There’s no shortage of issues for new parents to worry about – including allergies. Research is constantly changing on when and how to introduce potential allergenic foods to your children so we connected with Dr. Charlotte Miller, a pediatric allergist, to get her take on what parents need to know.
First of all – when should parents start trying new foods to their children?
The general guidelines are that children can start being introduced to all solids between four to six months of age, starting with some of the less allergenic foods like fruits and vegetables and cereals but eggs and peanuts can also be introduced at this age.
Are there any special circumstances to consider?
If a child has significant eczema (covering more than 40% of the body), they may be at higher risk of food allergy and should see an allergist first. The allergist may consider doing a skin test before introducing high risk foods like peanut, but generally we do not recommend doing skin testing before introducing the food for the first time.
What about if the child has a parent or sibling with food allergy?
These children may have a slightly higher risk of food allergy and some of these families find it helpful to speak to an allergist before introducing new foods to that child.
So what’s the process for introducing foods at home?
We always recommend giving a little bit the first time and then gradually increasing the amount each time until a normal serving amount is being tolerated. It is best to try only one new food at a time so you know what might have caused any reaction. You only need to wait a day or two between each trial. Once the food has been eaten without reaction, it is ideal to keep it in in the diet fairly regularly to confirm that they child continues to tolerate it – say about once or twice a month at minimum.
Any tips about the food order or food preparation?
We recommend starting with fruits and vegetables, meats and other cereals and then moving onto the more common allergens: milk, egg and wheat, followed by peanut, nuts, fish, sesame and shellfish. Sticky foods like peanut butter can be diluted in a small amount of baby cereal or puree. We suggest just popping a small amount into their mouth, making sure it doesn’t stick to their face. Some children can get rashes and even hives where the food contacts the skin even though they are not actually allergic to it.
What would you see if there is a reaction?
There might be itching, redness, swelling, hives (mosquito bite-like rash) tummy pain, vomiting or wheezing. If you see those symptoms within an hour of eating the food, you should avoid it and discuss it with an allergist. Allergic reactions start within one hour after eating within 95 per cent of the time and 99 per cent of reactions start within four hours. Taking photos of any rashes is very helpful.
Is there a best time to test these foods?
It should be done at a time when parents are around just in case there is a reaction – so in the morning, not right before the child’s bedtime.
Why should the introduction of these foods happen so early?
There has been a shift in our thinking over the past ten years and new studies have confirmed that early introduction may prevent allergies from developing in high risk children. But it’s always evolving – recent studies have confirmed that early introduction helps for egg and peanut, but not other foods like milk.
Anything else parents should know?
Generally if you don’t have a history of food allergy in the parent or siblings and they don’t have eczema, then food introductions are not high risk and can be done without too much caution.
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