Ten must-knows about first foods & allergies in infants
worried about what to feed baby and when? fear no more
Afraid? You’re not alone. Those first spoonfuls of solid food aren’t just exciting, they can also be terrifying! Even as you snap a zillion photos of the big moment, you’re also juggling a plateful of worries about timing, food choices, and allergic reactions. Of course we want our kids to develop adventurous palates and enjoy good food, but we also clearly don’t want to put them at risk. In an effort to help you relax and enjoy this ride, here are ten things to know about first foods and the latest perspective on allergies in babies. As always, consult your pediatrician before introducing new food to your baby.
- Though the incidence of food allergies has doubled in the last several decades, only about 8% of all children will experience an allergy to food in the first three years of life, and many will outgrow them. So the percentage of kids having or developing food allergies is much lower than many parents would think.
- Food allergies are more common in families with a history of allergies (food and otherwise), eczema, and/or asthma.
- In 2008, the American Academy of Pediatrics (AAP) revised their previous guidelines, stating “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”. In fact, some emerging science supports that introducing allergens early on actually may help prevent food allergies in healthy children. The AAP recommends starting between four to six months, as long as a few other typical first foods have been introduced and tolerated (e.g. whole grains, fruits or veggies). When it comes to introducing the most common potential allergens, our friend and advisor Dr. Alan Greene recommends waiting until six months.
- Whenever a child shows interest in solid foods after four months, parents may begin introducing them. But maybe you’re not ready to officially start with a babe that young? That’s OK. Maybe just tiptoe in by letting baby lick that organic apple she’s watching you eat and delight in the funny faces that will inevitably ensue.
- No need to hold off on offering allergenic foods just because you think you’re supposed to! While there are some circumstances that may require delaying, new research is finding that withholding these foods until after a baby’s first birthday may not reduce risk of developing allergies. For example, a growing body of evidence suggests that starting fish between six and 12 months results in fewer allergies.¹ We know this is a hard one to swallow, but even peanut products may be best introduced between six and twelve months.² Just make sure to take care to avoid choking hazards (e.g peanut butter or individual peanuts). Still having fears? We understand! Follow the path that feels right for you and your baby! And as always, we recommend consulting with your pediatrician.
- Approximately 90% of children’s food allergies are triggered by just five foods: cow’s milk, soy, eggs, peanuts, and wheat. Other key allergenic foods include fish, shellfish, and tree nuts. Most life-threatening food allergy reactions are caused by peanuts, tree nuts, shellfish, or fish. But did you know that 95% of kids never acquire a nut allergy and only 1-2% of kids are genetically pre-disposed? Also, only 2.5% of infants are affected by a cow’s milk or soy allergy, which many babies outgrow by 12 months and most who don’t, will outgrow them by age three.
- What does an allergy look like anyway? Food allergy symptoms run the gamut. They can be as minor as fussiness, colic, rash, itchiness, stuffy noses, runny noses, red or watery eyes, loose stools, and/or excess gas. More serious symptoms include vomiting, streaks of blood in the stools (these can indicate a milk allergy), hives, ear infections, wheezing, and/or asthma flare-ups. Call your pediatrician immediately if you see these or severe reactions like swelling of the lips, tongue, and throat.
- Until recently parents used to follow a set order of what to introduce to kids and when. Guess what? Research now shows there’s no such order you need to follow. If you or your closest friends and family members fed your first babies the old way, it can be hard to embrace the new rules. But it’s OK! You can also give up introducing foods individually and waiting three to five days between introductions. According to Dr. Greene, introducing new foods rapidly and feeding mixtures of foods together may lead to more adventurous eaters. If an allergy develops, it will take a little more work to figure out the cause. As long as your infant is tolerating new foods well, have fun seeing what they enjoy.
- Before you go totally wild, there are some safety and health precautions to keep in mind.Always avoid foods that might cause choking due to texture or size (like peanut butter or individual peanuts) or trigger infections (think undercooked fish, meat, or eggs). Skip added salt, refined sugars, and artificial ingredients. And choose organic whenever possible.
- Is your baby sick? New foods, especially those considered highly allergenic, should not be introduced when your child has a compromised immune system like a cold or virus, is on antibiotics, or is already showing signs of an allergic reaction. If your family has a history of allergies, talk to your pediatrician before introducing new foods.
1Jessica Magnusson, Inger Kull, Helen Rosenlund, Niclas Ha ̊kansson, Alicja Wolk, Erik Mele ́n, Magnus Wickman, and Anna Bergstroem: Fish consumption in infancy and development of allergic disease up to age 12 y1–3
2 Du Toit, G., et al. “Early Consumption of Peanuts in Infancy Is Associated with a Low Prevalence of Peanut Allergy.” Journal of Allergy and Clinical Immunology, 2008, 122: 984–991.aa