Question

Food Allergies & Food Intolerance

How should I introduce my baby to food to lower the risk of food allergies?

A Answers (2)

  • AScott H. Sicherer, MD, Pediatric Allergy & Immunology, answered on behalf of The Mount Sinai Health System

    Current guidelines do not suggest a specific order of solid foods to feed an infant to reduce the risk of food allergies. Nor are there suggestions to avoid or significantly delay giving foods that are commonly considered more “allergenic” such as milk, egg, peanuts, or fish to prevent food allergies. Previous US recommendations had suggested, for families with a history of allergies, that the infant should delay ingesting cow’s milk proteins until age 1, egg until age 2 and peanuts, tree nuts and fish until age 3 years. However, studies have not supported those suggestions, and the recommendations were rescinded in 2008. It makes sense to only feed babies what they are able to manage according to texture, without gagging or choking, which changes as the infant gets older (ask your pediatrician). If you suspect that your infant had an allergic reaction to any food, talk to your pediatrician or allergist before trying other new foods. 

  • American Academy of Pediatrics (AAP) guidelines on that subject have changed of late. The AAP now recommends that all infants be exclusively breastfed until 4 to 6 months old. The AAP does not recommend restricting foods from the maternal diet during pregnancy or lactation as a strategy to prevent the development of food allergies.
     
    Guidelines do recommend hydrolyzed infant formulas, as opposed to cow’s milk formulas, as a strategy for preventing development of food allergies in at-risk infants who are not breastfed. (At-risk children include those with pre-existing severe allergic disease and/or a family history of food allergy.) Finally -- and this is a significant change from previous guidelines -- the introduction of solid foods should not be delayed beyond 4 to 6 months of age, including the introduction of potentially allergic foods.

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How should I manage my child's food allergy?