By Lauren Gladman
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 about food allergies. This combined with lots of new research and therefore many changes to the introducing solids recommendations can be confusing. So what is the best way to move your baby from their first mouthful to eating 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 cause has been identified yet. 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.
During pregnancy, some mothers are manipulating their diet hoping to reduce food allergy risk for their child. However, this is not supported by research. It is recommended that a varied and healthy diet is consumed during pregnancy and while breastfeeding. A varied diet includes a range of grains, fruit, vegetables, dairy, eggs, nuts and meat. Restricting your diet whilst pregnant should be avoided or done with caution and medical consultation. Risks of inadequate nutrition in a pregnant mother include poor growth in babies and nutrient deficiencies.
Any length of breastfeeding provides benefit to mother and baby. Continuing to breastfeed during the age solids are introduced may assist with food allergy prevention. Although scientific evidence around this has weakened in the past few years, there remains many other benefits to be gained from breastfeeding.
The age of your babies first mouthful of food 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 start solids before 4 months and 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 dairy, wheat, cooked egg, peanuts and fish that need to be avoided or delayed. These foods should be introduced before 12 months of age along with fruits, vegetables and grains when the family are consuming them. Further research is required to determine the best age to introduce these foods. Trialling a new food every 2 days will enable you to identify foods if they cause a reaction.
Recent research has emerged showing exposure to peanut pastes from between 4 and 11 months of age, at least 3 times per week may decrease the risk of peanut allergy significantly. Similarly, studies looking at cooked egg have shown introduction before 8 months of age can reduce the risk of egg allergy. This is particularly in families where another member has a food allergy. To introduce peanut, use a peanut paste. To start egg, use a boiled egg that is mashed. Gradually increase egg or peanut from a ¼ baby spoon to full serves mixed with other foods such as puree vegetables. Once introduced, continue to offer both foods at least twice a week.
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.
Embrace sharing food and eating with your child as it is an exciting and messy milestone that the whole family (including your furry friends) are sure to enjoy.
Remember: All infants, including those at high-risk of food allergy should be introduced to foods that are common food allergens before 12-months of age. These include peanut butter, cooked egg, wheat products, dairy and fish.
Lauren Gladman is an Accredited practicing dietitian (APD) specialising in infant, children and adolescent nutrition for 11 years. She is also the proud mum to Isla, 3 years and Finn, 18 months.