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Food Allergens for Infants - A Rough Guide

Amongst children aged up to two, the incidence of proven food allergies is only 5% and such reactions are generally mild.We previously looked at the types of food for parents to avoid giving infants and now follow up with a separate post about foods that are most likely to cause allergic reactions in the very young.

Some reactions towards food are also not true allergies, in the scientific sense. For those that are, it’s important to stress that severe allergic reactions (a.k.a. ‘Anaphylaxis’) in infants under one are rare. However such severe reactions should always be treated as a medical emergency. Even amongst children aged up to two, though, the incidence of proven food allergies is only 5% and such reactions are generally mild. Nonetheless, parents, carers and guardians of infants will naturally want to be cautious. Today’s post discusses the food types that most commonly cause allergic reactions and how they can be introduced to infants.

Severe allergic reactions (Anaphylaxis) in infants under one are rare, however such reactions should be treated as a medical emergency.

Symptoms to Look Out For

So, what are the symptoms of an allergic reaction? The NHS lists symptoms like sneezing, wheezing, coughing and a blocked or runny nose as possible signs of an allergic reaction. Itchy, red, watery eyes or a red, itchy rash are also possible signs, as are worsening symptoms of eczema or asthma.

The Most Common Food Allergens

According to the NHS, the 8 food types that are most likely to cause allergic reactions are:

Cows’ milkEggs
Gluten (found in wheat, barley, rye, oats etc.)Nuts including peanuts*
Seeds & seed derivatives*Soya
Shellfish*Fish

* We touched upon some of these ingredients in our A-Z Guide to Foods to Avoid Giving Infants but will mention the following again: seeds and nuts, including peanuts, should only be served to under-fives crushed, ground or as a ‘butter’ as they are otherwise a choking hazard; eggs should be avoided before the age of 6 months and thereafter never be served raw/lightly cooked except if they exhibit the Red Lion or “British Lion Quality” stamp; shellfish should also never be served to infants raw or lightly cooked.

Always read food labels carefully.

Eggs are one of the 8 food types that are most likely to cause allergic reactions, according to the NHS.Mustard, celery, the preservative/antioxidant sulphur dioxide, the legume lupin and molluscs are the next most common food allergens after those listed in the table above. Kiwi, the fruit, is also known to cause allergic reactions in some infants, however is apparently the only potential allergen out of those listed above that doesn’t have to be listed, by law, on the ingredients list of pre-packaged food products.

When to Start Watching Out for Allergens

The NHS recommends slowly introducing the food types above, usually from about the age of 6 months if they’re developmentally ready. This is the age when babies most commonly start the process of weaning i.e. moving – gradually – towards eating solids. Start only when the infant is well, including having a good skin condition, because eczema is a possible sign of an existing allergy. The NHS strongly recommends that you talk to a GP or health visitor before introducing new foods to infants who are already known to have an allergy diagnosis or family history of allergies, including eczema, asthma and hay fever.

Any ‘new’ food types, particularly known allergens from the list above, should be introduced to the infant only one at a time, preferably early in the day so that you have more time to monitor for any reactions. Accepted advice is to start only with a tiny initial amount and monitor for possible symptoms of an allergic reaction. When the introduction of peanuts was delayed to a later time in the child's development, the risk of developing an allergic reaction to them increased.Amounts can later be increased, bit by bit over the following days, if the infant is found to be tolerant. And, of course, a new food type can then be tried only once the previous one has ‘passed the test’. However, bear in mind that some allergic reactions are far from immediate. Known as non-IgE food allergies, their symptoms can take anywhere from 2 hours to 3 days to show. So, the message is to be very careful and methodical when it comes to introducing new foods to your infant.1

1: More detail about IgE (rapid) and non-IgE (delayed) allergy symptoms and other useful information about the introduction of potential allergens to infants can be read in a very good article by baby and child nutritionist Charlotte Stirling-Reed.

Once introduced and shown to be tolerated by the infant, the new foods should then remain a part of the child’s usual diet and be eaten regularly. This minimises the chances of the child developing an allergy to such food types later on. Interestingly, where the introduction of peanuts and hens’ eggs has been delayed to a later time in the child’s development, the risk of developing an allergic reaction to them has actually increased. So, the risks need to be carefully balanced.

Special Mention: Milk Conundrums

The NHS recommends “exclusive breastfeeding or First Infant Formula” milk for babies during their first six monthsThe NHS recommends “exclusive breastfeeding or First Infant Formula” milk for babies during their first six months (and, indeed, breastfeeding has many benefits). Breastfeeding is not always possible though, for one reason or another, which is where the mention of First Infant Formula comes in. However, with standard First Infant Formula Milk being based on cows’ milk, and cows’ milk being one of the food types that infants are most commonly allergic or intolerant to, a healthcare professional will need to be consulted in the event of a reaction. For those found to have Cows’ Milk Allergy (‘CMA’), alternatives like Hypoallergenic Formula Milk, Lactose-Free Formula Milk or even Soya Formula Milk may be suggested by the GP/healthcare professional. However, it’s important for such milk alternatives to be given only under professional medical supervision as there are important and specific considerations around each. We’ll explain more about those in a separate post in due course, where we’ll outline the different types of milk and formula for babies and infants. Watch this space for more details soon.

Another milk-related conundrum that nursing mothers may have is whether they should avoid potential allergens themselves in case it passes to the infant through breast milk. The NHS’s advice in this regard is succinct and straight forward:

“If you’re pregnant or breastfeeding, you do not need to avoid foods that can trigger allergic reactions (including peanuts), unless you’re allergic to them.” (NHS)

Please note: We hope guide is a useful starting point for parents/guardians who want to learn more about safely introducing little ones to new food types. However, it is a guide only and you should do your own research. Talk to your GP, health visitor or other healthcare professional if you need professional advice or guidance in regard to your child’s diet and any allergy- or health-related issues. Always check food labels and contact the emergency services urgently if your child exhibits signs of a severe allergic reaction.

Healthy Food at Leaps & Bounds Day Nursery, Edgbaston, Birmingham

Healthy snacks are included in the fees at Leaps & Bounds Day Nursery in Edgbaston/Birmingham.Meals at Leaps & Bounds Day Nursery are freshly made, using high quality, nutritious ingredients, which are prepared for us by award-winning early years caterers. Healthy snacks, meals and drinks are all included in our nursery fees, as appropriate. We cater for all dietary needs (e.g. vegan, vegetarian etc.) and, of course, are mindful — and hugely careful — about any allergies amongst the little ones. We also participate in the ‘Startwell’ programme, which encourages our children and families in the Birmingham area to eat healthy meals and to live healthy lifestyles.

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Leaps & Bounds nursery & pre-school is in Edgbaston, Birmingham B16, near Harborne, Ladywood, Bearwood & Smethwick

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Next Time

Today’s article focuses on food that may cause allergic reactions in infants. We subsequently follow up with a great guide to Seasonal Allergies in Under-Fives. Instead of being caused by food, seasonal allergies are caused by such things as pollen, dust, mould and pet dander at certain times of the year. Click the green link above to learn about symptoms, causes and ways to help children affected by such allergies.