Babies and food allergies

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Introducing family foods to your baby can be a challenge, especially if you are concerned about food allergies and introducing common allergy causing foods.

Prevention of Food Allergy

Research has shown that introducing common allergy causing foods to babies before they are one year of age can reduce the risk of developing an allergy to that food. Babies with eczema have a higher chance of developing a food allergy so following this recommendation is even more important.

It is recommended that common allergy causing foods should start to be introduced to babies around 6 months, not before 4 months, when the baby is showing signs that they are ready to eat solid food.

The common allergy causing foods are

• Egg
• Cow’s milk (dairy)
• Peanut
• Tree nuts
• Shellfish (mollusc and crustacean)
• Fish
• Soy
• Wheat
• Sesame

Key points on introducing common allergy causing foods to infants:

• All infants who are ready to eat solid food should have common allergy causing foods introduced, even if there is a family history of allergic disease or if the baby has eczema.
• Start introducing common allergy causing food when your baby shows signs that they are ready, around 6 months, not before 4 months.
• Once introduced to the baby, the food should be given about twice a week if there are no signs of allergic reaction.
• Most babies will be able to eat common allergy causing foods without having an allergic reaction.
• Allergic reactions to food usually happen within minutes of eating the food but can take up to 2 hours to develop.
• If your baby has a reaction to one type of allergy causing food, this does not mean they will have allergies to other common allergy causing foods.
• Screening for food allergies before introducing common allergy causing food is NOT recommended.

Allergic reactions in babies

Recognising an allergic reaction in a baby can be a little more difficult than in an adult because babies cannot tell you what they are  feeling and you are relying on symptoms that you can see or hear, and changes in their behaviour.

The Nip Allergies in the Bub website has information on How to recognise an allergic reaction – Prevent Allergies.

Signs of a mild to moderate allergic reaction include:

• Swelling of the lips, face, eyes
• Hives or welts
• Tingling mouth
• Abdominal pain, vomiting

Signs of a severe allergic reaction (anaphylaxis include):

• Difficulty or noisy breathing
• Swelling of the tongue
• Swelling in the throat (more drooling than normal, difficulty swallowing)
• Change in voice or cry
• Wheeze or persistent cough
• Pale and floppy

The Nip Allergies in the Bub website has information What to do if you think your baby is having an allergic reaction – Prevent Allergies.

If your baby is showing any ONE sign of anaphylaxis, with or without mild to moderate signs, lay your baby flat, give adrenaline injector if available, call triple zero (000) for an ambulance.

If your baby is showing signs of a mild to moderate allergic reaction, without any sign of anaphylaxis:

• Stay with your baby and watch them for any sign of anaphylaxis.
• If there are no signs of anaphylaxis, mild to moderate reactions usually go away by themselves.
• If you have antihistamine which your doctor or pharmacist says is safe for your baby, you may give them a dose as advised on the bottle.
• Antihistamine may help mild to moderate symptoms get better sooner but it will not stop a mild to moderate allergic reaction becoming anaphylaxis.
• If your baby has itchy skin, place a cool wet cloth on the area.
• Seek medical advice. Make an appointment to speak with your GP/doctor about the reaction.
• If you can, take photos of the signs to show the doctor.

Remember, mild to moderate signs can look scary but are not life threatening. Speak with your doctor about the allergic reaction and ask for advice.

How to give babies common allergy causing foods

Avoid food on skin

Don’t rub food on your baby’s skin, especially if they have eczema, as this may cause the skin to become red and be mistaken for a food allergy. It is also thought that putting food on the skin before baby is eating that food may increase the risk of developing an allergy to that food.

When introducing a new common allergy causing food, the parent should feed the food directly into the baby’s mouth. This will help reduce the chance of the food being smeared on the skin around the mouth which can cause redness and can be confused with an allergic reaction

Barrier creams around the mouth may help prevent the skin in that area becoming red.

Family foods

• Introduce common allergy causing foods that the family eats first. For example, if your family eats fish more often than shellfish, introduce fish first.
• Introduce one new common allergy causing food at a time. If more than one new food is introduced at a time and the baby has an allergic reaction, it is hard to know which food caused the reaction.
• Start with a small amount of the food (for example cover the tip of a teaspoon – about  1/8-¼  teaspoon)
• Offer the food when the baby has just woken and will be awake and with you for a few hours after eating so you can watch for any signs of an allergic reaction
• Introduce new common allergy causing foods when baby is well. Sometimes a viral illness can cause an allergic reaction to be worse.

Texture

Giving food in a texture that is right for the age of the child is extremely important. There is a risk of choking for babies and young children if foods such as peanut and tree nuts are given whole or even in small pieces.

Babies, toddlers, and young children under the age of 5 years are unable to chew hard foods safely. Hard foods such as peanuts and tree nuts can get stuck in the airways (breathing tubes) and lungs. This can make it difficult for the baby or child to breathe.

Please remember to only give SMOOTH peanut butter/tree nut pastes or peanut/tree nut flours such as peanut flour or almond meal until at least 5 years of age.

• You may choose to mix peanut/tree nut flours/meals into food they are already eating regularly.
• Whole or crushed peanuts or tree nuts, including crunchy peanut butter, should NOT be given because of the risk of choking.

For recipe ideas and information on appropriate forms of food for your baby or toddler see the resource page on the Nip allergies in the Bub website Feeding your baby resources – Prevent Allergies.

Once introduced to the baby, the food should be given about twice a week if there are no signs of allergic reaction.