Discovering foods: A whole new world!

 

As baby approaches 6 months of age, it is time to start solid foods! A lot of pleasure in perspective as baby discovers new tastes, flavours and textures. Just like it is better to be prepared in case of choking (and know the difference between gagging), it’s a good idea to learn a bit more about allergic reaction and know what to look for.

 

Know the allergens and how to introduce them before starting solid foods with baby

 

 

 

Is my baby at risk of an allergic reaction?

 

Your baby might be at increased risk if one or both parents or a sibling has an allergic condition like asthma/atopic dermatitis, eczema, hay fever (conditions regrouped and often referred to as atopy), or food allergies. If your baby has severe eczema, s/he might be at increased risk of having food allergies.

 

If that is your family situation, talk to your family doctor about the best strategy to introduce common allergens to your baby. Perhaps you have experience with an older sibling who has allergies, but it doesn’t hurt to see if science and treatments have changed since then!

 

Your family doctor might refer you to an allergist, where a multidisciplinary health team will support your family.

 

Your child might be at risk of allergic reaction if other members of your family have allergies

What is an allergen?

 

An allergen is a protein that our body sometimes recognizes as harmful. The immune system will then react as it mistakes this food for something potentially dangerous. That will create an allergic reaction.

 

 

What is an allergic reaction?

 

After ingestion of an allergen, a reaction can occur in the minutes, or up to two days. The visible signs of the allergic reaction will vary depending on the child, the severity of the allergy and the dose of the allergen eaten. The allergic reaction will happen every time an allergic child eats that food.

 

When to introduce potential allergens?

 

    Should I avoid allergens during pregnancy?
No, avoiding allergens, even if your baby is at higher risk of food allergies, is not suggested during pregnancy. Avoiding eating fish or peanut during pregnancy will not prevent your child from being allergic to fish or peanut.

 

    Should I avoid certain food while breastfeeding?
No, it is not recommended to avoid allergens when you are breastfeeding either. It doesn’t offer any benefits for baby, unless there is a diagnosed allergy or food intolerance. A typical case is cow’s milk protein allergy, in which case the mother can choose to continue breastfeeding if she excludes food sources of cow’s milk protein in her own diet. The guidance of a registered dietitian can help ensure that the mother’s diet stays balanced, and that baby’s symptoms under control.

 

    Should I delay the introduction of allergens past 6 months of age?
Latest evidence have demonstrated that there are no benefits in delaying introduction to solids food, including allergens, past 6 months of age. Delaying the introduction of allergens could in fact be increasing the risk that your child develop an allergy. When you begin introducing solid food to baby around 6 months, make sure to introduce the common allergens.

 

    Should I introduced allergens at 4 months of age?
Earlier is not better either! Currently the recommendation and the evidence we have from research on peanut allergy support the introduction of solid foods, including allergens, around 6 months of age. At that time, baby is physiologically ready, needs iron-rich foods, can slowly be exposed to various textures and flavours, and can benefit from ingesting regularly allergens to maintenance tolerance.

 

Introduce allergens to your baby at 6 months of age, not before, not after.

How to introduce potential allergens?

 

We suggest you offer one allergen at a time, waiting 3 days before introducing another allergen. This way, you will be able to look for any symptom of an allergic reaction and know exactly which food was in cause. You can offer non-allergen food at the same time. For example, you could introduce scramble eggs with chopped tomatoes and parsley flakes. In this case, the allergen is the egg, but you can introduce tomatoes and parsley at the same time as these food are not major allergens. If an allergic reaction occurs, it would likely be due to the ingestion of the egg.

 

Offer one allergen at a time, repeated over 3 days and monitor any symptoms

We created a table to give you ideas on how to introduce each allergen in a safe manner for your 6 months old baby. Subscribe to get it now.

 

How do I know it is an allergic reaction?

 

First, you will know that you are introducing a new allergen, so you are on the lookout for signs. It can be a good idea to offer the allergen in the morning so you can monitor the reaction throughout the day (rather than having to monitor throughout the night!). If there is no reaction after your child eat the allergen, repeat offering the same allergen for 3 days as you monitor the reaction. After 3 days, if there is no reaction, it is safe to assume that your baby is not allergic.

 

If you suspect that certain foods cause an allergic reaction (or intolerance), keep a diary of food and symptoms. Note down what your child ingested, what were the reactions, the time it took for the signs to show up and dissipate. You can exclude this food from your child’s diet and see if the symptoms disappear. Bring that diary with you at your next medical visit.

 

Your doctor and registered dietitian will help you determine if it is a food allergy or intolerance, and what to do next. We suggest to consult with your doctor or registered dietitian before you exclude food groups from your child diet (but do exclude the food that cause the allergic reaction temporarily), so we ensure your child’s nutrients needs are met and his/her growth is optimal.
 

 

Mild to severe allergic reaction can occur after your child eats an allergen. Keep your eyes open.

Will my child outgrow the allergy?

 

As their immune systems mature and grow, kids might outgrow their allergies to dairy, soy and eggs. Unfortunately, there are no guarantee that your child will outgrow his allergy, and the allergist will guide you as your child grows.

 

Some kids will outgrow their allergy as their immune system mature

A side note: Food allergies vs food intolerances

 

Food allergies are triggered by the immune system, while food intolerances are not. Food allergies are digestive problems that can be as incapacitating as food allergies, but they are two different conditions. It is important to seek appropriate help for both conditions so that your child’s diet is balanced, that his/her growth is optimal and that food items and food groups are not excluded with no reason. Your family doctor, your allergist and registered dietitian can help your family manages your child’s food allergies and intolerances.

 

Although food allergies and food intolerances are different, both require changes in your child’s diet, and a registered dietitian can guide you

 

References
Dietitians of Canada

 

EatRight Ontario

 

Healthy link British Columbia

 

Ierodiakonou D, Garcia-Larsen V, Logan A, Groome A, Cunha S, Chivinge J, Robinson Z, Geoghegan N, Jarrold K, Reeves T, Tagiyeva-Milne N. Timing of allergenic food introduction to the infant diet and risk of allergic or autoimmune disease: a systematic review and meta-analysis. Jama. 2016 Sep 20;316(11):1181-92.

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