There is a certain excitement every parent holds when it comes to introducing your baby to new foods. Wondering what they will like (or not like!), watching their faces putter up when they eat something new…the taste testing process is exciting! However, it’s not unusual for stress to creep up on parents when it comes to introducing those foods that are known to be highly allergenic, because really…it’s scary not knowing how your child may react and if they will be ultimately be ok. It’s especially stressful, as in the past there has been conflicting information on if and/or when to introduce high-risk foods, making it very confusing for parents.

For a long time, it was thought that the introduction of the top allergenic foods should be delayed until the child was at least a year old, especially if they were at a high risk of developing allergies. These common allergenic foods include:

  • Eggs
  • Fish
  • Milk (cow’s milk protein)
  • Tree Nuts
  • Peanuts
  • Sesame
  • Shellfish
  • Soy
  • Wheat

However, these recommendations have recently been proven to not be as effective as we once thought for decreasing the risk of the development of food allergies in our babies. New research has come out that has changed the type of information we are giving moms in terms of the process of introducing of certain foods. Although more research and more studies are required to answer all the questions, the best evidence now suggests that there is no benefit in delaying the introduction of any specific solid food beyond the six-month mark in hopes to decrease the chances of your baby developing a food allergy (1). In fact, new findings say it could actually promote the onset of allergies. A study conducted in the United Kingdom found that the prevalence of peanut allergies actually tripled when the recommendation was to delay the introduction of peanuts until three years of age (2).

When is the best time to introduce allergenic foods?

According to Health Canada, the Canadian Paediatric Society, Dietitians of Canada and the Breastfeeding Committee of Canada; exclusively breastfeeding for the first six months and thereafter introducing solid foods is recommended has been shown to be for beneficial in preventing food allergies (3). However, other allergy prevention guidelines have put in place a slightly different recommendation, in which exclusive breastfeeding need only continue until four months of age, at which point solids can be introduced, along with breastfeeding. This is based on research that shows a “window of opportunity” may exist where babies develop a tolerance to certain solid foods early on.

While the evidence may seem conflicting on when to introduce solids for allergy prevention, what is a common consensus is the finding that breastfeeding duration, rather than breastfeeding exclusiveness decreased the risk of food allergies. Therefore, the American Academy of Allergy, Asthma and Immunology has proposed a compromise where mothers should breastfeed exclusively until four to six months of age, and introduce solids within this period of time while continuing to breastfeed until at least the six month mark, or until two years of age and after (1).

If you’re ready to introduce solids to your baby, you’ll want to grab my list of Easy First Finger Foods For Baby here. 

 

How should I introduce allergenic foods to my baby?

The question then comes – how should I go about giving my baby allergenic foods?

Regardless if you are breastfeeding or formula feeding, your baby can be considered either at a low risk or high risk for developing a food allergy. Your baby may be considered high risk in developing a food allergy if a parent or sibling has a food allergy, or if they have persistent eczema. In this situation, it may be beneficial to seek a referral from your paediatrician to see an allergist to determine if further testing is required and to decide the safest way to introduce allergens. 

If your baby over 4 months of age and has safely tolerated a few non-allergenic foods, then parents can begin to introduce allergenic foods right away, following these guidelines:

Stay home!

  • It is always best to introduce these foods in the presence of a parent in their own home, rather than at a daycare or when they are dining out. Ensure you have easy access to a hospital or medical clinic in case any serious reaction occurs.

Start small!

  • Offer the food to your child in teeny tiny amounts at the beginning, and then increase the quantity of food over a few days. A little bit of peanut butter on the tip of your finger, for example, is all you need for exposure.

Space out the introduction of foods!

  • When starting the taste testing of solid foods, try introducing no more than one food per day and then wait about 3-5 days few days before to introducing another new allergenic food. This is a helpful and safe way to start your baby on solids to ensure that you can easily detect which food (if any) may be causing an allergic reaction.

Don’t stop after the first time!

  • Your baby will need to be regularly exposed to each of the new foods in order to build tolerance to it. As long as no reaction happens the first time, keep offering the food regularly. 

Record symptoms!

  • It can take only minutes or up to several hours for an allergic reaction from food to appear, so recording everything your baby is eating for those few days is a good idea. The common signs to watch for that may mean something more serious is going on include:
      • Itching, tingling or swelling of the mouth, lips or tongue
      • Itchy ears
      • Hives
      • Trouble breathing
      • Eczema
      • Vomiting
      • Diarrhea

If your child is experiencing any of these symptoms, call your doctor or seek medical help right away.


