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Entries in food allergy (2)


Update: Starting Solids (revised recommendations)

We had a big milestone at the Brown house last week - our baby girl got her first taste of solid foods.  Like most little ones faced with their first experience eating something other than breastmilk or formula - her reaction was priceless (some truly hilarious facial expressions).  We are all asked for advice about how to introduce solid foods on a daily basis in clinic.  And while experts recommend introducing solid foods around 6 months of age... a lot of the guidelines for what to give and when to give it have changed recently based on new research.  

Here's our revised edition of Twin City Ped's guide to starting solids. 

First, consider starting solids at a time when your baby is hungry but not starving, such as after he has had a little formula or breast milk, but not after a full milk feeding when he is not at all hungry. Try to introduce new foods with enthusiasm, but do not force your child to eat something.  If your child is not interested in a new food, put it away and try introducing it again later.

Start with infant cereal, fruits, or veggies. For most babies it does not matter what the first solid foods are. Traditionally, pediatricians have recommended starting with one of the single-grain cereals (rice, oat, whole wheat, or barley cereal). However, there is no medical evidence that introducing solid foods in any particular order has an advantage for your baby. Others may encourage you to start vegetables before fruits, but there is no evidence that your baby will develop a dislike for vegetables if fruit is given first. Babies are born with a preference for sweets, and the order of introducing foods does not change this.

  • To make your baby’s cereal: Take 1-2 tablespoons of  cereal and put it in a cup or bowl, add formula or pumped breast milk, and make it very soupy (thinner than applesauce)
  • To feed your baby solids: Put your baby in a bouncy seat (a Bumbo seats work well too).  Using a spoon, drip "the soupy-cereal mix” or fruit or veggie on the back half of your baby's tongue so that it will go down his throat! 
  • Good choices for first fruits and veggies include the following (in pureed form):

Click to read more ...


Evolving Food Allergy Guidelines

Food allergies have become increasingly common among children. Because of this increase, it has naturally made us more wary about starting particularly allergenic foods in young children. Back in 2000, the American Academy of Pediatrics attempted to decrease the prevalence of these food allergies by recommending that parents wait until age 1 to introduce cow’s milk, age 2 to introduce eggs, and age 3 to introduce peanuts, tree nuts, and fish. These guidelines didn’t seem to make a noticeable difference in the development of food allergies; therefore, they have since been revised to make food introductions a little bit easier.

With all of these changes in guidelines, it has been confusing for both parents and pediatricians to decide when it’s safe to introduce these highly allergenic foods. Fortunately for us, the American Academy of Allergy, Asthma, and Immunology has recently outlined the approach to introducing allergenic foods even more explicity…and I’m here to share this information with you (this recent Wall Street Journal article also does a nice job discussing this issue)! Here are the highlights:

  • It is OK to introduce these highly allergenic foods (i.e. cow’s milk products, eggs, peanuts/tree nuts, and fish) BEFORE the age of 1. That being said, infants under age 1 should still receive breast milk or formula as their primary source of nutrition. Before age 1, cow's milk products should be limited to yogurt, cheese, etc. 
  • Start with cereal, fruits, and vegetables at 4-6 months according to your pediatrician’s recommendations. If these are tolerated well, it is reasonable to introduce the above foods any time afterwards.
  • Start with a taste of one of the allergenic foods at home (as opposed to daycare/elsewhere). If tolerated well, slowly start to introduce more of that food into the diet and only introduce one new food every 3-5 days

And regarding those questions about mom while pregnant and breastfeeding:

  • There’s no evidence to suggest that moms need to avoid allergenic foods during pregnancy or breast feeding in order to prevent the development of food allergies in their child. Instead, it’s important to maintain adequate sources of nutrition and protein while you’re feeding your little one!
  • Breastfeeding your little one CAN be beneficial in protecting from food allergies, asthma, and eczema (among other things). 6 months or more of breastfeeding is ideal, but you do the best you can!
  • If you’re choosing formula for your baby, there’s no reason that soy formula should be used over milk-based (regular) formula to prevent allergies

As always, ask your pediatrician if you have any specific questions or concerns about these guidelines. It is particularly important that you talk with your doctor if there is a strong family history of food allergies, as these can tend to run in families, and there may be a different plan for introducing these foods to your child. Otherwise, rest easy knowing that you can introduce lots of new foods earlier!