Hypoallergenic food for babies

Most & Least Allergenic Foods For Babies With Allergies

Food allergies in babies are something that many parents worry about. Not only are they scary, but they can make introducing solids challenging. Food allergies in babies can also go undiagnosed for quite some time, leaving you confused about what may be leading to the symptoms your baby is experiencing.

While some babies may be at a higher risk of developing food allergies due to family history, some babies may have no greater risk at all and still experience an allergic reaction to certain foods.

In this article, we will explore how to know if your baby is allergic to certain foods and some of the most allergenic and the least allergenic foods for babies. We will also talk about food allergy testing and some steps you can take if your baby suffers from food allergies.

Is My Baby Allergic to Certain Foods?

So, maybe you have been suspecting a food allergy due to certain symptoms your little one is experiencing. Many mommas just have a gut feeling when something isn’t settling well with their child. For some moms, the first indication of a food allergy starts in infancy. If your baby is breastfed and experiences reflux, eczema, blood in their stools, or fussy behavior, there’s the potential for an underlying cow’s milk allergy if dairy is part of the mom’s diet. The dairy can pass through breastmilk and cause allergic symptoms in a baby with a cow’s milk allergy.

Other babies don’t develop symptoms until moms start introducing solid foods. Again, gastrointestinal symptoms can arise, as can fussiness and irritability, eczema, and even some life-threatening reactions like anaphylaxis shock. There’s also a condition called FPIES which stands for Food protein-induced enterocolitis syndrome, which is a rare but severe food allergy that affects the gastrointestinal system. An FPIES reaction can cause intense vomiting, diarrhea, and even shock.

If your baby is experiencing any of these serious and potentially life-threatening allergic symptoms, it is crucial to get immediate medical attention and then follow up with a pediatric allergist to help identify the exact food or foods causing these symptoms.

Some other commonly seen symptoms of food allergies in babies include:

Coughing
Wheezing
Difficulty breathing
Facial, tongue, or lip swelling
Rash
Hives

Introducing Solid Foods to Babies with Food Allergies

If you suspect your baby suffers from food allergies or your baby has already been diagnosed, introducing foods can be challenging. However, working with a pediatric allergist can help you develop a safe plan for solid food introduction. It may also help to know the least allergenic foods for babies as these foods are less likely to trigger an allergic reaction. However, keep in mind that every baby is different, and a baby can be allergic to any food, whether it’s on this list or not! This is especially true for babies suffering from FPIES, so always speak with your doctor first.

Keep reading because we will take a look at some of the least allergenic foods and the most allergenic foods in babies.

Understanding Allergies in Babies

Before we jump into the foods you will want to watch out for, there are some surprising statistics about infant food allergies that are important for every parent to know about. According to the Food Allergy Research and Education organization, 1 in 13 children have food allergies, and 30% of them are allergic to more than one food.

Food allergies in children are also skyrocketing. The CDC has estimated that food allergies in children have jumped up by 50% from the years 1997-2011. That’s a massive jump and something we need to be paying more attention to.

Many parents also wonder if their babies will outgrow their allergies. While many pediatricians tell parents that babies generally outgrow allergies to milk, the FARE (Food Allergy Research & Education) states that allergies to milk, eggs, wheat, and soy are generally resolved in childhood. Still, children are starting to outgrow these allergies at a much slower rate than what had previously been documented. This means that many children over the age of five have still not outgrown these allergies. Allergies to foods like peanuts, tree nuts, fish, and shellfish are generally not outgrown, and the child will likely have an allergy to these foods lifelong.

Another interesting area of research has shown that the season your baby is born may also play a role in their risk of developing a food allergy. Interestingly enough, a study found that babies born in Boston in the fall or the winter were more likely to have food allergies. So, what does this have to do with? It was hypothesized that this likely had to do with low UVB exposure and not enough vitamin D. This one study concluded that changes in exposure to sunlight and vitamin D might play a role in the development of childhood food allergies. Interesting, right?

