Food allergies: A closer look

I have two babies: one born in the spring of 2007, and the other delivered late last summer. And somewhere in that three-year span, pediatric recommendations for avoiding food allergies and other allergic diseases, such as asthma and allergic eczema, shifted noticeably. In 2007, many doctors were urging parents to wait a full six months before offering solid foods (well, mushy solids) to their infants. They were also recommending holding back certain could-be allergens until the first birthday, sometimes longer. I stuck to these guidelines religiously, even though my hungry little honey was eyeballing my dinner plate by four months. I didn’t want to inadvertently burden her with food allergies, after all!
But by the time I took baby number two in for pediatric feeding pointers, the rule book had changed; in turn, I had to realign my thinking and loosen my iron grip on the rubber-tipped spoon. My baby’s doc strongly suggested introducing first foods closer to four months, and baby’s diet was open to all kinds of palatable provisions. Most spices, flavors and ingredients were free game from the get-go, as long as they were administered in a gooey, gummable form. According to my current pediatrician, only whole milk from a cow and honey are strictly off-limits until after the first birthday. (Sorry, honey, gotta keep botulism at bay.)
I wondered: What happened between babies one and two to trigger this shift in thought? As it turns out, a report released by the American Academy of Pediatrics (AAP) in January 2008 declared that delaying the introduction of food allergens doesn’t necessarily prevent childhood food allergies. In response, pediatricians nationwide changed their feeding recommendations. While it’s still important to wait at least four months before giving your baby solids, it’s perfectly OK to introduce a wide variety of foods at that time. Even babies at risk for developing atopic conditions are fine to incorporate allergenic foods such as eggs, milk products and peanuts into their diets before 6 months (rather than waiting two to three years, as was previously recommended).
Prebirth prevention
There has been speculation lately on whether a pregnant or breastfeeding mama’s diet could put her little bun at risk for developing food allergies. Should mom ban peanuts or other allergens from her prebaby menu? Although some early studies have suggested that maternal dietary restrictions could reduce baby’s likelihood of developing food allergies, as of December 2010, experts officially say it isn’t so: There is not enough evidence to recommend that expectant moms alter their diets to prevent allergies.* So if you’re craving a crunchy PB&J during pregnancy or lactation, don’t hold back for fear of provoking food allergies. (You may have other reasons for passing up the high-calorie comfort food, but that’s between you and your doctor!)
Of course, studies are ongoing, so it’s important to talk with your doctor about your pregnancy and lactation diet. She can help you establish a healthful prenatal meal plan, and she’ll be able to work with you on any specific personal concerns.
Lowering the risks
Banning possible allergy-inducing foods from mom and baby’s diet is typically uncalled for, but there are other ways to lessen the likelihood of childhood allergies. First—and you’ve heard this before—nearly all experts agree that breast is best. A mom with a well-rounded diet is going to produce the best nutrition for her baby, so exclusive breastfeeding is recommended from birth until at least 4 months. At that time, complementary foods may be introduced as mom continues to breastfeed until baby is age 1 or older. (A healthy baby should not surpass 6 months of age before being introduced to solids.) Because the breastfeeding “ideal” doesn’t work for everyone, infant formula may be used as a healthy alternative.
If your baby is both formula-fed and at risk for developing allergies, Scott H. Sicherer, MD, professor of pediatrics and researcher at the Jaffe Food Allergy Institute at Mount Sinai in New York, suggests, “There are certain hydrolyzed formulas that might provide protection against allergic eczema or food allergy compared to using typical cow’s milk-based formula … Reports do not suggest using soy for this purpose.”
How do you know if your baby is “at risk” for food allergies? Sicherer states, “Food allergies are more likely to occur in those who are at risk for any allergic diseases (including allergic asthma, atopic dermatitis (eczema) and hay fever). If a parent or sibling has an allergic disease, the infant is at increased risk.” With such an infant, it is especially important to introduce one allergenic food at a time so you can track any reactions to the source. Says Sicherer, “If a child is showing signs of allergic reaction—for example, hives with milk or egg—then one must take caution in adding more allergenic foods (e.g., peanut) because he might react to them as well.” Talk to your doctor for individual care and suggestions for success.
*Source: The Journal of Allergy and Clinical Immunology, December 2010