Preventing Food Allergies in Infants and Children
It can sometimes feel like children with food allergies
surround you. Your best friend is breastfeeding and cannot eat dairy because her baby is allergic. You cannot pack peanut butter and jelly sandwiches for your child’s lunch because her classmates may be allergic. Deviled eggs are off limits at family gatherings because of your nephew’s allergy.
With all the buzz about food allergies, you may be wondering how you can keep your child allergy-free.
What Are Food Allergies?
When someone has a food allergy
, their immune system overreacts to a food they eat. Reactions can range from mild, to severe, to life-threatening. Some of the most common reactions include:
- Runny nose
- Itching or swelling of the lips, tongue, or throat
- Upset stomach, cramps, bloating, or diarrhea
- Wheezing or difficulty breathing
Anaphylactic shock—This is a life-threatening reaction that requires medical care right away.
Infants and children can be allergic to a variety of foods. The most common are:
- Peanuts and tree nuts, such as walnuts, pecans, almonds, and cashews
- Cereal grains such as wheat and barley
If you or your child’s doctor think that your child has a food allergy, your child may need to be tested
. Food allergies are most often diagnosed through skin tests or blood tests.
How Common Are Food Allergies?
Food allergies affect 1 out of every 13 children less than 18 years of age in the United States. In recent years, the number of children with food allergies has been increasing, especially peanut allergy. This has many doctors worried.
Can Food Allergies Be Prevented?
If you have a food allergy, you know how difficult it can be to keep your diet free of the offending food. And you probably want to save your child from that hassle. Is there anything you can do to prevent food allergies in your child? A lot of research is being done to try to answer that question.
Not long ago, the American Academy of Pediatrics (AAP) recommended that pregnant women avoid eating peanuts. It was thought that this might eliminate peanut allergy in young children. However, recent studies have not found a connection between eating peanuts during pregnancy and peanut allergy in children. The AAP now states that there is no evidence to suggest that restricting certain foods during pregnancy will prevent allergies in infants. However, if your newborn will be at high risk for developing food allergies, it is a good idea to discuss your options with your doctor. All pregnant women should eat a balanced, healthy diet to provide the best start for their babies.
Some mothers of children with food allergies need to avoid eating certain foods while breastfeeding. But can avoiding common allergic foods prevent an allergy in an infant who is not yet allergic? While some studies have shown a benefit and others have not, the AAP has not found enough evidence to recommend that breastfeeding mothers avoid common allergic foods like milk, eggs, and peanuts. Once again, if your new child is at high risk for developing food allergies, it is a good idea to discuss your options with your doctor.
Some studies have suggested that in infants who are at risk of developing allergies due to family history, exclusive breastfeeding rather than formula-feeding for the first 4 months may reduce the risk of cow’s milk allergy. But not all studies have shown that breastfeeding reduces the risk of food allergies. Nevertheless, for this and other reasons, many organizations such as the National Institute of Allergy and Infectious Diseases recommend that all infants be breastfed exclusively until 4-6 months of age unless there is a medical reason not to do so.
Introducing Solid Foods
When it is finally time for your baby to eat solid foods
, you may wonder when to introduce common allergic foods. The AAP recommends waiting to introduce solid foods until your baby is 4-6 months of age and whole cow milk until 12 months of age. But this is mainly to make sure your baby gets all the nutrition they need from breast-milk or formula. It used to be recommended that common allergic foods like eggs, nuts, and fish not be introduced into your child’s diet for up to several years. But recent evidence suggest that we should not delay introducing foods that commonly cause allergies. Newer studies are showing that delaying giving these foods may not prevent food allergies. In some cases, it may even increase the chance that your child will develop an allergy. Current guidelines now state that high-risk infants with severe eczema and/or egg allergy should be introduced age-appropriate peanut-containing food at age 4-6 months to reduce the risk of peanut allergy. There are no current guidelines for other potentially allergic foods.
