Introducing Allergenic Foods to Babies by Lucy Stewart of @lucystewartnutrition

Introducing allergenic foods is a big part of starting solids, and a time that can cause a lot of stress and anxiety for parents, but it doesn’t have to be.

Food allergies are on the rise at an alarming rate with around 10% of infants affected by a food allergy, and in Australia, admissions for anaphylaxis due to food allergy in children aged 0 – 4 years has increased 5x over the last decade. But, diagnosing and managing them can be challenging.

Parents are usually the ones to diagnose their children but most aren't fully educated on these conditions. Also, because allergies, sensitivities, and intolerances all have overlapping symptoms, it can make them easy to misinterpret.

Additionally, reactions to foods are often overlooked by mainstream medicine because typical symptoms are simply accepted as commonly experienced childhood conditions, like: gas, rashes, eczema, irritability, reflux, cold symptoms, and ear infections. Although these are common for babies to experience, they should not be considered ‘normal’. They’re our body giving us messages that something is going wrong internally, and they shouldn’t be ignored.

 

WHEN TO INTRODUCE ALLERGENIC FOODS

The Australian Society of Clinical Immunology & Allergy recommends that allergenic foods be introduced to babies, when they begin solids and before the age of 12-months. Current research shows that delaying the introduction of these foods does not help prevent food allergy in the future. In fact, some studies show that early and frequent exposures to these allergens will actually decrease the risk of allergies. If your baby is breastfed, and mum also eats these foods, then baby will be getting a small amount of exposure through her milk already.

For particularly high-risk babies, parents may want to consider having access to baby-friendly antihistamine medication for initial introductions at home. Or it may be recommended to perform an oral food challenge in your doctor’s office in case of a serious allergic reaction. Children are considered high-risk for developing food allergies if they have: a family history of food allergies, moderate to severe eczema and/or asthma. If your baby is considered high risk, it’s best to consult with your doctor first, before introducing allergenic foods.

While any food has the potential to cause an allergic reaction, there are 9 high-risk foods that make up 90% of all food allergies in babies:

  • Eggs 
  • Cows milk 
  • Peanuts 
  • Tree nuts 
  • Shellfish 
  • Soy 
  • Fish
  • Sesame 
  • Wheat

Although these foods are considered ‘allergenic’ because they have a higher risk of reaction, the majority of children are absolutely fine with them.

 

HOW TO INTRODUCE ALLERGENIC FOODS TO BABIES

1. Introduce each allergenic food one at a time.

2. Introduce them at the start, or early in the day, or during the longest period your baby is awake for, so that you can monitor them for any kind of reaction.

3. Start with just a small amount, a little taste, and then wait 10 minutes to watch for any immediate reaction. If there is no reaction, offer a little more, up to 2 tsp to start with.

4. Wait 4 days before introducing that allergenic food again, and before introducing any other new foods so you can watch for any delayed reactions.

5. Start from step 1 again and aim for at least 5 more exposures. If you have no reaction, you can safely keep that food in their diet.

6. Move on to introducing the next allergenic food.

 

TIPS FOR INTRODUCING ALLERGENIC FOODS

Nuts: When introducing nuts, know that each type of nut will need to be tested individually for tolerance. You can rub a small amount of nut butter or nut that’s been ground in to a powder (use a mortar and pestle) on the inside of baby’s cheek first and watch for any reaction.

Eggs: When introducing eggs, introduce the yolk and the white separately. The yolks contain all the nutrients and the whites contain all the protein, but it’s the whites that are highly allergenic. A boiled egg is the easiest way to separate the yolk and the white. The yolk can then be mixed through other food.

Cows dairy: Start with fermented versions like kefir and yogurt and plain, full fat and organic where possible. Ghee or clarified butter is also nourishing (it doesn’t contain cow’s milk protein) and is easy to digest.

Shellfish: You can test for allergic tolerance with shellfish by first giving baby some shellfish to hold or rubbing the shell on their skin.

Soy: Although I’m not a fan of soy products for babies, introducing soy is important to test and build allergic tolerance. I recommend introducing fermented soy such as tempeh – this can be cooked and cut in to fingers that are easy for babies to pick up. Favour organic soy where possible too as soy is one of the most genetically modified and heavily pesticide foods.

 

ORDER OF ALLERGENIC FOOD INTRODUCTION

I like to introduce allergenic foods and an order that offers the most nutritional benefits:

6 - 8 months: Egg yolk, sardines, peanuts and tree nuts.

8 - 10 months: Soy (tempeh), shellfish, fatty fish (salmon, trout, barramundi, snapper, tuna), sesame.

10 - 12 months: Egg white, grass fed butter, cow’s milk kefir, cow’s milk yoghurt, labneh, wheat and gluten (rye, spelt, barley, kamut, oats)

WHAT IS A FOOD ALLERGY?

A food allergy occurs when the immune system recognizes proteins of a particular food as a harmful invader and responds with an immune attack, which is known as an IgE response.

When the immune system encounters the ‘offending’ protein it banks it in their memory and creates an antibody. The immune system uses the antibody to identify and neutralize the invading foreign object, and the next time that specific antigen enters the body, the immune system responds by producing more of the same antibodies. This means that every time your baby comes into contact with that allergen, they will experience allergy symptoms.

