Preventing Allergies: When Should We Introduce Allergenic Foods To Our Babies?

| August 28, 2017 | Author: naturopath

Preventing Allergies: When Should We Introduce Allergenic Foods To Our Babies?

Worldwide prevalence of food allergies is on the rise.

Figures by the Australian Bureau of Statistics reveal that about 13% of children aged between two and 18 avoid a food due to allergy or intolerance, and data from the U.S. suggests that 4 out of every 100 U.S. children have a food allergy.

Most children grow out of their food allergy; however, when adults develop food allergy, it usually persists.

Preventing allergiesWhat is food allergy?

Food allergy is an immune system reaction to food that can sometimes be life threatening, as in the case of anaphylaxis. The most common triggers, accounting for 90% of food allergic reactions, are these eight foods: milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, and soy. However, there are more than 170 foods known to have triggered severe allergic reactions. 

Currently, there is no cure for food allergy other than avoidance of the triggering allergenic food.

Not all food reactions are food allergies. Food sensitivity, also called food intolerance, does not involve the immune system, and does not cause severe allergic reactions.

Symptoms of food allergy

Reactions usually occur within minutes following exposure to an allergen, and most often result in hives, swelling of the lips, eyes, or face, nausea, abdominal pain or vomiting. The most severe form of food allergy is anaphylaxis. Some of the symptoms of anaphylaxis include difficult/noisy breathing, swelling of tongue, and tightness in throat. Anaphylaxis can be fatal if left untreated.

Asthma, hay fever, and eczema are often associated with food allergy.

Allergenic food introduction

While the reasons for the increasing prevalence of food allergies are a subject for ongoing research, there is some evidence that suggests that delayed introduction of certain potentially allergenic foods may increase your baby’s risk for food allergies.

What does the research say?

peanutsPeanuts. One study found that children in Israel were 10 times less likely to develop peanut allergy when they were compared with Jewish kids in the United Kingdom. The researchers noticed that Israeli kids consumed high amounts of a popular peanut snack called Bamba, from approximately 7 months of age, while in the United Kingdom peanut-based foods were usually introduced in the diet only after the first year of life.

The researchers suggested that the early introduction of peanuts to the diet offered protection from the development of peanut allergy. A later study showed similar results. It involved 640 allergy-prone infants, between 4 months and 11 months of age. The infants were divided into two groups. One group consumed Bamba or smooth peanut butter, while the other group was to avoid any peanut consumption. When the infants were 60 months of age, those who consumed peanuts were about 80% less likely to develop a peanut allergy compare with the group that avoided peanuts.  

EggsEggs. When infants with eczema received 1 teaspoon of pasteurised raw whole egg powder daily from 4 to 8 months of age, they had reduced incidence of egg allergy at 12 months of age, compare with infants who were not fed any eggs until 8 months.

Milk. Researchers followed the feeding history of over 13,000 newborns. They found that those who were started on cow’s milk formula before 14 days of age were at significantly reduced risk for developing milk allergy compare to those who were given formula between the ages of 105 and 194 days.

This is not to discourage breastfeeding. The Department of Health guidelines recommend exclusive breastfeeding of infants to around six months of age when solid foods are introduced and continued breastfeeding until the age of 12 months and beyond, if both mother and infant wish.

Fish. Another study, from Sweden, found that early introduction of fish (before 9 months of age) was associated with reduced risk of developing asthma at 8 years of age.

Multiple allergenic foods.  A U.K. trial divided breast-fed babies into two groups. One group, ‘the early-introduction group’, consumed at least 5 of 6 allergenic foods: milk, peanut, egg, sesame, fish, and wheat, for at least 5 weeks between 3 and 6 months of age, while in the other group, ‘the standard-introduction group’, there was no consumption of the allergenic foods before 5 months, with the exception of formula milk. It turned out that out of the 6 foods, the prevalence of peanut allergy and egg allergy were significantly lower in the early introduction group, suggesting a protective effect for early introduction of peanuts and eggs.

