As exciting as it is introducing solids, it can also be met with worry and uncertainty. My baby’s Paediatrician, who is also an expert in the allergy field, encouraged me to introduce allergens as early as possible as reactions would be a lot milder than if one were to postpone it to months later. Guest editor – Davina Goliath
1. Does my child have an allergy and how will I know?
New nutrition guidelines from the American Academy of Paediatrics say it’s okay to introduce allergy-causing foods when your baby is ready to eat solids. There is no evidence that waiting until the baby is older prevents food allergy. If you believe your baby has an allergic reaction to a food, talk with your child’s doctor.
Symptoms of a reaction usually appear very soon after the food is eaten — within a few minutes to a couple of hours. If you’re introducing a new food to your baby, keep an eye out for these symptoms:
• Hives or welts
• Flushed skin or a rash
• Face, tongue, or lip swelling
• Vomiting and/or diarrhea
• Coughing or wheezing
• Difficulty breathing
• Loss of consciousness
If you see mild symptoms, such as hives or a rash, contact your paediatrician for further evaluation. The doctor might refer you to an allergist (allergy specialist doctor), who will ask more questions and do a physical exam. The allergist may order diagnostic tests such as:
• A skin test. This test involves placing liquid extracts of food allergens on your child’s forearm or back, pricking the skin, and waiting to see if reddish raised spots form within 15 minutes. A positive test to a food only shows that your child might be sensitive to that food.
• Blood tests to check the blood for IgE antibodies to specific foods
• Other tests often testing panels through different means are NOT RECOMMENDED, NOT VALIDATED, and may infact lead to incorrect diagnosis and unnecessary elimination of foods in your child’s diet.
Some allergies go away with time. Egg and milk allergies often go away as children get older, but peanut, tree nut, and some seafood allergies tend to persist.
2. Are allergies hereditary?
If there is a family history of allergy, your baby has an increased risk of also developing allergies, although it is not a certainty. A child without any family history of allergies is now at approximately 15% risk of developing an allergic condition within the first few years; if one parent has an allergic condition, the child is at 40-50% risk of allergies, and if both parents are allergic, this increases to 60-80%. Having a sibling with allergies also carries an increased risk of allergic conditions developing. Whilst the rates of hereditary likelihood has remained unchanged – climate and lifestyle factors have played a role in increasing the risk of allergy development in the world today.
3. How do I prevent allergies?
In a reversal of earlier policy, the American Academy of Paediatrics is now recommending that potential allergens be introduced to your infant earlier rather than later.
Breastfeeding your baby for 4-6 months is still recommended as way to strengthen the immune system and help prevent potential allergies.
The AAP (American Academy of Paediatrics) now advises that, in the case of infants who are at high risk of allergies, peanuts should be introduced between 4-6 months. Infants at highest risk of developing peanut allergies are those with eczema or egg allergies or both. It was originally believed that introducing your baby to the foods when they are older might make any reactions more manageable. Other potential allergens such as tree nuts and fish should be introduced over a period of time as you introduce your baby to solid foods, between 6 and 9 months.
4. My child is allergic, how do I cope?
Food allergies can be worrying, frustrating, stressful and restrictive, to the patient and to their entire families. Seeing an allergist is important to tease out the foods that can be tolerated and those that need to be avoided. Whilst your own family diet and preferences are important – it is always better to know which foods are truly dangerous to prevent a fatal reaction. Seeking the assistance of a dietician with a good knowledge of allergy and being monitored by an allergist can help alleviate the anxiety around eating out. Food manufacturers are getting better at catering for people with food allergies, so there’s more choice of dairy-free, lactose-free or nut-free foods. There are also many groups advocating for patients with allergies. These support systems can be helpful but ensure that you are listening to advice from credible sources.
by Dr Thulja Trikamjee, Paediatrician and Certified Allergist
