How do you know if your baby has an allergy to food

Babies and Food Allergies | Children’s Hospital Los Angeles

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Health and Safety Tips

Experts agree: Feeding infants peanuts, eggs and other common allergens makes them less likely to develop sensitivities to these foods.

By Stephanie Cajigal

A lot has changed when it comes to caring for babies, including how to feed them. It used to be that parents were told to wait until their child was 3 to give him or her foods many people are allergic to, like peanuts. Not anymore.

Experts now recommend feeding babies common allergens before they turn 1 to reduce their chances of developing allergies to these foods.

Jill Madison, MS, RD, a Clinical Dietitian at Children’s Hospital Los Angeles, and Jonathan Tam, MD, Medical Director of the Gores Family Allergy Center at Children’s Hospital Los Angeles, offer these tips for feeding your little one.

Feed solids at around 4 months

Your baby is likely ready to start eating food when he or she has good head control, can sit up unassisted, and shows interest in foods, Madison says. At the baby’s 4-month checkup, your pediatrician will tell you whether it’s time to introduce solids. This means giving your baby a single-item food, like steamed carrots, not a combination of foods, like steamed carrots blended with potatoes.

“Historically, we started with purees. Now we know you can give a baby a whole food as long as it’s soft enough to chew, like a slice of ripe peach,” Madison says. To prevent choking, make sure that chunks of food are not round and hard, and can be mashed with a fork.

The first foods babies typically eat are single-grain cereals, vegetables, fruits and meat. Once your baby has gotten comfortable with these foods, you can start feeding him or her common allergens, introducing them one by one.

Safely introduce allergens

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 he or she turns 1, with the exception of milk in liquid form. That’s because cow’s milk has more calcium than breast milk and could interfere with the way your baby absorbs iron. Give your baby cottage cheese, yogurt or other forms of dairy, but wait until 12 months to give a cup of milk, Madison says.

As for nuts, babies can choke on these when they’re whole, so opt instead for nut butters that are creamy and smooth as opposed to chunky. You can make the nut butter less sticky by mixing it with water or breast milk or even blending it with apple sauce, Madison says. Another option is to stir a nut flour such as almond flour into a food your baby has already eaten many times before.

Pay attention to texture when feeding your baby, making sure food is soft enough to chew. Dip whole wheat bread in breast milk or water, for example, and mush shellfish and fish with a fork. You can mash a hardboiled egg and serve it as is or blend it with breast milk. Yogurt is an easy one to introduce since you don’t need to do anything to it. Start with plain yogurt made with whole milk, Madison says. You can also stir the yogurt into a fruit puree to change things up.

Ask your doctor about your baby’s allergy risk

Talk to your pediatrician if your baby has eczema, because this can put your baby at higher risk for developing a food allergy. And children with one food allergy may develop other food allergies. Children with an egg allergy, for example, are at higher risk of developing a peanut allergy, Dr. Tam says. If your child already has a food allergy, your pediatrician can give you advice on when to introduce other potential allergens.

Keep in mind that you should not avoid giving your baby a food just because someone in your family has an allergy to it.

“Since we know that in some context giving food early can prevent food allergy, then it would be even more important for an at-risk child to have it introduced early and purposefully,” Dr. Tams says.

Follow the 3-day rule

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.

“We want to give the child enough time to actually ingest the food and see how their body does with it,” Madison says.

While you’re doing this, remember to keep offering your baby foods you’ve already introduced.

Prepare foods at home

With all the jars, pouches and puffs available at stores, the options for feeding your baby may seem endless—and overwhelming. But Madison says making meals for your infant can be really simple.

As you’re cooking foods for the rest of your family, you can set aside a portion that doesn’t have salt or other seasoning. Say you’re cooking cod and asparagus, for example. You can cook the cod on the stove with some olive oil and mush it up with a fork for your baby. You can also cook the asparagus with olive oil on the stove top or in the oven and then puree or slice into half-moon pieces for your little one.

Madison says that while store-bought baby foods can be a good option for parents in a pinch, it’s best not to depend on them too much since studies show they can have unsafe levels of lead, mercury and other metals.