Least Allergenic Foods for Babies

Now that we know a little more about food allergies in babies, let’s take a look at some of the least allergenic foods for babies. According to Dr. Sears, some of these foods include apples, avocados, broccoli, peaches, carrots, asparagus squash, sweet potatoes, rice, oats, chicken, turkey, lamb.

Apples

Homemade applesauce is often the very first food for babies. It is full of vitamin C and naturally sweet, so babies tend to love it! You can try using different varieties of apples to introduce new flavors. Homemade applesauce is also great for mixing with other fruits as well such as mangos and peaches.

Peaches

Another great fruit to start with are peaches. They are very sweet and can easily be made into a puree. They are also high in vitamin E, K, folate, and potassium.

Avocados

Avocados are another great first food. They are very high in monounsaturated healthy fats, rich in magnesium and fiber, and can be mashed for babies. Babies generally enjoy the mild flavor.

Broccoli

Broccoli makes for a great first veggie. You can puree broccoli with some chicken broth for added flavor to provide your little one with fiber, folic acid, vitamin K, and C.

Carrots

Carrots are often a go-to veggie for parents. They have a mild but sweet flavor that most babies enjoy. Carrots can be puréed for little babies and then steamed and served with chicken or turkey for older babies ready for finger foods. They are rich in beta-carotene, fiber, vitamin K, and potassium.

Squash

Butternut squash is a delicious vegetable to introduce your baby to. It makes a yummy puree and is packed full of fiber and vitamin B6.

Sweet Potatoes

If your baby likes butternut squash, they will likely enjoy sweet potato too. Sweet potatoes are rich in calcium, selenium, and B-vitamins making them an excellent addition to your little one’s diet.

Rice & Oats

Many parents start with rice or baby oat cereal when starting solids. They are often fortified with iron and folic acid, but rice and oats are great additions in their whole and natural state when baby is older. Rolled oats mixed with banana and molasses is a great breakfast option for an added fiber and iron boost, and rice served with a protein like chicken or turkey also makes for a well-balanced meal for older babies who are ready for more solid foods.

Proteins

Chicken, turkey, and lamb are generally considered to be low allergenic foods for babies. If tolerated, these proteins can be alternated in your baby’s diet and served with a veggie and carbohydrate for a balanced meal.

Most Allergenic Foods for Babies

While some foods are generally well-tolerated, a handful of foods are commonly known to trigger allergic reactions. According to Dr. Sears, some of the most allergenic foods for babies include:

Peanuts
Nuts
Coconut
Eggs & egg whites
Dairy
Soy
Wheat
Shellfish
Yeast
Citrus fruits
Corn
Peas
Tomatoes
Pork
Mustard
Cinnamon
Chocolate
Berries
Buckwheat

If your child suffers from food allergies, it may be best to avoid these foods until you work with an allergist to determine a plan to avoid introducing foods your child may react to.

What to Do If You Suspect a Food Allergy

So, what do you do if you suspect your baby has a food allergy? First, you will want to avoid that food. Do not introduce the suspicious food or any other highly allergenic foods to your baby’s diet until you speak with your pediatrician.

There are also specific food allergy tests a pediatric allergist can perform to really pinpoint what foods are causing issues. These tests include a skin prick test which is often combined with blood work.

While baby food allergies are very scary, working with the right medical team and knowing exactly what foods to avoid can help make the transition to introducing solid foods a little less stressful.

Early introduction - Food Allergy Canada

Helping to prevent the development of food allergy in infants

Recommendations for the introduction of common allergens to infants has changed over the last few years as research has emerged on ways to help prevent the development of food allergy in babies.

In 2019, the Canadian Paediatric Society (CPS) released recommendations on the specific timing of early introduction of allergenic foods for high-risk infants. The guidance is to actively offer non-choking forms of foods containing common allergens (e.g. peanuts, egg) around 6 months of age, but not before 4 months, as this can be effective in preventing food allergy in some high-risk infants. This specific timing is reinforced, along with other recommendations, in the position statement co-published by CPS and the Canadian Society of Allergy and Clinical Immunology in 2021.

This represents a dramatic shift from previous advice to parents and caregivers regarding the introduction of common allergens in a child’s diet.

