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peanutsFood allergies are becoming more and more prevalent in children. Food allergies are triggered by the immune system reacting to proteins found in foods and are most prevalent in children younger than 3 years of age. Some foods such as peanut-containing foods, strawberries and shell fish may cause severe life-threatening reactions and the benefits vs risk ratio should be evaluated by you and your baby's doctor prior to introducing these foods. Common allergy causing foods include:

 

  • Berries
  • Citrus fruits
  • Cocoa 
  • Egg whites
  • Fish
  • Milk or milk products
  • PEANUTS/peanut butter products
  • Shellfish-shrimp, lobster, crabs, etc.
  • Soy
  • Strawberries
  • Tomatoes
  • Tree nuts
  • Wheat

Milk, eggs, peanuts, tree nuts, fish, shellfish, wheat, and soy account for 90% of allergies. Allergic response to food can occur within minutes after ingesting food or within 2 hours after ingestion and diagnoses can be difficult. Signs and symptoms of food allergy include:

  • Diarrhea
  • Hives
  • Eczema
  • Swelling of mouth and/or lips
  • Shortness of breath
  • Wheezing
  • Vomiting
  • In severe cases, loss of consciousness and swelling of the airway can occur which can be a life-threatening event!

In years past, the American Academy of Pediatrics recommended to delay introducing allergenic foods such as eggs, milk, fish and peanut-containing foods. The old recommendations were to:

  • Introduce peanut butter products after 1 year of age if no family history of peanut allergy exists. If peanut allergies exist, peanut-containing foods were to be avoided until after 3 years old.
  • Introduce egg whites after 12 months of age unless family history exists. If there is significant family history, eggs were to be avoided until after 2 years of age.

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 How To Deal With Food Allergies in Babies
     


In a recent study, the AAP states, "Although solid foods should not be introduced before 4 to 6 months of age, there is no current convincing evidence that delaying their introduction beyond this period has a significant protective effect on the development of atopic disease regardless of whether infants are fed cow milk protein formula or human milk. This includes delaying the introduction of foods that are considered to be highly allergic, such as fish, eggs, and foods containing peanut protein.1" However, the AAP states that more studies are needed on this topic. Therefore, discuss with your baby's healthcare provider which foods to avoid (if any) due to your family history, your current feeding regimen and your infant's response to foods.

Although food antigens have been detected in breastmilk, it is unlikely that it contributes to food allergies in infants1. Some infants may have a sensitivity to cow's milk protein found in formula, breastmilk and diary products which typically resolves at 1 year of age. Some parents have confused milk protein allergy with lactose intolerance. Lactose intolerance is not common in infants under 1 year of age2, 3 and symptoms include: abdominal distention, flatulence, abdominal cramping, and diarrhea. Signs of milk protein allergy include:

  • Blood streaked stool
  • Diarrhea
  • Excessive crying
  • Poor growth
  • Nasal stuffiness
  • Wheezing
  • Eczema
If a sensitivity to cow's milk protein is present, elimination of milk and other dairy products usually clears up the problem in approximately 2-4 weeks (see other sources of cow's milk protein and soy protein). If diary products are eliminated from either your diet or your child's, be sure to discuss calcium supplementation with you and your child's healthcare provider. If formula feeding, changing to an extensively hydrolyzed protein formula is recommended. Soy based formulas are not recommend because they too can cause allergic reactions.

When starting your child on solids, it may be helpful to keep a log of the food(s) introduced, date of introduction and if any reactions were noted. Also, introduce new foods gradually to monitor for food allergies (minimum of 2-3 days according to the AAP).

Cited:
1. Greer, F, et. al (2008). 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 Vol. 121 No. 1 January 2008, pp. 183-191
2. Brill, H (2008). Approach to milk protein allergy in infants. Canadian Family Physician. 2008 September; 54(9): 1258–1264.
3. Heyman, M (2006). Lactose Intolerance in Infants, Children, and Adolescents.PEDIATRICS Vol. 118 No. 3 September 2006, pp. 1279-1286

Additional Sources:
Bhatia, J., et. al (2008). Use of Soy Protein-Based Formulas in Infant Feeding. PEDIATRICS Vol. 121 No. 5 May 2008, pp. 1062-1068
Cafarelli, C., et. al (2010). Cow's milk protein allergy in children: a practical guide. Italian Journal of Pediatrics. 2010; 36: 5.
Fiocchi A., et. al. (2006). Food allergy and the introduction of solid foods to infants: a consensus document. Ann Allergy Asthma Immunol. 2006 Jul;97(1):10-20
Gupta, R., et. al (2011). The Prevalence, Severity, and Distribution of Childhood Food Allergy in the United States
The Food Allergy & Anaphylaxis Network (2006). Food Allergy Training Guide for Hospital and Food Service Staff
 

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