Introducing food allergens when weaning
Paediatric allergies and weaning
In the past decade the guidance and advice around when to introduce allergens into an infant's diet has changed and varied causing health care professionals and parents confusion.
Fortunately over the past five years there has been increasing research in food allergies and weaning; focusing on the prevention of food allergies such as the LEAP and EAT studies. Data from both LEAP and Eat show that by introducing allergenic foods at the same time as other solid foods may in fact protect infants from a developing a food allergy.
What are the main allergies?
There are 14 main allergens listed below that are the most likely foods to trigger an allergic reaction across the whole of the UK population. By law these allergens have to be highlighted on an ingredients list on any pre-packaged foods you buy
These are:
Cow’s milk
Egg (egg without the red lion stamp should not be eaten raw or lightly cooked in infants)
Cereals containing gluten, including wheat, rye, barley & oats.
Tree nuts (crushed, ground or a butter for children under 5 years).
Peanut (crushed, ground or a butter for children under 5 years).
Sesame
Soya
Shellfish (not to be served raw or lightly cooked for infants)
Fish
Mustard
Celery
Sulphur dioxide
Lupin
Molluscs (not to be served raw or lightly cooked for infants)
First steps into solid foods
Can baby hold their head up and sit unsupported?
Does the baby have hand - eye coordination? Do they bring food to their mouth?
Can they move food from the front their mouth to the back of their mouth and swallow?
Once your baby is ready to wean, at around 6 months of age (and not before 4 months) parents can introduce complementary foods, usually as pureed. They should start by offering small amounts of vegetables, fruit, starchy foods, protein. Once they feel confident that baby is managing purees they should start to consider introducing allergens and the following below:
Ensure baby is well and not recovering from any sickness
Include foods associated with food allergies that are part of the family’s diet: this can include egg, foods containing peanut and tree nuts, pasteurised dairy foods, fish/seafood and wheat.
Introduce one allergen at a time
Consider offering food earlier in the day for example at breakfast or lunch to allow for time to monitor any signs or reaction,
Start with a small amount e.g ¼ teaspoons and slowly increasing over the next 2-3 days
Once foods containing allergens have been introduced it is important for parent to continue introducing those foods. Particularly egg and peanut aiming for 2-3 times week.
If the infant does have eczema, it is best to make sure their skin is in a good condition prior to introducing a new allergen. Consider maximising their eczema treatment and any emollients they may use.
If the infant dislikes the food reassure parents to be patient and try again another day.
Allergen Recommendations
Egg: Choose British Lion stamped eggs. Egg in raw form are more likely to cause an allergic reaction than in a baked food. Boiled egg could firstly be offered mashed into other cooked foods e.g vegetables or rice. As baby progresses this could be offered as a finger food as scrambled egg or an omelette, or pancake. Aim for one egg over the course of the week.
Peanut: Never give whole peanuts or chopped nuts Use finely grounded nuts or a smooth peanut butter, or “puffed peanut” snacks
Tree Nuts: Never give whole nuts or chopped nuts. Use finely grounded nuts or smooth nut butters e.g cashew butter, almond butter mixed with yoghurt, porridge or fruit
Cow’s Milk: Sugar free yoghurts or fromage frais, fresh whole milk added to meals e.g porridge, sauces, mashed potatoes.
Wheat: Weetabix or other cereals containing wheat, well cooked pasta, toast fingers
Seeds: Hummus mixed with tahini (sesame seeds), crushed seeds added to yoghurt or porridge or fruit.
Fish, seafood: Purred, flaked or mashed cooked fish (cooked haddock salmon or trout) or seafood (prawns, crab mussels)
Soya: Is found in many bread products and so does not need to be offered separately as a soya product.
I hope you found this blog useful and if you would like more information on paediatric allergies please book a consult.