Looks for signs of a food allergy

How do you know if your baby is having an allergic reaction? Look for changes that begin within minutes to two hours after he or she ate the food. Hives and vomiting are the most common symptoms in infants, Dr. Tam says. Shortness of breath, coughing or wheezing can also happen, but are more common reactions in older children. If your baby develops a rash, take photos to track whether it’s getting worse, he says.

Seek medical attention for serious symptoms

If your baby is acting normally but has a mild rash or some hives, you could give your baby an antihistamine. Diphenhydramine (Benadryl) can provide comfort, but second-generation antihistamines like cetirizine (Zyrtec) and loratadine (Claritin) last longer and are less likely to make your baby sleepy, Dr. Tam says.

If your baby is vomiting, coughing, having difficulty swallowing (pay attention to new, suspicious drooling), or acting very sleepy, seek immediate medical attention. Try to get a doctor on the phone or go to the emergency department, Dr. Tam says.

Focus on variety over the long term

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

“Children eat what their parents eat,” says Madison. “If parents eat vegetables and try new foods readily, babies and kids will too.”

Click here to learn more about raising a happy, healthy baby.

Baby Food Allergies: Identifying and Preventing Them

Written by Gina Shaw

Start Gradually to Identify Any Food Allergies
Babies and Allergies: The Top 8 Allergenic Foods
Food Allergy Symptoms to Watch for in Your Baby
Severe Food Allergy Symptoms: When to Call 911
Dealing With Mild Food Allergies in Baby
The Family Food-Allergy Connection
Protecting Baby Against Food Allergies: Easy Does It

Starting to feed a baby solid foods is an exciting milestone for parents. However, it comes with a lot of questions and concerns, especially about food allergies. What foods are most likely to cause allergies in babies? How do you avoid them?

Emerging research has shown that introducing multiple foods together is safe, and may help the immune system have a lower risk of developing food allergies, but more studies are needed. Check with your doctor for what’s best for your baby.

Start Gradually to Identify Any Food Allergies

It’s most important to introduce a baby to new foods gradually, one at a time, in case of food allergies. If not, a parent may have trouble tying an allergy to a specific new food. For example, if you give your baby three new foods over the course of a day and they develop an allergic reaction, you won’t know which of the foods provoked it.

The type of food or the order in which food is introduced is not much of a concern, as long as the foods you are offering are healthy and well-balanced for the baby. Each time you offer a new food, you should wait three to five days before adding another new item to the menu. Don’t eliminate the other foods your baby is eating during that time; you already know these are safe because the child has not had any food reactions up until now. Just don’t add anything else new.

Babies and Allergies: The Top 8 Allergenic Foods

With any new food, you’ll want to be on the lookout for any allergic reactions. There are more than 160 allergenic foods; certain foods may be more allergenic than others. The following eight foods and food groups are known to possibly cause problems with allergic reactions possibly up to 90% of the time.

Cow's milk
Eggs
Peanuts
Tree nuts (such as walnuts or almonds)
Fish
Shellfish
Soy
Wheat

New nutrition guidelines from the American Academy of Pediatrics say it's okay to introduce these allergy-causing foods when your baby is ready to eat solids. There is no evidence that waiting until the baby is older prevents food allergy. If you believe your baby has an allergic reaction to a food, such as diarrhea, rash, or vomiting, talk with your child's doctor about the best choices for the diet.

Within a few months of starting solid foods, your baby's daily diet should include a variety of foods, such as breast milk, formula, or both; meats; cereal; vegetables; fruits; eggs; and fish.

Food Allergy Symptoms to Watch for in Your Baby

Food allergy symptoms usually appear very soon after the food is eaten -- within a few minutes to a couple of hours. If you’re introducing a new food to your baby, keep an eye out for these symptoms:

Hives or welts
Flushed skin or rash
Face, tongue, or lip swelling
Vomiting and/or diarrhea
Coughing or wheezing
Difficulty breathing
Loss of consciousness

Severe Food Allergy Symptoms: When to Call 911

Severe allergic reactions can be fatal very quickly. If your baby is having trouble breathing/wheezing, has swelling on their face/lips, or develops severe vomiting or diarrhea after eating, immediately call 911. You can inform your pediatrician at a later time.

