Early Infant Feeding Can Prevent Food Allergies

By Guest Author, Sherry Coleman Collins, MS, RDN, CDN

Introducing food allergens to babies can be stressful for parents. Fear of food allergy reactions and having heard horror stories from friends can paralyze parents at a time when their actions can have life-long implications for babies. Research has shown that introducing peanut foods at around 4-6 months, depending on risk, can reduce the risk for developing a peanut allergy by as much as 86%. This is significant, since having a peanut allergy can be lifelong and result in reduced quality of life for the individual and caregivers. While food allergies have been on the rise, it’s important to remember that more than 90% of children do not have a food allergy – and less than 2% have a peanut allergy. Having any food allergy can impact the whole family, making prevention an important part of early infant care. Most reactions in infancy are mild and most often includes vomiting and/or hives. Anaphylaxis (the most severe kind of food allergy reaction) in infancy can happen, but is rare. Early introduction is protective and the overall risk of developing a food allergy reaction is low.

If you’re wondering where to start, here are some tips:

• Know your child’s risk for developing food allergies. In the Learning Early About Peanut Allergies (LEAP) study, researchers identified moderate to severe eczema and existing egg allergies as the risk factors for developing peanut allergy. Moderate to severe eczema that is difficult to treat and long-lasting is a risk factor for developing food allergies. In addition, having a first-degree relative increases the risk of developing food allergies. If your child has these conditions, talk to your pediatrician or allergist first about introducing potential food allergens.

• If your child doesn’t have risk factors, introducing food allergens should be safe…and fun! The NIAID has great information on how to introduce peanut foods for infants with low risk. Check out this handout and use it for peanut foods and in considering how to introduce other foods too. Be familiar with the signs of a reaction and ready in case you need to stop the feeding and consult your pediatrician if you have any concerns or questions. 
  Here are a few other helpful tips when introducing potential allergens:

  • Start with a healthy baby! Don’t introduce new foods when baby is sick, miserably teething, or is especially fussy. You don’t want to mistake illness for a food allergy reaction.

  • Use age-appropriate forms of the allergen, such as thinned peanut butter, plain whole milk yogurt, and mashed egg yolk.

  • Begin early in the day, well before a nap, when you can monitor baby during and for a couple of hours after the feeding.

  • Give baby just a small amount of the allergen to start and work up to a full (infant-size) serving if baby has no reactions. See the NIAID handout for descriptions of reactions.

• In the event a child has a potential food allergy reaction, reintroduction should wait until evaluation by a pediatrician or allergist. Note: Food challenges are not considered essential during the Covid-19 period, according to AAAAI, so those should wait until the pandemic has subsided.

Sherry Coleman Collins, MS, RDN, LD is the owner of Southern Fried Nutrition, a private nutrition practice in Marietta, Georgia. Her areas of expertise include food allergies, digestive health, and nutrition communications. Sherry is co-host of the podcast Southern Fried Girlfriends. She  frequently writes for Today’s Dietitian and works with National Peanut Board. Follow Sherry on Twitter, Instagram and Facebook and connect with her via LinkedIn for professional inquiries.

Helpful Resources:

NIAID Guidelines Summary for Parents and Caregivers: https://www.niaid.nih.gov/sites/default/files/peanut-allergy-prevention-guidelines-parent-summary.pdf

NIAID Home Feeding Instructions of Peanut Foods for Low Risk Infants: https://www.niaid.nih.gov/sites/default/files/addendum_guidelines_peanut_appx_d.pdf

National Peanut Board Prevent Peanut Allergies website: www.preventpeanutallergies.org

Australia’s Nip It in the Bub allergy prevention campaign: https://preventallergies.org.au