Practical tips for introducing each allergen


Wheat:

Grains are one of the easiest first foods to introduce to your child, and my recommendations are to start with iron fortified grains if possible, including gluten containing ones no later than 7 months of age (ie. Wheat)! The reason why I recommend a gluten containing grain early is because late introduction has been shown to increase the risk of developing celiac disease.

Cream of Wheat or Farina is a great iron fortified wheat option to start with. If your baby is capable of handling more solid foods, lightly toasted whole grain bread or crackers will do!

For those babies now exploring different textures, you can expose them to wheat through pasta such as bowtie or rotini (which are easier for your child to pick up themselves!)

Fish:

Salmon, tuna, or any white fish can be baked and flaked into tiny pieces or pureed with a little bit of breast milk or formula into one of your baby’s favourite foods like sweet potatoes, squash, or any other veggies. Just make sure to be extra careful removing all bones from the fish before giving it to your baby.

Peanuts:

Whole peanuts or large amounts of peanut butter should never be given to your infant or toddler as they can both be a choking hazard. The best way to start out is to put to take an 1/8th of a tsp and mix it with 1/3 tsp of pureed fruit of vegetable.  Once you’ve determined that there is no allergic reaction, you can move up to 1/4 tsp of peanut butter mixed with 3/4 tsp of puree fruit/veg, and keep increasing volume each time. You can also try one of the following:

  • Thinly spread peanut butter mixed with applesauce or yogurt on a piece of bread.
  • Mash a ripe banana with a small spoonful of peanut butter.
  • Thin out a small amount of the peanut butter in cereal or quick cook oats.
  • Peanut flour or peanut butter powder (about 2 tsp) with 6-7 tsp of pureed tolerated fruit/veggies. 

Tree Nuts:

You can introduce tree nuts like almonds and hazelnuts simply by  mixng one of these nut flours into a puree food like applesauce or yogurt and feeding it to your baby. You can also steam and grind the nuts to a smoother consistency such as done in this delicious Apple Walnut puree recipe!

As baby develops an affinity to more textures, you can use nut flours like almond flour to make pancakes and cut into longer or bite sized pieces for your baby as finger food.

Eggs:

It is perfectly fine to give your baby whole egg when introducing solid foods. There is no longer a need to separate the egg white and the yolk. Just make sure the egg is cooked all the way through (as they may contain salmonella, which could cause serious food poisoning), then cooled down enough after cooking. Try to refrain from using salt, pepper or other spices to season the egg – let your baby taste the natural flavours! Mash the yolk with a spoon and mix it with a tiny bit of breast milk or formula if it is too dry for your baby to swallow.

Dairy:

Children under 1 year of age should not be getting cow’s milk as a beverage in their diet. You can however introduce cow’s milk protein by incorporating cow’s milk in baked goods, mixing tiny bits in a cereal, or feeding your child yogurt or soft cheeses such as ricotta cheese.

Soy:

My favourite way of introducing soy to a baby is by offering an organic non-gmo tofu! If they are on purees at this time, you can easily blend a soft tofu in with your baby’s favourite veggies. If they are ready to move onto different textures, serving chunks of lightly fried tofu in coconut oil is a delicious way to explore it!

NOTE: It is NOT recommended to rub a food your infant’s skin as a way to expose them to that food. Certain foods that are acidic (such as berries, tomatoes, citrus fruits, and vegetables) can be potentially irritating on the skin, causing redness and rash. However, this is NOT an accurate measure of an allergy. For most parents, the best way to introduce these foods is to do it at home, orally, at the time of starting solids.

Ready to start introducing your baby to solids? Contact me for a free discovery call to chat about your questions, challenges and see if I can help!

Here is an easy recipe from to get you started on your and your baby’s journey to healthy and safe foods!


Eggy Guacamole
Recipe from www.eggs.ca

What you’ll need:

– 1 egg
– 1 ripe avocado

What to do:

  1. Fill a small pot with cold water and cover, bring to a boil
  2. Add egg to the pot of boiling water, turn down heat slightly and boil for 13 minutes
  3. Drain pot of hot water and cover egg with cold water to cool. You may have to change the water a few times as it warms from the hot pot.
  4. Peel hard-boiled egg and mash well with a fork. 
  5. Cut avocado in half, remove pit and scoop out the flesh. Mash the avocado well with a fork. 
  6. Combine the egg and avocado together

Tip: Boil more eggs and store in fridge for up to one week for quick and easy snacks or meal pairings!

Happy Eating with your baby!

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