Key Strategies for Reducing Infant Food Allergies
Co-Written by Emily Stevens, Dietetics Student
Introducing allergens can be a terrifying step when introducing foods to your baby. The thought of your baby having an allergic reaction can often be enough to avoid these foods altogether - but is that the right route to take?
What is a food allergy, and how does it occur?
When a food is introduced, our immune system will sometimes mistake the protein from the food as harmful or dangerous for our body, and label it an allergen (1). When the immune system targets this allergen as harmful, we will have an allergic reaction each time it is consumed (1). It is important to note that experts in the field still do not definitively know what causes food allergies from person to person, and there are likely a combination of many factors that contribute. (2)
Before we talk about introducing allergens, it is important to understand which foods are identified as priority food allergens, meaning they are the most common food allergies. Over 90% of food allergies are caused by the following eight common allergens (2):
Fish and Shellfish
Eggs
Milk
Mustard
Peanuts and Tree Nuts
Sesame
Soy
Wheat and triticale (a wheat hybrid)
Parents can often put a lot of pressure on themselves if their baby does develop a food allergy, for not introducing the right foods at the right time. Regardless of how or when you have introduced allergens to your baby, remember that although the allergens' introduction may play a part, it is not the only factor at play in allergy development (2).
Luckily, with the wealth of research in this area, there are some tips we can offer to introduce allergens to your baby in the safest way possible, and to potentially reduce the risk of having food allergies.
Tip 1: Include allergens frequently throughout pregnancy and breastfeeding.
Many women believe that avoiding common allergens during pregnancy and lactation may help to prevent food allergies – but this is actually the opposite of what is true. Introducing your baby to these priority food allergens does not need to start after birth. Incorporating these allergens into your diet while pregnant and breastfeeding can help expose your baby safely and early.
Of course, if you yourself are allergic to a food, you shouldn’t consume it while pregnant or breastfeeding – but if you don’t have a reaction, then it can be beneficial to include these foods frequently throughout your pregnancy to expose your baby to the allergens in your womb and breastmilk, and potentially help strengthen their immune tolerance (3).
Tip 2: Omega 3’s.
Increased intake of omega 3’s (a form of poly-unsaturated fat) during pregnancy and while breastfeeding may have a protective effect on your childs’ risk of food allergies. Whenever possible, its best to get omega 3’s through food, such as fatty fish (i.e. salmon, mackeral, trout, or sardines) or olive oil, walnuts, flax, or chia seeds. If you are unable to get sufficient amounts of Omega 3’s through food, a supplement can also be beneficial. Taking omega-3 supplements through pregnancy and while breastfeeding has also been identified as a potentially protective factor against food allergies, specifically egg and peanut allergies (4).
Tip 3: Introduce Common Allergens Early and Often.
Once your baby is old enough to start including complimentary foods (typically at 6-months old and never before the 4-month mark (1)), you can begin including these priority allergens in their diet. The key is to introduce the priority allergens often, and aiming to have all priority allergens introduced by 12 months of age (5).
An example of an early introduction to a priority allergen could be well-cooked scrambled eggs (5) or peanut butter blended into breast milk or warm water (1). You must offer textures of the allergen ingredients safe for your baby's developmental stage and age (1).
Tip 4: Avoid Skin Contact.
One thing to note is that it is important to introduce allergens through food first, before allowing them to be introduced through skin contact (6). For example, introducing coconut oil as a lotion for your baby's eczema may lead to a higher coconut allergy incidence due to the allergen entering the baby's system through cracked skin (6). Rather, it’s best to wait to use coconut oil as a skin treatment until after 6+ months of age when they have been introduced to coconut through foods several times.
Tip 5: Optimize Prenatal Supplements with a Dietitian.
As research emerges in this area, we come across many more 'maybes' around food allergy development. This emerging research has indicated that you may want to avoid high-dose folic acid supplements late in pregnancy, which could be a potential risk factor to allergy development (7). Additionally, a pregnancy probiotic for the last four weeks of pregnancy may be a protective factor to allergy development (4).
Because prenatal supplement recommendations can be very individualized, it’s always best to optimize your protocol with your dietitian and health care team.
Overall, the introduction of priority allergens is a crucial step when introducing your baby's first foods. Introducing these allergens early and often is a protective factor against the development of food allergies – and it doesn't have to wait until your baby is introduced to solid foods! You can begin introducing your baby to allergens throughout pregnancy and while breastfeeding by including them in your own diet.
All babies are individuals and may have their own unique risk factors for food allergies. When in doubt, check in with your baby's dietitian and healthcare team for guidance around introducing allergens.
References:
1. HealthLink BC. Reducing Risk of Food Allergy in your Baby [Internet]. PEN The Global Resource for Nutrition Practice: HealthLink BC; 2020 [cited 2021 Feb 26] Available from: https://www.healthlinkbc.ca/hlbc/files/healthyeating/pdf/reducing_risk_of_food_allergy_in_your_baby.pdf
2. Food Allergy Canada. Early Introduction to Food Allergens [Internet]. Food Allergy Canada. 2020 [cited 2021Feb26]. Available from: https://foodallergycanada.ca/living-with-allergies/ongoing-allergy-management/parents-and-caregivers/early-introduction/
3. Lavery WJ, Assa’ad A. How to prevent food allergy during infancy: what has changed since 2013? Current Opinion in Allergy and Clinical Immunology. 2018;18(3).
4. Garcia-Larsen V, Ierodiakonou D, Jarrold K, Cunha S, Chivinge J, Robinson Z, et al. Diet during pregnancy and risk of allergic or autoimmune disease: A systematic review and meta-analysis. PLos Med. 2018 Feb; 15(2):1-25
5. ASCIA. Parent Information: Frequently Asked Questions (FAQ) How to Introduce Solid Foods for Allergy Prevention [Internet]. ASCIA Australia; 2020 [cited 2021 Feb 26] Available from: https://www.allergy.org.au/images/pcc/ASCIA_PCC_How_to_introduce_solid_foods_FAQ_2020.pdf
6. HealthLink BC. Eczema and Food Allergy in Babies and Young Children [Internet]. Dietitian Services: HealthLink BC; 2020 [cited 2021 Feb 26] Available from: https://www.healthlinkbc.ca/healthy-eating/eczema-allergy-baby-children
7. Soncha-Banasiak A, Kamer B, Paczes K, Slusarek B, Pawilkowski B, Czkwianianc E. Trends in folic acid supplementation during pregnancy – the effect on allergy development in children. Adv Dermatol Allergol. 2018 Apr; 2:139-144