An allergic reaction can take place anywhere between a few minutes to a few hours after eating a food. This is why we want to introduce any allergenic foods early in the day so you can watch for a reaction, and if there are any sensitivities, then this will also allow time for the food to pass through before bedtime so they’re sleep isn’t disturbed by an upset tummy.

Some signs to look out for include:

  • Rashes, spots, hives (around the mouth or on the body)
  • Sneezing
  • Colic / reflux
  • Unsettled behaviour – tantrums, irritability, difficulty sleeping, hyperactivity, restlessness, apathy
  • Change in bowel habits – constipation, diarrhea, gas, bloating, green frothy stool, cramping
  • Eczema
  • Runny nose
  • Watery eyes
  • Dark circles under the eyes
  • Crusting behind the ears
  • Little bumps under the skin on the backs of arms, like sandpaper
  • Flushing
  • Vomiting – nausea
  • Swelling of tongue, lips, throat
  • Difficulty breathing – coughing, wheezing, chest congestion

If your baby experiences an immediate reaction, or a reaction up to 2 hours after exposure. This reaction is more likely to be an allergy, and you should consult your health care practitioner before exposing them to that food again.

If the reaction happens more than 2 hours later, it’s likely to be an intolerance or a sensitivity, and less likely to be a true allergy.

 

WHAT IS A FOOD SENSITIVITY?

Food sensitivities are non-IgE reactions. Like an allergy, sensitivities also involve an immune response in which antibodies are created. Food sensitivities do not pose the threat of causing anaphylaxis, however, while reactions are not life-threatening they can still be significant and can pose considerable discomfort.

The immune response to a sensitivity is more delayed than with an allergy and symptoms arise anywhere between a few hours to 3 days after consuming a trigger food. This makes food sensitivities more difficult to determine.

Food intolerances or sensitivities can generally be improved with some gut healing, and time – as baby’s digestive system matures.

 

WHAT IS A FOOD INTOLERANCE?

A food intolerance involves a problem digesting food or an absence of digestive enzymes.

An example of this is lactose intolerance. People who are lactose intolerant do not produce the enzyme, lactase, which is required for the proper digestion of lactose – the sugar found in milk and dairy products. Unlike food allergy or sensitivity, the immune system in not involved in the associated physical response of a food intolerance. Again, although a food intolerance does not pose an immediate threat, it can cause considerable discomfort for babies.

AVOID INTRODUCING ALLERGENIC FOODS WHEN…

  • Your baby is unwell. If their immune system is compromised, they are more likely to react and it will also be difficult to note if any symptoms are related to the illness or the food.
  • If your baby is showing any signs of an upset tummy.
  • Your baby has colic or reflux. It will make determining any food reactions difficult.
  • Your baby is at daycare or a restaurant, or not with you.
  • It is your babies very first food. Egg yolk is a wonderfully nourishing first food, that can be introduced when they begin solids, but it is an allergen so make sure they are eating other solid foods first. You can read more in y article Nourishing First Foods For Babies.
  • If your baby has just started a new medication. Wait at least 2 weeks to ensure that they are tolerating the new medication well.

 

WHAT TO DO IF YOUR BABY HAS A REACTION

It can take a few introductions before symptoms are detectable, as reactions can worsen with each exposure to that food. This is why it’s important that you continue to expose them, at least 5 times, to prime their immune system and so that you know that food is safe for them. If your baby does have a reaction, you should:

  • Stop the meal immediately and separate your baby from the food.
  • Wipe their mouth and hands.
  • Stay with them and monitor for an increase in severity of symptoms, especially: swelling, difficulty breathing, vomiting and lethargy.
  • Optional (depending on severity) administer a baby-friendly antihistamine.
  • If symptoms are mild/moderate, contact your health care provider. 
  • If symptoms are severe, call 000.


DO BABIES OUTGROW FOOD ALLERGIES?

Babies usually outgrow their allergies as their bodies, gut and immune systems mature - especially with early intervention of an immune support and gut healing protocol.

They’re more likely to outgrow allergies to egg, milk, wheat and soy - but these allergies tend to be resolving less frequently than they have been in past decades.

Allergies to peanuts, tree nuts, fish and shellfish don't generally resolve with around 10 - 20% of children who have these allergies outgrowing them.

 

HEALING FOOD SENSITIVITIES & ECZEMA

Both food sensitivities and eczema point to excess intestinal permeability, commonly referred to as ‘leaky gut’. The intestinal wall is designed to act as a barrier keeping food particles and toxins confined to your digestive tract. However, when the intestinal wall is compromised, tiny gaps can occur between the cells of the membrane lining – think of it like a bag made of tightly woven cloth and the weaving becomes loose, creating holes.

These holes allow food particles from inside the gut to escape or ‘leak’ through the gut lining into the bloodstream, which can cause an allergic immune response resulting in eczema or other symptoms associated with food sensitivities and low-grade systemic inflammation.

Our gut houses 80% of our immune system, so healing the gut is a key component in healing from food sensitivities and eczema. The healthier your baby’s gut is, the better their digestion and immune system will function, and the better their little body will be able to tolerate an occasional or accidental exposure.

I support lots of babies and children with food sensitivities and eczema in my practise. By implementing a gut healing protocol, we can heal the intestinal wall, increase digestive capabilities and nutrient absorption, as well as create microbial diversity and balance. If you’d like some personalised support with introducing allergenic foods, or your little one has food sensitives or eczema, please reach out to me here, I’d love to help!

Lucy xx


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