Tips for introduction of highly allergenic foods

In the past, we have been advised to introduce highly allergenic foods after the age of one year old. These days, the evidence shows that delaying the introduction of these foods may increase your baby’s risk of developing allergies.

The Australasian Society of Clinical Immunology and Allergy recommends the following:Tips for introduction of highly allergenic foods

  • When your infant is ready, at around 6 months, but not before 4 months, start to introduce a variety of solid foods, starting with iron rich foods, while continuing breastfeeding
     
  • All infants should be given allergenic solid foods including peanut butter, cooked egg, dairy and wheat products in the first year of life. This includes infants at high risk of allergy
     
  • You may choose to introduce one new food at a time so that if a reaction occurs, the problem food can be more easily identified. If a food is tolerated, continue to give this as a part of a varied diet
     
  • Some infants will develop food allergies. If there is any allergic reaction to any food, that food should be stopped and you should seek advice from a doctor with experience in food allergy

References

Allergy & Anaphylaxis Australia (2017), What is Anaphylaxis? Available at: https://allergyfacts.org.au/allergy-anaphylaxis/what-is-anaphylaxis

American Academy of Allergy Asthma & Immunology, Preventing Allergies: What you should know about your baby’s nutrition. Available at: http://www.aaaai.org/

Australian Bureau of Statistics 2014, Australian Health Survey: Nutrition First Results - Foods and Nutrients, 2011-12.  Available at: http://www.abs.gov.au/

Australasian Society of Clinical Immunology and Allergy 2014, Food Allergy, Available at: https://www.allergy.org.au/

Australasian Society of Clinical Immunology and Allergy, Guidelines - infant feeding and allergy prevention. Available at: https://www.allergy.org.au/

Bertall, N., Allen, K., & Maguire, B. (2012). The Longitudinal Study of Australian Children Annual statistical report 2012 - 8 Children’s food allergies. Available at: http://www.growingupinaustralia.gov.au/

Branum, A. M. P. H., & Lukacs, S. L. (2008). Food Allergy Among U.S. Children: Trends in Prevalence and Hospitalizations. Retrieved from https://www.cdc.gov/nchs/data/databriefs/db10.pdf

Department of Health 2017, Breastfeeding. Available at: http://www.health.gov.au/breastfeeding

Goksör, E., Alm, B., Pettersson, R., Möllborg, P., et al. (2013). Early fish introduction and neonatal antibiotics affect the risk of asthma into school age. Pediatric Allergy and Immunology : Official Publication of the European Society of Pediatric Allergy and Immunology, 24(4), 339–44. http://doi.org/10.1111/pai.12078

Katz, Y., Rajuan, N., Goldberg, M. R., et al. (2010). Early exposure to cow’s milk protein is protective against IgE-mediated cow’s milk protein allergy. Journal of Allergy and Clinical Immunology, 126(1), 77–82.e1. http://doi.org/10.1016/j.jaci.2010.04.020

Palmer, D. J., Metcalfe, J., Makrides, M., et al. (2013). Early regular egg exposure in infants with eczema: A randomized controlled trial. Journal of Allergy and Clinical Immunology, 132(2), 387–392.e1. http://doi.org/10.1016/j.jaci.2010.04.020

Perkin, M. R., Logan, K., Tseng, A., et al. (2016). Randomized Trial of Introduction of Allergenic Foods in Breast-Fed Infants. New England Journal of Medicine, 374(18), 1733–1743. http://www.nejm.org/doi/10.1056/NEJMoa1514210

Du Toit, G., Katz, Y., Sasieni, P., et al. (2008). Early consumption of peanuts in infancy is associated with a low prevalence of peanut allergy. Journal of Allergy and Clinical Immunology, 122(5), 984–991. http://doi.org/10.1016/j.jaci.2008.08.039

Du Toit, G., Roberts, G., Sayre, P. H., et al. (2015). Randomized Trial of Peanut Consumption in Infants at Risk for Peanut Allergy. New England Journal of Medicine, 372(9), 803–813. http://doi.org/10.1056/NEJMoa1414850

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