Infants who are not considered high risk should start to receive complementary foods when they are around 6 months of age and show signs of developmental readiness.

Please scroll below for information on the introduction of allergenic foods to babies. You will find recorded webinars for parents and healthcare professionals, a frequently asked questions document for parents, and other resources for families and healthcare professionals.

Guidance on the early introduction of allergens to babies: resources for families and healthcare professionals

Early introduction and COVID-19

The Canadian Paediatric Society continues to recommend introducing allergenic solids early to babies at high risk of food allergy, even during a pandemic.

Learn more

Watch the webinar

For parents: Recorded webinar on the updated guidance on the early introduction of allergens

We hosted a webinar in April 2019 on the CPS’ updated recommendations on the early introduction of allergenic foods for high-risk infants.

The webinar was presented by Canadian paediatric allergist Dr. Elissa Abrams who is an Assistant Professor in the Department of Paediatrics, Section of Allergy and Clinical Immunology at the University of Manitoba; and a co-author of the newly released CPS practice point on the introduction of allergenic foods. She is also Vice Chair of the Anaphylaxis and Food Allergy Section of the Canadian Society of Allergy and Clinical Immunology; and President of the Allergy Section of the CPS.

You can view a recording of the webinar below, which includes a question and answer period.

Parent resource: Eat Early. Eat Often.

Produced under the National Food Allergy Action Plan, this resource includes practical tips on feeding babies early, recipes for different allergenic foods, and more.

Download now

Parent resource: Frequently Asked Questions

Here is a detailed FAQ document for parents on early introduction.

These resources are based on the CPS’ updated recommendations on the specific timing of early introduction of allergenic foods for high-risk infants, and reviewed by Canadian allergists.

Download now

Parent resource: Recipe options for home feeding infants at low risk

Here are four recipe options for the home feeding of peanut protein to babies at low risk of an allergic reaction to peanut.

Download now

Source: NIAID (National Institute of Allergy and Infectious Diseases) guidelines

The NIAID guidelines for the introduction of peanut to babies were released in 2017. Please refer to the CPS’ recommendations on the specific timing of early introduction of allergenic foods for high-risk infants.

For healthcare professionals: Recorded webinar on the early introduction of allergens and food allergy prevention

We hosted a webinar tailored for healthcare professionals in June 2019 on the CPS’ updated recommendations on the early introduction of allergenic foods for high-risk infants.

This webinar is presented by Canadian pediatric allergist Dr. Edmond Chan who is a UBC Clinical Associate Professor and Head of the Division of Allergy & Immunology in the Department of Pediatrics at BC Children’s Hospital; and a co-author of the newly released CPS practice point on the introduction of allergenic foods.

You can view a recording of the webinar below, which includes a question and answer period.

Healthcare professionals:

Visit our section created exclusively for you. You’ll find patient information sheets on food allergy-related topics, additional medically-reviewed materials, and more.

Resources for healthcare professionals

Allergy Child Diet - Allergy and Asthma Treatment at Allergomed

The birth of a child is a joy for every family and, of course, parents want their child to grow up healthy, especially those who themselves suffer from allergic diseases.

BREASTFEEDING

Breastfeeding is essential to keep your baby less sick. What gives breastfeeding? It not only improves bowel function, forms the correct bite, protects against infectious diseases, but also strengthens the emotional bond between mother and child.

When a mother is breastfeeding, she must follow certain nutritional rules: exclude milk, replacing it with sour dairy products, and limit the consumption of chicken, fish, citrus fruits, nuts, cocoa coffee, because these products most often cause allergies. If the baby gains enough weight while breastfeeding, then the first complementary foods can be introduced at 6 months.

With a decrease in mother's milk, it is better to use non-traditional methods of treatment: homeopathy and reflexology.

FORMULA FEEDING

Formula-fed infants must receive formula. If the baby did not have any manifestations of allergies, then hypoallergenic mixtures are used (Humana, Nan GA, Hip GA), in the presence of allergic manifestations, the so-called hydrolysates (Alfare, Nutramigen, Pregestemil). Allergic reactions are caused by proteins.

