around 6 months of age, but not before an infant is 4 months of age. (Note: Infants at high risk of allergy are those with severe eczema or those with a sibling or parent with allergies.)
How to Reduce the Risk of food allergy in your high-risk infant
- Keep your baby’s eczema under control
- Breastfeed your baby if you can
- Introduce common food allergens at around 6 months of age and not before 4 months, when they are ready for solid foods.
-Offer the common allergens one at a time after you have introduced a few other solid foods.
-Consider introducing peanut and egg before the other common allergens milk, tree nut, soy, seafood, wheat and sesame.
- Offer tolerated common food allergens regularly, several times a week to maintain tolerance to these foods.
How to offer peanut and egg to your baby:
-Blend with some prepared infant cereal
-Offer just a taste
-Wait 10-15 minutes and watch for symptoms of allergic response
-If no response, offer more of that same allergen.
-Try a new one the next day or when you are ready. No need to wait a certain number of days in between.
Contact your health professional, Registered Dietitian or seek a referral to a pediatric dermatologist for assistance.
Peanut Butter: blend 1 Tbsp (15ml) warm water to 1 Tbsp (15ml) smooth peanut butter. Stir into 2 Tbsp (30ml) prepared infant cereal.
Instead of infant cereal blend the peanut butter water mixture into a fruit puree such as banana or apple. Try other nut butters the same way.
Hardboiled Egg: Mash or blend hardboiled egg with a fork and add a few tsp of water to moisten as needed.
When your baby is older offer peanut butter on strips of toast, scrambled egg and French toast.