Is it time for your baby to start eating solid food? Whether you’re diving in with baby led weaning or trying your hand at homemade purees, it’s a good idea to think about food allergies in babies before you begin.
But where do you start? In this post, we’ll answer your top questions about food allergies in babies, including:
What Is a Food Allergy?
A food allergy occurs when your body reacts to certain proteins in certain foods.
When a person (adult or baby) has an allergy to a certain protein, the presence of that allergen can trigger an adverse immune response. (source) Though many people think of hives when they think about food allergies, according to a study published in the Clinical Reviews in Allergy & Immunology, food allergies can affect the body in many ways. When it comes to food allergies in babies hives, eczema, and even colic are all effects of the body’s immune response. (source)
How Common Are Food Allergies in Babies?
If it seems like you’re reading about more and more about food allergies, you’re not imagining it. Food allergies are increasing each year.
- According to an article published in Journal of Allergy and Clinical Immunology, about 8 percent of babies have food allergies (5% of adults), but that number is projected to increase annually. (source)
- Another study, published in Clinical Reviews in Allergy & Immunology actually found a higher number: as many as 20 percent of babies are estimated to have food allergies. (source)
Risk Factors: What Causes Food Allergies in Babies?
Yikes! What is causing such an increase in food allergies? Children are more likely to develop allergies if they have a family history of allergies (source), but there are other factors at play here.
- Eczema: Infants with eczema are 30 percent more likely to develop food allergies. (source)
- Weak immune system: The Western Diet, lack of dirt exposure (i.e. playing outside), and poor gut health all contribute to an already vulnerable immune system. (Check out this post for tips on strengthening your child’s immune system.)
- Vitamin D insufficiency: Lacking this vitamin has been linked to many conditions including low mood and increased risk of food allergies. (source)
- Timing for introducing food: Introducing food (especially grains) too early can affect your baby’s digestive system due to an immature gut. (source)
The Most Common Food Allergies in Babies
Most food allergies in babies are caused by just eight allergens. The majority (90 percent) of babies with food allergies have one of the following allergies (source):
- Cow’s milk
- Tree nuts
Note: Cow’s milk, eggs, and peanuts are the most common of these allergies, accounting for nearly 80 percent of all food allergies, but milk and egg allergies are often outgrown. (source)
Is There a Way to Prevent Food Allergies?
Ah, the age-old question. Should you expose babies to allergenic foods early or hold off on introducing these foods? In the past, mamas delayed feeding food on this list to babies, but current research suggests early introduction is the key to preventing food allergies in babies.
To make this process easier—and safer—a crop of innovative companies such as Ready, Set, Food! have developed programs that focus on introducing the most common allergens to babies as soon as they begin eating solids. (Get more program specifics below.)
New Research Findings Regarding Food Allergies
What the most recent research says about food allergies in babies
- According to the results of the LEAP (Learning Early About Peanut) study, introducing peanuts/nut butter to at-risk babies before the age of 11 months dramatically reduces the risk of developing a peanut allergy up to 80 percent. (source) The LEAP study was the first study to consider early introduction as a way to prevent allergies.
- Another study, the EAT study found that early introduction in addition to extended breastfeeding reduced the risk of developing an allergy. (source)
- The PETIT study joins this list as another important study to support early introduction. While the LEAP study focused on peanuts, the PETIT studied focus on eggs. Researchers found that early introduction to hen’s eggs reduced allergies by 79 percent. (source)
The new guidelines
With all of the new research at our fingertips, it’s no surprise that the FDA, the National Institutes of Health, and the American Academy of Pediatrics have all updated their guidelines to support the science behind early and sustained allergen introduction.
- FDA: In a statement issued in September of 2017, the FDA confirmed that introducing a highly allergenic food, such as peanuts, between 4 and 10 months helps to reduce the risk of allergy in children. (source)
- NIH: Based on the results of the LEAP study, the NIH confirmed that the practice of giving peanuts to babies most at risk of developing peanut allergies reduced allergies by 70 percent. Their addendum suggested that babies between the age of four and six months be fed “an age appropriate” peanut source. (source) Age-appropriate certainly nixes whole nuts or a big spoonful of peanut butter, which can be too thick for a small baby to swallow. Age-appropriate samples could include a thin smear of peanut butter, peanut butter stirred into a cut of broth (like peanut sauce), or a peanut butter cracker for older babies.
- AAP: The January 2017 addendum issued by the AAP recommends introducing peanut to high-risk infants by the age of four to six months. High-risk infants have egg allergies and/or severe eczema. (source)
Note: Although many guidelines suggest you can begin introducing allergens as early as four months, there are plenty of reasons to wait until six months to do so. Read more about when to introduce solids.
