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Published on October 29, 2015

Protect your child from food allergiesProtect your child from food allergies

One of my patients, a young mother, suffered terrible food allergies as a child, including severe asthma, eczema and ear infections. So, when she recently had her first baby, she was anxious that the child was high-risk and would go through a similar experience.

Her concerns were understandable. One of every 13 children under the age of 18 suffers from a food allergy, and the percentage is on the rise.

The impact of these allergies to milk, eggs, soy, wheat, barley, fish and especially peanuts, among other foods, can range from hives, runny noses and itching of the lips, tongue and throat to much more severe reactions including diarrhea, difficulty breathing and even life-threatening Anaphylactic shock that requires immediate medical care.

However, instead of avoiding foods that affected the mother – including soy and grains – we actually introduced them to the baby beginning at four months of age. The child has not suffered any adverse impacts, and the mother has become much more relaxed about her baby’s diet.

Introducing allergenic foods to infants at four to 11 months is a relatively new strategy. A decade ago, it was much more common to avoid such foods until a child was three to five years of age.

The latest medical research strongly endorses this ‘early’ intervention.

Just this fall, a research team from the University of Manitoba’s Department of Pediatric Allergy and Clinical Immunology published a study in the Canadian Medical Association Journal strongly recommending introduction of allergenic foods at four to six months of age.

“Once highly allergenic foods are introduced, regular exposure is important for maintenance of tolerance — children should eat these foods on a regular basis,” said study researchers Drs. Elissa Abrams and Allan Becker.

Their recommendation accelerates findings of an earlier study this year in the New England Journal of Medicine. It found that for high-risk children who began eating peanut snacks by 11 months of age and continued eating them at least three times a week until age 5, their chances of becoming allergic were reduced by more than 80 percent compared to children who avoided peanuts entirely.

Overall, about 3 percent of kids who ate peanut butter or peanut snacks before their first birthday got an allergy, compared to about 17 percent of kids who didn’t eat them, the New England Journal of Medicine study found.

As a result of this LEAP study (Learning Early About Peanuts), the American Academy of Allergy, Asthma and Immunology, the American Academy of Pediatrics and the Canadian Society of Allergy and Clinical Immunology, now state that for infants at high risk, there is strong evidence to support the introduction of peanut between 4 and 11 months.

Why are food allergies on the rise?

Historically, especially when we were an agrarian society, children were exposed to a much broader diet from infancy on. They also were breast fed for up to two or three years.

But, about 50 years ago, there was a significant shift. Formula – including soy-based ones – began to replace breast milk, some or all of the time. And doctors began to recommend that parents wait three, four even five years to introduce new foods that could be allergens.

As a result, the infant’s immune system is not building up as rapidly as it might.

By waiting so long, the immune system is pretty well entrenched, and the child’s body is more apt to recognize a new food as something foreign, triggering an allergic reaction.

On the other hand, if you introduce these foods slowly, steadily and early, the body builds up immunities and doesn’t overreact.

In some ways, we are going back to the way it was a hundred years ago and longer.

When it is time to expose your child to potentially allergic foods, the American Academy of Allergy, Asthma and Immunology recommends these steps:

  • New foods should be rotated in and out of the diet every 3 to 5 days in an age-appropriate manner (to avoid choking).
  • Start with grains, yellow and orange vegetables and fruit.
  • Introduce one of the potentially allergenic foods, if well tolerated, in small amounts (e.g., cow’s milk, soy, eggs)
  • Introduce highly allergenic foods at home.
  • Increase the quantity of food over several days.
  • Be familiar with signs of food allergies, and call your doctor if you notice your child is having a reaction.

We encourage parents to introduce new foods to their children in the home rather than at the doctor’s office. Parents are much more aware of their children’s behavior. They develop a baseline at home, and can gauge faster and better any reactions that will need attention.

Your child could be allergic to any food, but these eight common allergens account for 90% of all reactions in kids:

  • milk
  • eggs
  • peanuts
  • soy
  • wheat
  • tree nuts (such as walnuts and cashews)
  • fish
  • shellfish (such as shrimp)

About the Contributor: Edward F. Caldwell, MD is a otolaryngologist with Cape Cod Healthcare.