Food Allergy in Infants – A Challenge in Child Care
Food allergies in babies are caused by an overactive immune system
The immune system protects our body from harmful substances. However, sometimes our immune system can identify harmless substances such as certain foods as potential troublemakers and attack them. This is called a hypersensitivity reaction of the immune system, which causes an allergy.
Babies with a strong history of allergies, asthma, eczema and other allergic conditions in the family are more likely to develop food allergies.
When do food allergies develop in babies?
Parents with any type of allergy in the family should be alert about any unusual symptoms that the baby is likely to develop allergies at the time of introducing new foods into the baby’s diet. Food allergies in infants develop mainly during the weaning period, around 4 to 6 months of age.
Some babies may also show allergic reactions to breast milk. This is because proteins in foods consumed by the mother are secreted into breast milk and cause allergies in breastfed babies. Atopic dermatitis or eczema is a common form of skin allergy present in breastfed infants. It presents with red, itchy and dry skin on cheeks, hands, feet etc.
Common Food Allergies in Babies
Foods that commonly trigger food allergies in infants include cow’s milk, egg, soy, shellfish, wheat, and peanuts.
There are two types of food allergies: an immediate allergic reaction (IgE mediated) and a delayed reaction (non-IgE mediated). Immediate allergic reactions occur within minutes of consuming the food. Delayed food allergies in infants occur 2 to 4 hours after consumption of the allergenic foods. In some cases, both immediate and delayed reactions occur at the same time.
Symptoms of a food allergy in infants vary from mild to severe in intensity.
Mild symptoms include the following:
Urticaria or hives, which include red spots or rashes with itching in specific areas or all over the body
itching inside the mouth, throat, or eyes
nose twitching
Serious symptoms (anaphylaxis) include the following:
1. Swelling of lips, face or tongue
2. Wheezing (whistling sound produced during the passage of air through tight airways while breathing). The cough is usually accompanied by wheezing.
3. breathing problem
4. Diarrhea
5. Vomit
A child with severe allergy symptoms needs emergency medical attention.
The symptoms of a delayed-onset allergic reaction are not life-threatening and are not very severe in intensity. These include the following:
1. Itchy skin with redness around the mouth.
2. Abdominal colic or cramps.
3. Loose stools with mucus or blood.
4. Running nose.
5. Wet eyes.
6. Cough with wheezing.
Allergy vs Intolerance
It is important to find out whether the baby has an allergy or intolerance after consuming a food. Food allergy (or allergy in general) is an immune system-mediated response, whereas food intolerance does not involve the immune system.
Symptoms of food intolerance in babies are feeling bloated with gases in the stomach, diarrhea, vomiting, stomach pain, etc.
How to Prevent Food Allergies in Babies
In 2008, the American Academy of Pediatrics (AAP) released new guidelines for the management of food allergies in child care.
- Infants should be exclusively breastfed until a minimum of 6 months of age. Only formula milk should be started in case of the development of food allergies in breastfed infants.
- The introduction of solid foods into a baby’s diet should begin around 4 to 6 months.
- Foods that are commonly seen to cause allergies should be introduced as complementary foods along with other foods at 4 to 6 months of age.
- Solid foods should be introduced one after another to observe if they are tolerated by the baby.
- Foods known to cause allergies (cow’s milk, egg, peanuts, soy wheat, etc.) should be introduced among well-tolerated foods. Once the child tolerates the allergy caused by the food, it should be gradually increased in quantity and frequency. Furthermore, allergy-causing foods should be introduced to the baby at regular intervals so that he can maintain exposure to the allergens in the food and develop immunity.
- Foods that are likely to cause allergies should be introduced to the baby better for the first time when he is not at home and not in a restaurant.
- Delaying baby food items until 1 to 3 years of age does not contribute to preventing food allergies in high-risk infants. In fact, it increases the risk of developing that specific food allergy.
- There is no research-based evidence to suggest that avoiding allergy-causing foods during pregnancy and breastfeeding prevents food allergies in the baby. Avoiding foods high in nutrients during pregnancy and breastfeeding can compromise the baby’s health and nutrition.
- The exception to these guidelines is peanut allergy. Pregnant women with evidence of peanut allergy in the family or a previous child should avoid peanuts during pregnancy. Alternatively, the baby can be tested for peanut allergy at 4 months of age.