In special mixtures, they are broken down into smaller components that no longer cause allergies. Parents need to remember that the new mixture is introduced gradually, adding 20 ml to each feeding. Thus, the introduction of a new mixture will take 5-7 days.

In recent years, soy allergy has become more common. Since soy inclusions are included in many products, soy mixtures are not recommended as substitutes for women's milk during artificial feeding.

Recently, a lot of various canned baby food has appeared. When choosing canned food for your baby, pay attention that green apple juice is included as a natural preservative, and not ascorbic acid or lemon juice.

PREVENTION OF FOOD ALLERGIES

In children of the first year of life, cow's milk, chicken egg (protein), fish and cereals (wheat, corn, barley, less often rice and buckwheat) cause allergies more often. For the prevention of food allergies in children under 1 year of age, cow's milk is excluded, up to 1. 5 years - chicken eggs, fish and seafood, up to 3 years of age - nuts.

It should be noted that children do not have “accumulation allergies”, after using the “guilty product”, allergy manifestations develop within a few minutes up to 4-5 hours.

FOOD FOR OLDER CHILDREN

Older children should also follow certain dietary guidelines.

All food products can be conditionally divided into three groups according to allergenicity: high, medium and low degree

First - (high degree of allergenicity): eggs, fish, seafood, caviar, wheat, rye, carrots, tomatoes, celery , bell pepper, wild strawberry, strawberry, raspberry, citrus, kiwi, pineapple, mango, coffee, cocoa, chocolate, mushrooms, nuts, honey, pomegranate, persimmon, melon;
Second - (moderate allergenicity): whole milk, butter, beef, chicken meat, buckwheat, oatmeal, potatoes, beets, peas, soybeans, apricots, peaches, cranberries, bananas, dark red cherries, rose hips, blueberries, lingonberries, black currants;
Third - (low degree of allergenicity): sour - dairy products, horse meat, rabbit meat, lean pork, lean lamb, pearl barley, millet, refined vegetable oil, green varieties of apples and pears, white and red currants, yellow and white cherries , yellow varieties of plums, gooseberries, zucchini, squash, cucumbers, cabbage, corn, parsley, dill;

Despite the conditional division of products into degrees of allergenicity, it is recommended to start expanding the child's diet with products of the third group, gradually adding products from the second group and, last of all, from the first. Parents should be careful and exclude exactly those products that caused an allergic reaction. It must be remembered that the diet can not permanent. With age, the child's diet should be expanded.

It must be emphasized that products such as chocolate, fish, citrus fruits, strawberries, egg white, tomatoes, when used, can cause the formation of active substances that cause allergic reactions. The composition of a number of products, such as soy, spinach, Gouda cheese, Cheddar, canned food, tomatoes, corned beef, sauerkraut, tuna, mackerel, includes histamine - the main "culprit" of allergic reactions.

Some foods should be completely excluded from the diet of a child with an allergy, regardless of age: chewing sweets and gums, sauces, fruit juices, soft drinks, instant soups, confectionery, yogurt, jams, ice cream if they contain industrial dye - tartrazine (E 102).

Parents often try to adjust the child's diet on their own and their views on this problem are completely opposite.

Some of the parents believe that the child should be on the strictest diet, leaving the child literally "on water and cabbage." At the same time, they do not take into account the fact that a child is a growing organism, therefore he needs “building materials” for normal growth and development, as well as the fact that with age the list of “forbidden foods” decreases. So, for example, milk allergy is most typical for children under 1.5 years old. If at an older age the child has any health problems when drinking milk and dairy products, this is most likely a gastroenterological disease and further dietary correction should be discussed with a gastroenterologist.

Some parents, on the contrary, allow the child to eat literally everything, citing pity for the child. Of course, if the doctor recommends excluding any products from the diet, they should not be on the general table so as not to cause the child to feel “inferiority”, but strict adherence to the diet should be mandatory at a certain stage of treatment.
What is it for? So that in the future allergic skin lesions do not degenerate into more serious diseases, such as, for example, bronchial asthma.