How to Introduce Allergens
There’s no denying that early and sustained introduction of allergens can affect your child’s development of (or lack of) allergies, but how exactly do you introduce allergens to babies?
Start with breastfeeding
First and foremost, do not avoid these foods for yourself (unless you’re allergic!) while you are breastfeeding. Just like certain proteins can trigger an allergic/immune response in your child’s body, certain proteins in breastmilk can also help prevent food allergies in breastfed babies. In fact, a 2018 study revealed that mother’s milk was able to reduce food-related anaphylaxis by helping the offspring tolerate the allergy. (source)
Talk to your pediatrician
The studies all demonstrate that starting early is much more beneficial than waiting until 11 or 12 months of age. Delaying introduction past this timeframe increases the risk of food allergies in babies.
That said, no two babies are exactly the same, and your pediatrician can help you determine what’s right for your child.
Go slow and steady
When you’re ready to start introducing solids (after baby is four to six months old), remember slow and steady wins the race. You need to introduce all eight of the most common allergens to baby, but you shouldn’t introduce them all at once. Why? If your baby does have a reaction to a certain food, it’s hard to pinpoint which food caused the reaction. Wait at least three days between introducing new foods.
Consider going with a program like Ready, Set, Food!
Consider using a program that can help you safely and effectively introduce allergens. I recommend Ready, Set, Food!, an allergist-developed system that allows you to gradually and gently introduce your baby (by mixing powder into your baby’s bottle) to peanuts, eggs, and cow’s milk.
After early introduction, you have to keep providing that food for at least three to six months. This is called sustained introduction, and it is just as important as the early introduction itself. For example, the PETIT study, which focused on eggs, required a daily dose of egg powder from five months through 12 months.
Signs of Food Allergies in Babies
What if you suspect your baby already has an allergy? It’s possible that your baby can show signs of allergies before he’s even eating solids. If you notice rashes or eczema, it could be that your baby is sensitive to something you’re eating. When this happens, cow’s milk is a common culprit. (source)
Below are the most common signs of a food allergy in a baby who has not yet started solids:
- Atopic dermatitis
- Runny nose
- Chronic diaper rash
- Dry skin
- Wheezing or asthma
- Red, itchy eyes
- Chronic ear infections
- Gastrointestinal upset (source)
- Body-wide diseases, such as enterocolitis and celiac disease (source)
Below are the most common signs of food allergies in babies and toddlers who consume solid food:
- Hives or welts on the body
- Rashes (on the body or in the diaper area)
- Itchy mouth (a toddler may even describe food as “spicy” for this reason)
- Facial swelling
- Difficulty breathing
- Swelling of the throat
- Fainting or loss of consciousness
- Lips turning blue
This list is provided by research from Food, Allergy, Research and Education. (source)
A note on anaphylaxis: The thought of anaphylaxis is scary, but you must remain vigilant. If your baby or toddler experiences facial swelling, difficulty breathing, or has severe vomiting, call 911 immediately.
How to Manage Food Allergies in Babies
You’ve probably noticed the increase in peanut-free classrooms and peanut-free lunch tables. This is a big movement towards helping young child (who may not be able to avoid allergens without the help of adults) stay safe at daycares and schools. But what can you do to manage an allergy in your home?
For mild allergies, your child’s pediatrician will likely create a treatment plan, which may include:
- Avoiding the allergen
- Keeping a journal to monitor your child’s system (many foods may take a few weeks to completely leave your child’s system)
- An emergency plan that includes instructions about what to do if your child is exposed
For severe allergies, your child’s pediatrician may suggest:
- Carrying an Epi-pen
- Instructing your child’s teachers to use the pen
- Creating an emergency plan
- Removing the allergen from your house
- Avoiding repeated exposure, since some allergies can get worse with each exposure
Do Food Allergies in Babies Go Away?
If your baby does develop an allergy, there is good news: Not all allergies are lifelong. Some allergies (particularly egg and milk allergies) dissipate by the time your child reaches early childhood. On average, children who outgrow a milk allergy do so by the time they turn 5.5 years old (or 66 months). (source) Unfortunately, if your child has not outgrown an allergy by the age of 10, it is unlikely that s/he will do so. (source)
On the other hand, certain allergies tend to be lifelong. This includes peanut, tree nut, and shellfish allergies. Less than 22 percent of children outgrow these allergies. (source) Since there is no cure for any of these food allergies, early introduction and sustained introduction as a form of prevention is so important—it’s your baby’s best defense against food allergies.
How About You?
Have you tried early introduction? What worked (and what didn’t)? Have you tried a program instead? Share your experiences below!