Dealing With Mild Food Allergies in Baby

If you see mild symptoms, such as hives or a rash, contact your pediatrician for further evaluation. The doctor might refer you to an allergist (allergy specialist doctor), who will ask more questions and do a physical exam. The allergies may order diagnostic tests such as:

A skin test. This test involves placing liquid extracts of food allergens on your child's forearm or back, pricking the skin, and waiting to see if reddish raised spots form within 15 minutes. A positive test to a food only shows that your child might be sensitive to that food.
Blood tests to check the blood for IgE antibodies to specific foods

Remember, just because a baby’s initial allergic reaction to a new food may be mild, it may get worse upon following exposures. Talk to your pediatrician about any food allergy symptoms in your baby.

Some allergies go away with time. Egg and milk allergies often go away as children get older, but peanut, tree nut, and shellfish allergies tend to persist. That said, research shows that in the case of peanut allergies, peanut immunotherapy drops administered under the tongue are safe and effective as treatment for peanut allergy, even in children as young as 1. They were also found to help significantly desensitize the patients to peanuts.

The Family Food-Allergy Connection

If there is a family food allergies, your baby has an increased risk of also developing allergies, although it is not a certainty. If you have the allergies, the odds are 50-50 for them to have them as well.

It’s best to introduce the 8 allergens gradually, at one-to-two week intervals over time so that you can recognize if an allergy develops.

Protecting Baby Against Food Allergies: Easy Does It

In a reversal of earlier policy, the American Academy of Pediatrics is now recommending that potential allergens be introduced to your infant earlier rather than later. In doing so, the move may actually help prevent them from developing allergies to those foods.

Breastfeeding you baby for 4-6 months is the best way to prevent a milk allergy. Remember that breast milk or formula is higher in nutrition. When you begin to introduce whole milk, you should do so under a doctor’s supervision. Yogurt and soft cheeses are fine, because the proteins in these dairy products are broken down and less likely to cause tummy trouble.

The AAP now advises that, in the case of infants who are at high risk of allergies, peanuts should be introduced between 4-6 months. Infants at highest risk of developing peanut allergies are those with eczema or egg allergies or both. It was originally believed that introducing your baby to the foods when they are older might make any reactions more manageable.

Other potential allergens such as tree nuts and fish should be introduced over a period of time as you introduce your baby to solid foods, between 6 and 9 months

You should wait until at least age 1 (some experts say age 2) to introduce honey, which can cause a potentially serious disease called infant botulism. Ask your pediatrician for guidance.

Food allergies in children - symptoms, treatments, diet its individual components. What are its causes, what are the risk factors, and what food to choose in case of an allergic reaction - read in this material.

Food allergy symptoms

The causes of food intolerance are related to the fact that the immune system "incorrectly" recognizes them as potentially dangerous, and produces protective antibodies in excess. Excessively violent reaction leads to the fact that the child develops an allergy to certain types of food. ^1.3

Symptoms of food allergy in children are different. But most often, food allergies manifest themselves on the part of the skin - itching, a feeling of tightness and dryness. Local swelling may occur on the skin, a rash (urticaria), redness, blisters may appear. In second place in terms of frequency of manifestation - reactions from the respiratory system. Runny nose, nasal congestion, sore throat, cough of varying intensity. Also, reactions from the organs of the gastrointestinal tract can indicate food allergies. A very young child begins to be disturbed by colic, dyspepsia, stool disorders from diarrhea to constipation. Older children complain of nausea, vomiting, abdominal pain, a feeling of scratching in the throat, behind the sternum.

Do not forget about the general symptoms of food allergies: the child becomes lethargic, capricious, sleeps poorly, does worse in school (or psycho-emotional development), is prone to daytime sleepiness. ^2.3

Causes of food allergies

Newborns and young children, if predisposed, may suffer from allergies due to their physiological characteristics. The fact is that a child is born with an immature gastrointestinal tract, the intestinal walls are permeable to many substances, the enzyme system is still imperfect. Therefore, it is difficult for the body to cope with the digestion of proteins. The body seems to be in a state of constant "combat readiness" and the ingestion of even a small amount of allergens leads to a response from the immune system and the development of a violent allergic reaction. ^1.2