At the appointment, parents often ask: “Will an allergy develop if the child is given all the foods in a small amount?”. An allergic reaction occurs when even an extremely small amount of the “guilty allergen” is consumed. If a child is prone to overeating, then exacerbations of the disease are not always allergic in nature.

THEREFORE, THE CHILD'S DIET SHOULD BE SELECTED STRICTLY INDIVIDUALLY AFTER A CAREFUL ALLERGOLOGICAL EXAMINATION AND CONSULTATION BY A DOCTOR - ALLERGIST.

Therapeutic nutrition for infants suffering from food allergies | #06/02

In recent years, pathologies caused by food intolerance, especially allergy to protein components of food, have acquired a large proportion in the structure of morbidity in young children. Almost any product used in a child's diet can cause the development of allergic and pseudo-allergic reactions, the frequency of which depends on the nature of the product and its individual tolerance.

The program of dietary treatment developed by us for patients with food allergies provides for the earliest possible detection of causally significant allergens, the justification and timely appointment of an elimination hypoallergenic diet. Therapeutic diets are built taking into account the age and nutritional status of the child, the period of the disease, the results of allergological testing, the characteristics of the functional state of the gastrointestinal tract, and comorbidities [1].

For the diagnosis of food hypersensitivity in the acute period of the disease, the main, most accessible studies that allow the determination of IgE-specific antibodies remain immunological (RAST, MAST, ELISA) conducted "in vitro". Tests such as skin tests (prick tests) in young children, especially in the first year of life, can be extremely difficult to properly perform and evaluate; The double-blind, placebo-controlled test, the “gold standard” for diagnosing food allergies, is certainly accurate, but technically complex and can only be performed in scientific clinical centers [2, 3].

Our studies have shown that in children of the first year of life suffering from atopic dermatitis, hypersensitivity to proteins of cow's milk (85%), banana (81%), chicken egg (62%), gluten (53%) is most often detected. Less common is sensitization to buckwheat proteins (48%), potatoes (26%), soybeans (26%), and even less often to corn proteins (12%), various types of meat (0-3%). It should be noted that the majority of children (76%) have polyvalent sensitization, i.e. allergy to three or more food proteins [4].

An important component of the complex treatment of children suffering from food allergies is diet therapy [5].

Children of the first year of life need to make individual elimination diets (dairy-free, agliadin, with the exception of certain complementary foods, etc.). Patients older than a year for the duration of the survey (7-10 days) are prescribed a non-specific hypoallergenic diet, then an individual hypoallergenic diet.

In the acute period of the disease, the diet should be as strict as possible and provide, on the one hand, the elimination of products with high sensitizing activity, the exclusion or restriction of causally significant and cross-reacting allergens, and on the other hand, an adequate replacement of the eliminated products with natural or specialized products or mixtures. In the remission phase, the diet is gradually expanded due to previously excluded foods and dishes. At the same time, regardless of the period of illness, the diet should provide the physiological needs of children for basic nutrients, energy, vitamins, mineral salts, and microelements [6].

Breastfed children should be breastfed for as long as possible, prescribing a hypoallergenic diet to the mother, which is used throughout the lactation period and provides for the elimination of products with increased sensitizing activity, as well as products and dishes containing extractives and essential oils ( meat, chicken, fish and mushroom broths, hot spices, garlic, radish, radish, raw onion, etc.). Dairy products are allowed only in the form of fermented milk drinks, sour cream and mild cheese. The amount of cereals and pasta, wheat bread, sugar is reduced by 20-25%, salt - by 30%.

As noted above, cow's milk proteins are often the cause of the development of food allergies in children of the first year of life. This product contains about 15-20 antigens, of which the most allergenic are b-lactoglobulin, casein, a-lactoalbumin, bovine serum albumin. It is known that in the first year of life, allergy to cow's milk proteins occurs in 0.5-1.5% of children who are breastfed, and in 2-5% of children who are formula-fed. Among patients with atopic dermatitis 85-90% of children are allergic to cow's milk proteins [1, 3].

