WORDS CHRISTEL GERALYN GOMES
Starting your bub on solids is an exciting and fun time for a new parent. For most parents, feeding your child solids should go smoothly enough. A few children, however, may have allergies to certain foods. Read on for what foods are most likely to cause allergies in babies.
Experts agree that baby should only be started on solids after he or she has passed the four-month mark, and not before. The recommended weaning age is usually six months, but according to Dr Christelle Tan, specialist in paediatrics at Raffles Specialists, Holland V, some evidence shows that weaning earlier – between four and six months – can result in decreased allergies.
Of course, if you choose to start weaning your child at four months, always make sure he or she is developmentally ready. In other words, he must be able to hold his head up well, sit supported and he should be showing interest in food, explains Dr Elizabeth Tham, consultant, Division of Paediatric Allergy, Immunology & Rheumatology, National University Hospital
Common Food Allergies
In Asia, our experts agree that soy, wheat and fish allergies far less common than in the West. Instead, most allergies in this part of the world involve egg or cows’ milk. “As they grow older, we see cases of peanut, tree nut and shellfish allergies. Specific to Singapore, we do see bird’s nest allergies in children older than a year”, says Dr Tan.
Recognise the Symptoms
According to Dr Tham, food allergies commonly manifest as “rashes around the mouth or on the face and swelling of the eyes or lips”. These symptoms may occur together with vomiting, wheezing, or breathing difficulties. Typically, symptoms of a food allergy show up about one to two hours after the feed. If your child is developing any of these symptoms, especially wheezing or difficulty breathing, take her to the doctor immediately as “this can be life-threatening if not treated promptly,” says Dr Tan.
Introducing Solids in the Proper Order
There is, in fact, a correct order in which you should start your baby on big people food. According to Dr Tham, “Infants should first be introduced to vegetable or fruit purees that are appropriate in texture and consistency for their developmental age, to avoid choking. First foods should also be iron-rich, especially in fully breastfed infants. An increasing range and variety of foods, including allergenic foods, should then be introduced in succession so that the infant is exposed to a wide variety of foods.”
Both our experts agree that introducing milk, egg-based
foods or other allergenic foods like peanuts should
not be avoided as delaying the introduction of allergenic
foods into your baby’s diet can increase the risk of allergies.
What Should be Avoided in Baby’s First Year?
According to our experts, there is no reason to hold back on letting your child try any type of food for fear of allergy. However, Dr Tan lists five foods that you may choose not to give your child if he or she is below the age of one. To be clear, the rationale for avoiding these foods has little to do with the potential for allergies.
Where honey is concerned, “there is a risk of contamination with Clostridium botulinum spores, and if ingested, can result in infant botulism – a life-threatening condition whereby babies become weak and constipated,” says Dr Tan. After the age of one, you may choose to give your child honey freely.
You may want to avoid feeding your baby things like sashimi. “Baby’s immunity is low when young and eating raw foods can increase the risk of contracting bacterial gut infections”, says Dr Tan. Your child will be able to handle raw foods better after he or she passes her 2nd birthday.
“Apart from the risk of contracting a Salmonella (bacteria) gut infection, the proteins in half boiled eggs also have a higher risk of causing allergic reactions compared to a fully boiled egg,” explains Dr Tan. After your child turns one, he or she will be able to handle a half-boiled egg better.
Fresh cow’s milk
According to Dr Tan, fresh cow’s milk is low in iron, which can cause iron deficiency anaemia if given to children under the age of one. “Also, there are a lot of proteins in cow’s milk which are harder to digest compared to breast milk and formula milk and hence this is not suitable for those below the age of one,” she says.
Dr Tham adds that the risk of iron deficiency is especially
high if fresh cow’s milk is being given as the sole source
of milk instead of formula or breast milk at that age.
While there is nothing nutritionally wrong with the nuts themselves, their size and shape make them a potential choking hazard. Dr Tan says, “As these nuts tend to be tiny, it is easy for children to accidentally breathe them in while handling them. This can result in the nuts causing a major block in the airways resulting in severe breathing difficulties. A safer way of introducing nuts can be through nut spreads like peanut butter for example.”
Infants at Highest Risk
As with many health conditions, some babies are at higher risk than others of developing an allergy. “Infants with a sibling or at least one biological parent who has allergic conditions such as allergic rhinitis, eczema or asthma are at higher risk,” says Dr Tan.
Dr Tham adds, “Children with severe eczema should thus be referred to a paediatrician specialising in allergy to be evaluated for possible food allergies such as to egg and peanut. He or she will take a full history and examine the child, may perform tests such as skin prick tests or blood tests, may offer a food challenge to diagnose if the child has food allergies, and give advice on the appropriate timing of introduction of these foods.”
Breastfeeding May Help Prevent Allergies!
If you’re wondering if there’s anything you can do to minimize your child’s risk of developing an allergy, try breastfeeding!
“Studies have shown that breast milk contains many antibodies and immune cells which strengthens the baby’s immune system and coats the baby’s gut with beneficial microbes, which protects the baby against developing allergic responses to foods. Breast milk is also least likely to trigger an allergic reaction compared to cow’s milk or soy formulas and has myriad other health benefits to both mother and baby. The World Health Organization thus recommends that mothers should breastfeed their babies for up to two years or beyond”, says Dr Tham.