Article of the month
Introducing solids and preventing food allergy
by Lauren Gladman – an accredited practicing dietitian (APD) specialising in infant‚ children and adolescent nutrition
Introducing solid foods to your baby is a very exciting milestone. These days however, with the rise in food allergy this excitement is often tainted by anxiety around food allergy possibly occurring. This combined with lots of new research and therefore many changes to the recommendations can confuse parents about the best way to move your baby from first mouthful to family foods. The following is an up to date summary of what every parent needs to know.
It is not fully understood why allergy, especially food allergy, has increased so quickly in recent years, particularly in young children. Allergy prevention information is important to parents and rightly so. In Australia recent studies show that 10% of infants have an immediate food allergy and severe reactions (anaphylaxis) have increased 4-fold in the last 14 years. The reason for this is a complex mix of lifestyle, environment and genetics. No single causative factor has been identified. There are many studies on allergy prevention underway, however, to date there are no clear guidelines on specific actions parents can take to prevent food allergy in their children.
Starting with pregnancy mothers are manipulating their diet hoping to reduce food allergy risk for their child. This is not supported by the research and it is recommended that a varied and healthy diet is consumed during pregnancy or while breastfeeding. A mother restricting her diet to prevent food allergy in her infant is not supported by the research. Being cautious with dietary restrictions is important as inadequate nutrition in a pregnant mother can cause poor growth in babies and is not recommended.
Any length of breast feeding and particularly continuing to breast feed to the age of solids introduction offers some benefit in preventing food allergy.
The age of your baby’s first mouthful is one of the most studied aspects of allergy prevention. Despite evidence not yet informing an optimal time, starting between 4-6 months is currently recommended. Specifically, don’t delay solids beyond 6 months as this may increase (rather than decrease) the risk of allergy.
Beyond commencing iron-rich foods as one of the first foods (e.g. rice cereal), foods can be introduced in any order and at a pace that suits your baby. There are no particular allergenic foods such as milk, egg, peanuts and fish that need to be avoided or delayed. These foods should be introduced along with fruits, vegetables and cereals when the family are consuming them. Trialling a new food every 2-3 days will enable you to identify foods if they cause a reaction.
If your baby does react to foods as they are introduced seek medical advice. For those diagnosed with food allergy the only current treatment is avoidance of that food. A medical practitioner or accredited practicing dietitian (APD) will assist with advice to avoid foods if needed. This requires a sound understanding of food labels. In Australia infant formula and infant foods must comply with mandatory allergen declaration requirements to assist parents in selecting the right food for their children.
Further information for food allergy prevention can be found in the following places;
- NHMRC Infant feeding guidelines 2012
https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n56_infant_feeding_guidelines_150917.pdf
- Dietitians Association of Australia
www.daa.asn.au
- Australasian Society of Clinical Immunology and Allergy 2010
http://www.allergy.org.au/
- National Allergy Strategy
http://www.nationalallergystrategy.org.au/images/doc/NAS_Document_Final_WEB.pdf
- Australian Breastfeeding Association
https://www.breastfeeding.asn.au/
- Allergy & Anaphylaxis Australia
https://www.allergyfacts.org.au/
