Food Allergy Prevention and Introducing Solids – What does the research say?

Introducing solids to your baby is an exciting time! A lot of parents tell me that it is also a nerve-wracking journey—especially when it comes to their concern about food allergies. Many parents wonder when and how to introduce common allergy-causing foods. As a paediatric dietitian, I’m here to explain current best practices and offer some reassurance as you navigate this important and exciting milestone.

When to introduce solids

• Feed your baby their first foods when they are ready, at around 6 months, but not before 4 months. Signs for readiness include, good head and neck control, showing an interest in others food and opening their mouth when offered food.

• Start to introduce a variety of solid foods. Foods containing iron (such as iron enriched cereals, meats, poultry, fish, well cooked egg, tofu and legumes) should be included from around 6 months of age.

What are the common allergy causing foods?

The main foods that are known to cause allergies include:

• Peanuts

• Eggs

• Cow’s milk

• Tree nuts (such as almonds and cashews)

• Wheat

• Soy

• Fish

• Shellfish

• Sesame

These foods are part of a balanced diet and essential for your baby’s growth and nutrition, so introducing them is important for overall wellness.

When to introduce common allergy causing foods

All infants should be given the common food allergens, in a suitable texture, before 12 months of age, unless they are already allergic to the food.  There is no need to delay or avoid introducing any allergenic food.

Image: Baby having fun exploring solids

Why Is Early Introduction Important?

Research has shifted the conversation around food allergies. Rather than delaying the introduction of common allergenic foods, studies show that introducing them before your baby’s first birthday, can help reduce the risk of developing food allergies.

How to Safely Introduce Allergenic Foods

It’s essential to introduce common allergenic foods one at a time.  This allows you to identify the food causing the allergy if a reaction occurs. Reactions can include hives, swelling of the lips/face/eyes, vomiting, or difficulty breathing. Offering the food soon after your baby wakes allows you to watch your baby and easily respond if they show signs of an allergic reaction.

Start by offering small amounts of well-cooked foods. For example, mashed hard-boiled egg or smooth peanut butter mixed with breast milk, formula, or a puree can be a good first step. Gradually increase the quantity if your baby tolerates the food well. Avoid whole nuts, as these pose a choking hazard for infants and young children.

Once you give these foods to your baby, continue to offer these foods regularly (about twice a week).

Does breastfeeding prevent allergies?

Breastfeeding is recommended for at least 6 months, and beyond that for as long as mother and baby wish to continue. Breastfeeding may not prevent all food allergies but is recommended for the many other benefits it provides to both mothers and babies. If possible, continue to breastfeed while you introduce solid foods to your baby.

Feeding is a relationship between caregiver and bub. For a positive feeding relationship, both parties need to be supported on that journey. I talk to a lot of mums and understand that sometimes breastfeeding is not possible in that journey. When breastfeeding is not possible, a standard cow’s milk-based infant formula can be given. Current research shows that soy or goat’s milk formula does not reduce the chance of allergies developing when compared to standard cow’s-milk based formula.

What if my baby has eczema?

Many babies with moderate or severe eczema will also have a food allergy. Although this does not mean that the food is the cause of the eczema, avoiding the food is still important to prevent the child from having an allergic reaction. However, it is important to feed your baby the common allergy causing foods that your baby is not allergic to, to prevent them from developing other food allergies. It is important to optimise eczema management to prevent food allergy sensitisation through the skin.

When to Seek Professional Help

If you’re unsure about introducing allergenic foods or suspect your baby may have a food allergy, it’s crucial to get professional advice. Early diagnosis and support can make a big difference. If your baby develops any concerning symptoms after eating a new food, stop offering it and see your doctor. They may recommend further testing or a referral to an allergy specialist for ongoing support. If your baby is showing signs of severe allergic reaction (anaphylaxis), call and ambulance 000.

An accredited practicing dietitian (APD) will assist with advice to support you if your child has food allergies. I can provide support on ensuring nutritional needs are met while avoiding the allergenic foods and guide with understanding food labels.

Final Thoughts

Introducing solids, especially potential allergens, can feel overwhelming, but with the right approach, it can be a positive experience for both you and your baby. By introducing allergenic foods before your baby’s first birthday, and keeping them in their diet every week, you can reduce the risk of food allergies.

This blog post is based on the following references. If you're interested in more information on allergy prevention, I recommend reviewing them.

Until next time,

Ash

Your Child’s Nutrition Specialist

References:

- National Allergy Strategy, 2023. *Prevent Allergies: Feeding your baby and introducing common allergy-causing foods*. Available at: <https://preventallergies.org.au/> [Accessed 18 Sept. 2024].

- Australasian Society of Clinical Immunology and Allergy (ASCIA), 2023. *Infant feeding and allergy prevention: Clinical update*. Available at: <https://www.allergy.org.au/hp/papers/infant-feeding-and-allergy-prevention-clinical-update> [Accessed 18 Sept. 2024].

- Australian Breastfeeding Association, 2023. *Breastfeeding and allergies*. Available at: <https://www.breastfeeding.asn.au/resources/allergies> [Accessed 18 Sept. 2024].

- National Allergy Council, 2023. *Our strategy*. Available at: <https://nationalallergycouncil.org.au/> [Accessed 18 Sept. 2024].