Introducing the Common Allergens
The introduction of solid foods can be very exciting! What will make them pucker, what will they fall in love with? Yet, it also can bring on much anxiety. How will you introduce them- purees versus baby-led weaning? What if they have an allergic reaction?
While we used to wait on the introduction of common allergens, we now know there is a benefit to introducing allergenic foods earlier. Once your baby reaches around four to six months of age and shows the developmental signs of readiness to start solids, the recommendation is that allergenic foods should be introduced as early as possible and continued in the diet often. Delaying these foods could actually promote the onset of allergies. This is especially important for babies that are at high risk for allergies. Babies that are at high risk mean they have an immediate relative, like a parent or a sibling, with a food allergy or they have other allergic conditions like reactive airways disease, eczema, or another known food allergy.
Common allergens include:
- Shellfish (shrimp, lobster, crab, etc.)
- Cow’s Milk
- Tree Nuts (almonds, walnuts, cashews, hazelnuts, etc.)
When should we introduce them?
Your baby should always be healthy (no fever, runny nose, cough, etc.…) at the start of introducing any new food whether it is a common allergen or not. This allows us to make sure allergic symptoms are not being masked due to illness.
The best time to introduce common allergens is in the morning. While it is perfectly fine to do it at any time of the day, mornings are just the easiest to be able to best evaluate if a reaction has occurred. It is also encouraged to introduce new foods at home versus at daycare as reaction histories can be hard to capture and the child is not as closely watched.
How to introduce them?
There is no specific order on how to introduce common allergens. The key is your baby needs to be regularly exposed to each new food in order to build a tolerance to it. Offer the food to your child in tiny amounts at the beginning, and then increase the quantity of food little by little over a few days. Often the easiest way to introduce common allergens is by mixing the allergen with otherwise well-tolerated food or purees. If you are doing purees, you can mix in the peanut butter or other nut butter with the pureed food. You also can mix it in with a baked good if you are doing baby-led weaning. This is also a good approach to introducing wheat, milk, or soy as well. Remember, you really only need a small quantity of the food to be swallowed to be considered an exposure!
Often times parents ask if an exposure includes just rubbing the food on the skin. You should never trust a reaction based on contact with the skin. This is due to some foods being acidic, potentially irritating the skin and causing a false reaction.
How often should I introduce allergens?
You should only introduce one new food every 3-4 days. This is the safest way to ensure that you can easily tell which food may cause a problem. If no reaction occurs, keep offering the food regularly. Most reactions typically begin within 10-15 minutes after eating the food, with less severe reactions taking up to several hours to appear.
What type of reaction should I look for?
The most common reactions in infants and children are skin reactions such as hives, itchy skin, swelling, or redness of the face or chest. Other symptoms can include trouble breathing, coughing or wheezing, worsening eczema, vomiting, diarrhea, or bloody stools. If your child experiences any of the symptoms, call us, or seek medical help right away!
The introduction of solid foods brings on both excitement and anxiety. Know that you are off to the right start and the staff at Mainstreet Pediatrics is always here to help you on your journey! Bon appetite!