Introducing solid food into your baby’s diet might seem like an easy, natural step in your child’s weaning process. That said, for many parents of infants, it often turns out to be a cause for anxiety and uncertainty. In this blog post, I will answer the most common questions I get from new parents visiting The Allergy Clinic.
Must I avoid allergenic foods during pregnancy and/or when I’m breastfeeding?

There is very little evidence to support an elimination diet during pregnancy. As a matter of fact, it might actually lead to an underweight infant, as well as preterm delivery with adverse effects on the infant’s health. It also places the mother’s health at risk.

Due to the same nutritional dangers, food avoidance is also not recommended during breastfeeding. However, if your baby is struggling with an allergic reaction like eczema, it might be worth considering avoiding certain allergens in your diet. This is because there is enough evidence of infants reacting to allergens through mothers’ breastmilk. As a result, certain allergenic foods might need to be removed from the maternal diet. This MUST be done under the care of a trained professional with experience in the management of food allergies in infants.

Does breastfeeding protect my child from allergies?

The World Health Organisation (WHO) recommends exclusive breastfeeding for six months. This is because breastmilk protects infants from gastrointestinal infections, malnutrition and obesity. When it comes to allergies, breastfeeding can assist in protecting against wheezing or asthma, and atopic dermatitis (eczema) for the first two years of your baby’s life.

Exclusive breastfeeding protects children up 6 months against the development of atopic dermatitis (Eczema). There might be protection that extends up to two years for rhinitis and reactive airways.

At what age do I start introducing solids into my baby’s diet?

As a rule of thumb, parents should introduce solids between four and 11 months. According to the Learning Early About Peanut Allergy-study (LEAP), there is a window of opportunity to introduce peanut to your baby’s diet to prevent peanut allergies in the long run.

The exact timing to introduce other allergenic foods is less clear, but the general consensus seems to be to not avoid allergenic foods during the introduction of solids. The American Association of Pediatricians stated as recently as 2019 that there is no evidence to avoid allergenic foods beyond four months for egg, peanut and fish. Their recommendation supported early peanut introduction as published in the LEAP study (more about the study at this link).

Allergenic foods should be introduced under the supervision of a trained medical professional if your child has egg allergies or severe eczema as this predisposes them to developing food allergies.

Can my child be allergic to a food that they have never eaten before?

Yes, your child can be allergic to food that he or she hasn’t eaten before.

Allergies happen when the body produces antibodies to an allergen, leading to an allergic reaction when or after consuming it. We refer to this stage of food introduction as sensitization, because having antibodies against a food does not make you allergic at first. The presence of antibodies means you have the potential to become allergic.

And while it’s understandable to want certainty in the form of medical results, it is not advisable to undergo food allergy testing if you haven’t had any allergic reactions. Following this route has the potential to lead to unnecessary food avoidance, costs and inconvenience in the long run. If, however, your child has one food allergy it is advisable to get help in introducing the other allergenic foods.

How and when should I start weaning my baby?

There are conflicting guidelines for weaning babies, but the most practical approach is to gradually start feeding your baby solids between 4 and 11 months of age. Your weaning process should most definitely include cooked (not raw!) egg, and peanuts. In children with no allergic history and no eczema, all allergenic foods can be introduced during this period. If you’re uncertain how to introduce these foods, ask your nearest medical professional for input.

Babies with severe eczema should be tested for egg and peanut allergy before starting introduction. If there is a delayed introduction to testing, the risk of an allergy developing, versus the risk of an allergic reaction should be weighed up.

  • The purpose of this article is to raise awareness of allergies and the treatment options that are available for it. This article should by no means be used, or viewed, as a primary source for medical or other professional advice – please arrange for a personal consultation with your medical practitioner before taking any decisions that could affect the wellbeing of you or your loved ones. Read our medical disclaimer for more information.

Marinda McDonald

Dr Marinda McDonald has offered specialised treatments for allergies for most of her professional career. Read more about her on the home page of this website (allergydoc.co.za).

1 Comment

Seven things you need to know about eczema | The Allergy Clinic · March 3, 2020 at 9:05 am

[…] Parents should remember eczema in children can lead to food allergies. It is especially infants with eczema and egg allergy that are at high risk for developing peanut allergy. If you’re going to introduce peanut to your child’s diet, and your child already suffers from eczema, it’s best to do it under the care of an allergist. All foods, including allergenic foods, should be introduced to infants between four and 11 months of age help to prevent food allergies. Read more about introducing solids in your baby’s diet here. […]

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