When it comes to caring for babies, a lot has changed over the past several decades, including how to introduce new foods. In the past, parents were told to wait to feed their child high-risk foods until they turned 3.

Not anymore. Experts now recommend feeding babies common allergens before their first birthday, shortly after they start eating solid foods. 

This approach has dramatically reduced the incidence of certain food allergies.

Dr. Tam offers tips for caregivers who want to know how and when to introduce common allergens.

Most babies are ready to begin eating solid foods at around 6 months of age. Parents should work with their pediatrician to identify three key signs of developmental readiness:

• Head Control: Your baby has strong, stable head control.

• Posture: They can sit up unassisted.

• Interest: They show active interest in foods.

The first solid foods babies typically eat are single-grain cereals, vegetables, fruits, and meat. Once your baby is comfortable with these foods, you may begin to introduce common allergens, introducing them one by one.

The most common allergens are eggs, milk, wheat, soy, sesame, tree nuts, peanuts, fish, and shellfish. It’s a good idea to feed these foods to your baby before they turn one, with the exception of liquid cow’s milk.

• Dairy: Wait until 12 months to serve liquid cow’s milk, as its high calcium content could interfere with how your baby absorbs iron. Safe alternatives include cottage cheese or plain yogurt made with whole milk. 

• Peanuts and Tree Nuts: Whole nuts can pose a choking hazard for babies, so opt for creamy, unsweetened smooth nut butters instead of chunky. You can make nut butter less sticky by mixing it with water or breast milk, or blending it with plain applesauce. You can also stir a nut flour (like almond flour) into a food your baby has already eaten many times before.

• Wheat: Dip whole wheat bread in breast milk or water so it softens up.

• Eggs: Mash a hardboiled egg and serve it as is or blend it with breast milk.

• Fish and Shellfish: Cook thoroughly and mush shellfish and fish with a fork.

Allergic reactions typically begin within two minutes to two hours after your baby eats the food. Studies have shown that allergic reactions to food are generally more mild for infants than for older children—but it's important to know the signs and symptoms.

• Common infant symptoms: Hives and vomiting are the most common symptoms in infants. Shortness of breath, coughing, or wheezing can also happen, but they are more common in older children.

• Tracking rashes: If your baby develops a rash, take photos to track whether it worsens.

Symptoms that are typically treatable at home include: 

• Mild rash

• Mild hives

If your baby is acting normally but has these symptoms, it’s safe to give them a long-lasting antihistamine like cetirizine (Zyrtec) and loratadine (Claritin). Diphenhydramine (Benadryl) is not advised as it can make babies sleepy.

Seek immediate medical attention if your baby shows any of these serious symptoms:

• Vomiting or coughing

• Difficulty swallowing (pay attention to new, suspicious drooling)

• Acting very sleepy, lethargic, or unresponsive

Your pediatrician may have told you to give your child a new food for three days in a row before introducing another new food. The same goes for common allergens.

“Your baby’s body needs enough time to actually ingest the food to understand how they do with it,” Dr. Tam notes. While following the three-day rule, remember to keep offering your baby foods you’ve already introduced.

Don’t avoid giving your baby a food just because someone in your family has an allergy to it. “Since we know that, in some contexts, giving food early can prevent food allergies, it’s even more important for an at-risk child to have the allergen introduced early and purposefully,” Dr. Tam says. 

Children with one food allergy, and children with eczema are also more likely to develop other food allergies. When in doubt, consult with your pediatrician on when to introduce other potential allergens.

As your baby grows up, remember to keep feeding them a variety of flavors and textures to help them develop a taste and tolerance for different types of foods.

“Food introduction is not one-and-done,” Dr. Tam notes. “After introducing a food, it's helpful to maintain consistency in your baby’s diet.” 

References:

1. https://www.newswise.com/articles/babies-and-food-allergies-a-parent-s-guide-to-early-introduction-and-safety

2. https://www.chla.org/blog/advice-experts/starting-solid-foods-comprehensive-guide-your-babys-first-solids

(Newswise/APC)