5 Ways to Prevent Food Allergy in Your Baby

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Timing is everything in preventing food allergies in your baby. Gail/Flickr

Will your baby develop a food allergy or not? Preventing food allergies is a top concern for many parents, especially in light of the rising incidence of food allergies among children. I, nor any other expert, can predict which children will develop a food allergy, and which will not. However, the science suggests that those children with a strong family history of food allergy, allergy to pollen, mold or other elements, asthma, and atopic dermatitis are more likely to develop a food allergy.

That’s because these children have a genetic or inherited tendency to acquire a food allergy.

Can you allergy-proof your baby? While there are no guarantees, here are 5 ways to food allergy-proof your baby, based on the latest research:

1. Don’t restrict your pregnancy diet

According to a 2011 study of pregnant women who consumed milk during their pregnancy to prevent Type 1 diabetes, their offspring had a lower incidence of cow’s milk allergy. Furthermore, a 2012 study of pregnant women who ate peanuts and tree nuts during pregnancy had babies with a lower incidence of asthma and allergy. The researchers suggested that eating peanuts and tree nuts during pregnancy conveyed a protective effect on allergy development.

The 2010 National Institute for Allergy and Infectious Disease (NIAID) guidelines for managing food allergy state that pregnant women shouldn’t use food avoidance as a way to prevent food allergy in their baby.

2. Breast-feed for at least 4 months

The American Academy of Pediatrics (AAP) advises that all babies be breast-fed for the first year of life. However, many moms are unable to breastfeed this long or choose not to, for a variety of reasons. To reduce the likelihood of food allergy development, the AAP suggests exclusive breastfeeding your baby for the first 4 months, at a minimum.

This means no additional formula feedings or solid food additions to supplement breast milk feedings.

Research suggests that exclusive breastfeeding for the first 4 months decreases the incidence of eczema and cow’s milk allergy in the first two years of life compared to babies who drink cow’s milk formula. Breast milk contains a variety of nutrients but also transmits immune properties from mother to baby.

If your baby has a strong family history (a parent or sibling with food or other allergy) of allergies and cannot breastfeed, use a partially hydrolyzed infant formula (also known as hypoallergenic formula) for your baby. Partially hydrolyzed formula contains protein that is partly broken down so your baby’s digestive system doesn’t have to digest it fully. This also means that intact proteins, such as whey and casein found in cow’s milk infant formula, won't sensitize your baby’s immune system, alerting a potential allergic reaction.

3. Do not introduce solid food before 4 months of age

Babies who eat solid food before 4 months of age are more likely to develop a food allergy. At this early age, baby’s digestive system isn’t fully mature, leading to potential activation of the immune system against food allergens and diarrhea. There is also a risk for choking, as most babies aren’t able to sit up and hold their head upright.

According to a study performed by the Centers for Disease Control (CDC), 40% of mothers introduced solid food to their baby before 4 months of age. Nine percent of mothers started solid food before 4 weeks of age. Reasons for early introduction of solids included getting baby to sleep at night and the expense of formula.

4. Do not delay introducing solid food past 6 months

Delaying solid food introduction, like baby cereal, pureed veggies, fruit and meats do not appear to prevent food allergies in children. The latest information suggests that there isn't an ideal time frame for introducing gluten, as in the case of celiac disease. Previously, there was evidence that suggested the ideal window of time was between 4 and 6 months—however, researchers have found that this may delay the onset of gluten intolerance, but that it doesn't prevent it from occurring. For children at high risk of celiac, delaying the introduction of gluten to 12 months may delay symptoms but not development. 

In foreign countries like Israel, where peanuts are introduced before 9 months of age, children have a lower incidence of food allergy. In countries like the United States and the United Kingdom where the practice has been to restrict food allergens, the incidence of food allergies is increasing.

5. Do not avoid foods containing allergens

After 6 months of age, there is not enough evidence to suggest you should avoid food allergens like milk, soy, egg, peanut, tree nuts, fish, and wheat. Use a prudent approach: introduce single ingredient foods such as iron-fortified infant cereal, pureed fruit, vegetable, and meats every two to three days and watch for signs of intolerance like spitting up or vomiting, diarrhea, or skin rashes which may indicate an allergic reaction. Although the traditional time frame has been every three to five days between new foods, there isn't sufficient evidence to indicate this length of time between new foods. If your baby isn't having a negative reaction to a new food in 2-3 days, proceed with the next new food and continue to monitor for adverse reactions.

Your baby may still develop a food allergy despite the above measures, however, steering clear of negative feeding practices such as the early introduction of solid food, late introduction of solid food, and not breastfeeding seem to enhance the chances for food allergy development in children.

Resources:

AAAAI: Prevention of allergies and asthma in children. http://www.aaaai.org/conditions-and-treatments/library/at-a-glance/prevention-of-allergies-and-asthma-in-children.aspx

Tuokkola J, Luukkainen P, Tapanainen H, et al. Maternal cow’s milk consumption during pregnancy is inversely associated with the risk of cow’s milk allergy (CMA) in the offspring in a prospective birth cohort study. Clin Transl Allergy. 2011;1(Suppl 1):P114.

Maslova E, Granstrom C, Hansen S, et al. Peanut and tree nut consumption during pregnancy and allergic disease in children—should mothers decrease their intake? Longitudinal evidence from the Danish National Birth Cohort. J Allergy Clin Immunol. 2012;130(3):724-732.

Collins SC. Can Food Allergies Be Prevented? — Studies Show Introducing Risky Foods in Infancy Lowers Incidence.Today’s Dietitian. 201315 (3): 14.

Clayton HB et al. Prevalence and Reasons for Introducing Infants Early to Solid Foods: Variations by Milk Feeding Type. Pediatrics. 2013; 131 (4): e1108 -e1114 

Castle JL & Jacobsen MT. Fearless Feeding: How to Raise Healthy Eaters from High Chair to High School. 2013; Jossey-Bass.

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