In older children, many internal and external conditions become risk factors. For example, heredity - after all, if one of the child's parents suffered from an allergic disease, then with a high degree of probability the child will also be given a tendency to it. Unfavorable environmental factors influence - polluted atmosphere, car exhausts, lack of green plants in cities. Very often, a violation of the immune system in the form of an allergic reaction occurs in children with a labile, mobile psyche, with sharp transitions from friendliness and calmness to crying and back. Finally, bad habits, both in children and mothers during pregnancy, become an important factor. This is incorrectly introduced complementary foods and early introduction of potentially allergenic foods into the child's diet: citrus fruits, nuts, chocolate, berries, honey, and, of course, the habit of children to eat only something tasty (usually unhealthy; chocolate, carbonated drinks, fast food ) ^2,3,4

List of products that provoke allergies

Due to the extreme individuality of the immune system, it is almost impossible to predict its reaction. However, there is a rough list of foods classified into groups depending on their allergenicity - that is, the ability to cause a sharp reaction from the immune system and allergy symptoms. It is important to remember that it is not necessary that any product from the first column will cause a reaction. Like any low allergenic product, in some cases, it can cause an overreaction to it. ^2,3,4

Examples of the most typical exoallergens

Highly allergenic products	Foods of average allergenicity	Low Allergy Products
all citrus fruits, strawberries, strawberries, raspberries, blackberries, pineapples.	peaches, cranberries, lingonberries, cherries, blueberries, black currants.	pears, gooseberries, dried apricots, plums, white currants, apples and pears.
carrots, tomatoes, bell peppers, radishes.	potatoes, beets, peppers, peas, corn.	broccoli, green peas, zucchini, squash, white and cauliflower, cucumbers, pumpkin.
eggs, sausages and sausages, chicken, sea fish.	beef, rabbit, pork.	lamb.
whole cow's milk, cheeses, yoghurts with additives.		fermented milk products.
wheat, rye.	buckwheat, oats, rice, peas, beans.	barley, millet.
coffee, cocoa, chocolate, nuts, honey.		xylitol, fructose
mushrooms, carbonated drinks, packaged juices.		vegetable oil.

Diagnosis established

The diagnosis of this allergy, as well as the search for the causes that caused it, requires a careful and serious approach on the part of parents. The younger the child, the easier it is to find foods that cause illness. For this, two conditions must be met.

The first thing is to put a child or mother on a hypoallergenic diet if she is breastfeeding - a detailed nutrition plan will be helped by an allergist together with a pediatrician. Please note that during an exacerbation, the diet will be extremely strict, the so-called elimination diet - aimed at removing the allergen and reaction products to it with the complete elimination of potential and cross allergens. The duration of such a diet is determined by the doctor. When the exacerbation fades, the diet gradually expands due to safe foods. ^3.4

And the second is to start keeping a special food diary in which to record everything that was eaten and drunk by the child during the day, as well as what was prepared and how. At the first sign of an allergic reaction, suspicious foods should be eliminated one at a time (or from the mother's diet if the baby is breastfed). After elimination, within a few days, it is worth observing the reaction, if the manifestations of allergies decrease, then the product is really not suitable for the child - it should be avoided. If the child is very small, then the diary is kept according to the opposite principle: all foods that are introduced as complementary foods are recorded in it. The name of the product, the quantity, the time of eating and the reactions of the body are recorded over the next few days (the attending physician will determine the specific timing of observation). Next, the doctor will need to check and confirm the preliminary diagnosis by conducting special tests and analyzes.

Emergency measures for food allergies

First, you need to assess the severity of the manifestations of food allergies.

For any symptoms, the first step is to avoid contact with a specific familiar allergen or any suspicious food or drink.

If the symptoms of allergy are mild - itching, redness of the skin, then you can give the child an antihistamine, which was previously recommended by the doctor for such cases. In addition, you must also call the local pediatrician and carefully monitor the condition of the child.

In case of obvious or possible signs of deterioration, call an ambulance. Signs that you should pay close attention to and immediately dial 03 include spreading rash and redness, increased itching, fever, drowsiness and lethargy, vomiting and nausea, refusal to drink water, difficulty breathing, loss of consciousness and pallor .