What Can Parents Do?
All of this information may make you feel like you cannot win. With new studies coming out all the time and recommendations from groups like AAP changing, you may feel confused about how to protect your child from food allergies. The most important thing is to make sure your child eats a healthy diet
. It also helps to know that many children will outgrow milk and egg allergies by the time they enter school. Unfortunately, not as many children outgrow peanut allergies.
Feed your baby only breast-milk preferably or formula until age 4-6 months. If you have any family history of food allergy or reason to be concerned, talk to your doctor. When your child is old enough for solid foods, provide a variety of healthy foods for them. When you are introducing new foods to your child, be familiar with the signs of food allergy. Call the doctor if you notice your child is having a reaction.
You may not be able to prevent all food allergies in your child, but you can still give them a good start by eating a healthy diet during pregnancy and breastfeeding, and providing a healthy, balanced diet full of fresh fruits and veggies
when they are older.
Asthma and Allergy Foundation of America
Food Allergy Research & Education
Allergy/Asthma Information Association
Canadian Allergy, Asthma, and Immunology Foundation
Allergy testing for children. Asthma and Allergy Foundation of America website. Available at: http://aafa.org/display.cfm?id=9&sub=20&cont=278. Updated 2005. Accessed July 28, 2015.
Boyce JA, Assa'ad A, Burks AW, et al. Guidelines for the diagnosis and management of food allergy in the United States: summary of the NIAID-sponsored expert panel report. Nutr Res. 2011;31(1):61-75.
Du Toit G, Katz Y, Sasieni P, Mesher D, et al. Early consumption of peanuts in infancy is associated with a low prevalence of peanut allergy. J Allergy Clin Immunol. 2008;122(5):984-990.
Du Toit G, Lack G. Can food allergy be prevented? The current evidence. Pediatr Clin North Am. 2011;58(2):481-509, xii.
Facts and statistics. Food Allergy Research & Education website. Available at: http://www.foodallergy.org/facts-and-stats. Accessed July 28, 2015.
Food allergy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 5, 2015. Accessed July 28, 2015.
Food for thought: preventing food allergies. Kids with Food Allergies website. Available at: http://www.kidswithfoodallergies.org/resourcespre.php?id=108. Updated January 2015. Accessed July 28, 2015.
Foods to avoid in pregnancy. NHS Choices website. Available at: http://www.nhs.uk/conditions/pregnancy-and-baby/pages/foods-to-avoid-pregnant.aspx#close. Updated January 13, 2015. Accessed July 28, 2015.
Greer FR, Sicherer SH, Burks AW. Effects of early nutritional intervention on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formula. Pediatrics. 2008;121(1):183-191.
Ho MHK, Wong WHS, Heine RG, et al. Early clinical predictors of remission of peanut allergy in children. J Allergy Clin Immunol. 2008;121(3):731-736.
Perkin MR, Logan K, et al. Randomized trial of introduction of allergenic foods in breast-fed infants. N Engl J Med. 2016 May 5;374(18):1733-1744. Available at:
Accessed February 6, 2017.
Question & answer. Healthy Children—American Academy of Pediatrics website. Available at: http://www.healthychildren.org/English/tips-tools/ask-the-pediatrician/Pages/question.aspx?qid=1499. Updated April 3, 2014. Accessed July 28, 2015.
Savage JH, Matsui EC, Skripak JM, Wood RA. The natural history of egg allergy. J Allergy Clin Immunol. 2007;120(6):1413-1417.
Sicherer SH, Mahr T. Management of food allergy in the school setting. Pediatrics. 2010;126(6):1232-1239.
Switching to solid foods. Healthy Children—American Academy of Pediatrics website. Available at: http://www.healthychildren.org/English/ages-stages/baby/feeding-nutrition/Pages/Switching-To-Solid-Foods.aspx. Updated May 5, 2015. Accessed July 28, 2015.