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New Guidelines For Introducing Allergenic Foods

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Throughout my entire childhood (which I bid a fond farewell to roughly a decade ago), I can remember one person I knew with a food allergy—a boy at summer camp who was so allergic to peanuts we couldn’t serve peanut butter in the dining hall. Back then banning peanut butter felt like a foreign concept; today it seems common. I’ve often wondered if the apparent rise in food sensitivities is all in my head. Whether I was just oblivious to friends and classmates who couldn’t eat eggs, nuts, wheat, or other allergenic foods, and whether I’m simply more aware of food allergies now, working at Parents. That doesn’t appear to be the case. According to Food Allergy Research and Education, food allergies are on the rise: The number of people with a food allergy rose 18 percent between 1997 and 2007, and today 1 in 13 kids is affected, or roughly two in every classroom. What if there was a way to stop this trend in its tracks? A recent study from the American Academy of Allergy, Asthma & Immunology suggests parents may be able to do just that, by introducing the most common allergenic foods—cow’s milk, eggs, soy, wheat, peanuts, tree nuts, fish, and shellfish—around the time you start solids, generally between 4 and 6 months. “Food allergies have increased in the last 10 years, and it’s possible that delaying the introduction of allergenic foods has contributed to that,” says study coauthor David Fleischer, M.D., an associate professor of pediatrics at National Jewish Health, in Denver, Colorado. “There’s a window of tolerance for preventing food allergies.”

Before now there haven’t been any updated guidelines on how to give these foods to a child, and some parents may still follow the recommendations from 13 years ago, which advised against offering your child cow’s milk until age 1, eggs until age 2, and nuts and fish until age 3. But after looking over past research, Dr. Fleischer says it’s safe—and beneficial—to introduce these foods earlier, with a couple exceptions. Children with moderate to severe eczema, which puts them at higher risk for food allergies, and those who’ve already had a reaction to an allergenic food should see an allergist before trying any of the above (and below!) mentioned foods.

Now, without further ado, the most recent advice for introducing cow’s milk, eggs, soy, wheat, peanuts, tree nuts, fish, and shellfish:

  • Do not offer your child one of these highly allergenic foods as the first solid. Begin with rice or oat cereal, vegetables, or fruit to see how your child handles them. Once you’ve successfully introduced a few of these foods, you can begin to offer foods like fish, eggs, and yogurt.
  • The first time you introduce an allergenic food, give it to your child at home, rather than at day care or a restaurant. If there is no apparent reaction—including hives, a rash, swelling, breathing problems, vomiting, or diarrhea—continue to offer the food to your child, gradually increasing the amount.
  • Offer one new food every 3 to 5 days if you don’t see any reactions.
  • Continue to avoid whole cow’s milk until age 1, but not because of allergy risk—it can lead to kidney complications and may affect iron levels in the body. Cheese, yogurt, and milk-based formulas are fine to offer.
  • Peanuts and tree nuts pose a choking risk, so should not be offered before age 1, but nut butters are safe. If you have an older child with a nut allergy, see an allergist before offering peanut butter to your younger child—he’s at an increased risk for developing a peanut allergy.

 

Image: Spoon and jar of peanut butter


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