Currently, the consumer market has a wide range of therapeutic mixtures that can be used in the nutrition of children with milk allergies. The doctor has the opportunity to choose the necessary mixture in accordance with the age of the child, the period of the disease, the degree of sensitization to cow's milk proteins (Table 1).

Children with low sensitivity to cow's milk proteins, as a rule, tolerate fermented milk formulas well: adapted (Agusha 1, Nan fermented milk) and partially adapted (Agusha 2, Bifilin), and such products based on partially hydrolyzed milk protein: Humana GA1, Humana GA2 , Frisopep, Hipp GA (Table 2 and Table 3). In the diet of children older than 7 months, non-adapted fermented milk products (kefir, biokefir, Biolact, Narine, Acidolact, etc.) can be used in the amount of one feeding.

In the absence of a positive effect from the use of fermented milk products in the nutrition of children with an average sensitivity to cow's milk proteins, specialized mixtures based on soy protein isolate can be used: Humana SL, Alsoy, Nutrilak-soy, Nutri-soy, Soy-Samp, Frisovoy, as well as mixtures Suprolact and Supromilk produced in children's dairy kitchens (Table 4). These products are enriched with a vitamin-mineral complex and microelements in accordance with the physiological needs of children of the first year of life, do not contain milk protein, lactose, gluten. A positive effect should be expected no earlier than 3-4 weeks from the start of their use. The duration of the use of soy mixtures depends on the timing of achieving clinical and laboratory remission and can range from 3 to 9months or more.

However, it is known that 20-25% of children have allergic reactions to soy mixtures. The most common reason for their development is the rapid (within 1-2 days) introduction of these products, as well as the age of children (mainly the first six months of life) [7]. In such cases, the use of specialized hypoallergenic therapeutic mixtures prepared on the basis of milk protein hydrolysates with a high degree of hydrolysis is indicated: Alfare, Nutramigen, Pepti TSC, Peptidi-Tutteli (Table 3). When using these products in most patients (89-93%) it is possible to achieve positive dynamics on the part of skin, gastrointestinal and respiratory manifestations of food allergy after 2-3 weeks from the start of their use, and clinical remission is achieved after another 2-4 months.

During the period of remission, hypoallergenic, dairy-free diets are expanded through the introduction of fermented milk products and mixtures based on partial protein hydrolysates. Children older than a year are trying to add diluted dry milk to cereals and cottage cheese. The expansion of the diet is carried out carefully and gradually under the control of the general condition of the child, clinical and immunological parameters with the obligatory registration of allergic reactions that have arisen in the food diary.

At present, due to the wide choice of therapeutic mixtures, the timing of the appointment of complementary foods for children with food allergies practically does not differ from those in healthy children (Table 5 and Table 6). At the same time, it is necessary to take into account the individual tolerance of products [5, 6, 8].

The first complementary food - vegetable puree - is prescribed at 4.5-5 months. It can include zucchini, squash, cauliflower, white and Brussels sprouts, light-colored pumpkin, potatoes and other green or white vegetables. For the preparation of puree, both natural (including frozen) vegetables and canned vegetables for baby food from the above vegetables can be used.

The second complementary food - dairy-free porridge - is included in the diet of children from 5 months. It can be buckwheat, corn, rice, oatmeal. Hypoallergenic oatmeal, buckwheat, and corn porridges from the Heinz company, which have been tested at the National Health Center of the Russian Academy of Medical Sciences, have proven themselves well. Preference should be given to dairy-free cereals for baby food of industrial production, which are prepared from environmentally friendly raw materials, enriched with vitamins, mineral salts (including iron) and do not require cooking. Porridges are cooked on water or with the addition of a specialized mixture (based on soy or hydrolyzate).

In order to correct the protein part of the diet, meat puree is introduced into the child's diet from 5.5-6 months. In case of intolerance to beef, which has antigenic affinity for cow's milk proteins, it is recommended to use lean pork, rabbit meat, turkey, as well as specialized children's canned meat from horsemeat "Humpbacked Horse", pork "Pork Puree", a combination of these products "Cheburashka", as well as other domestic and foreign analogues.