For general symptoms, in which it is difficult to understand whether they are associated with allergies or not, and which may indicate a developing serious condition, an ambulance should be called immediately if the child has any difficulty or changes in breathing, shortness of breath, cough, croup, vote. If pains in the abdomen began, extensive swelling, redness, itchy skin areas appeared. There is dizziness, fainting, as well as changes in the pulse - slowing or increased heart rate. ^1,3,4

How to treat a food allergy in a child

Treatment depends on the stage of the allergic reaction process. With an exacerbation, antihistamines are prescribed that block histamine receptors, hormonal drugs. For skin manifestations of allergies, local preparations are used: creams, powders, etc. Respiratory reactions are treated with inhalation drugs and physiotherapy.

who is to blame and what to do?

Allergic diseases in children are among the top problems of modern pediatrics. Allergic reactions, in addition to unpleasant external manifestations, disrupt the physical and psycho-emotional development of the child. In addition, starting in early childhood, allergies can accompany a person all his life, developing into more serious forms (the so-called "allergic march"). All these facts oblige to treat allergies as a serious problem, not to self-medicate, and if a child has alarming symptoms, immediately contact a pediatrician or an allergist.

What could be the reason?

The direct cause of allergy is the contact of the child's body with the allergen. Among the most common allergens are the following:

Food

Allergies are more common in formula-fed children. Usually this is a reaction to cow's milk, which is part of an unadapted mixture. As complementary foods are introduced, a reaction to vegetable or animal protein may occur. That is why it is so important to introduce complementary foods gradually, in small portions, starting with the most “non-allergenic” foods.

Household

This is dust, animal dander, cleaning products, detergents and other allergens found in the home.

Contact

These are various cosmetics and dyes that get on the baby's skin or come into contact with it, causing irritation (soap, cream, clothing dyes, diaper impregnations).

Medications

Taking medicines, which inexperienced parents like to practice, can cause an allergy in a child. Thus, a negative reaction of the immune system to a foreign agent is manifested. Therefore, any medicine should be given to the child strictly according to the prescription of the attending physician.

In addition, there are a number of factors that increase the risk of developing allergies in babies.

First of all, this is heredity - parents suffering from certain forms of allergies can "give" this predisposition to their child. Moreover, the probability of inheriting the pathology increases if both parents have allergies.

Intrauterine hypoxia, premature birth, mother's smoking at any stage of pregnancy, and even insufficiently varied diet of a pregnant woman, which does not allow the baby to get acquainted with certain foods in the womb, can become provoking factors.

Unfavorable environmental conditions can also play a negative role in the appearance of allergic reactions in a child.

Oddly enough, an excessive desire of parents to ensure sterile cleanliness in the house can provoke an allergy. It is not necessary to do this - it is important for the child to train his immune system by contacting with various microorganisms.

How does an allergy manifest itself?

Most often, allergy in very young children manifests itself in the form of a skin rash, itching, redness, dry skin, peeling, crusts on the head. Possible reactions from the gastrointestinal tract - bloating, diarrhea, severe colic, frequent regurgitation, discoloration of the stool. At the same time, the child behaves restlessly, sleeps poorly, refuses to feed, often cries.

Respiratory symptoms such as sneezing, coughing, clear nasal discharge, watery eyes and red eyes are also typical of allergies.

Fortunately, severe manifestations such as edema in the face, neck and chest, anaphylactic shock, generalized urticaria in infants are extremely rare.

How to diagnose allergies?

It is worth noting that allergies can have similar manifestations to prickly heat, parasitic or infectious diseases. Therefore, one should not hurry with self-diagnosis, and even more so with treatment.

The first thing to do if you suspect an allergy is to contact a specialist. The doctor will perform an examination, prescribe a blood test for the presence of specific antibodies (skin tests are not taken from infants), and only after that will determine the treatment.

An allergen can also be detected with the help of simple observation - to monitor how the child reacts to potential allergy triggers: dyes, powder, diapers, pets, etc. It is very effective for parents to keep a food diary, which indicates all new foods introduced as complementary foods, and the baby's reaction to them.

What to do if the diagnosis is established

The most important thing in the treatment of allergies is to eliminate provoking factors. It is important to switch to hypoallergenic cosmetics, perhaps change the manufacturer of diapers, limit contact with pets, use only baby powders for washing things.

If an infant has a food allergy and is formula-fed, hypoallergenic formula milk is recommended. Complementary foods should be introduced according to the scheme approved by WHO, not earlier than the child reaches six months. And such obviously "allergic" products as citrus fruits, eggs, fish, nuts, should be introduced after two years of life.

How do you know if your baby has an allergy to food