All about introducing allergy foods to your baby

While weaning your baby is a milestone in their developmental journey, many parents worry about food allergies linked to introducing solids. Between four to six months of age, your baby should be started on solids foods gradually. Egg, dairy, peanut, tree nuts, fish, and shellfish should only be introduced after less allergenic foods have been tolerated.  Follow our expert advice about when and how to introduce your baby to specific foods.  

Sooner rather than later

Preliminary data from the South African Food Sensitisation and Food Allergy (SAFFA) study shows a true food allergy rate of 2.5% among one- to three-year-olds. This translates to 50 000 children with a food allergy in this age group alone. The study found that egg was the most common allergen, followed by peanuts, cow’s milk, and fish. Looking at this data, it’s understandable why parents are hesitant to include these foods in their children’s diets when starting solids. But, Leigh-Ann Silber, a dietician at the Ubuntu Family Health Centre, says research shows introducing allergenic foods sooner, rather than later, may protect against allergies. “You can start introducing allergy foods when you start introducing solids, or when your baby is six months old,” says Leigh-Ann. “Once introduced, continue to give these foods to your baby twice a week as part of a varied diet to maintain his tolerance for the food. Trying a food, and then not giving it regularly, may result in him developing a food allergy,” she says. “However, if there is a strong family history of food allergies, or if your little one is already showing signs of allergies, such as eczema, your baby will need to be assessed by a specialist before introducing allergenic solids,” write Meg and Kath in Weaning Sense. They say this is best done between four and five months of age, so allergy foods can still be introduced in a timely fashion after a careful assessment has been made.  

Did you know that most food allergies, particularly to milk, eggs, soy, and wheat, are usually outgrown within the first 10 years of life? In contrast, peanut, tree nut, fish, and shellfish allergies are often lifelong allergies, with only 20% of sufferers outgrowing peanut allergy, for example.  

Start with small quantities of allergy foods.

Leigh-Ann suggests introducing small quantities of well-cooked eggs and smooth peanut butter to start with. It’s best to do this for the breakfast or lunch meal so you can watch your baby to see whether he has an allergic reaction. Rub a small amount of the allergy food inside your baby’s lip. If there’s no allergic reaction after a few minutes, you can start giving him small amounts of the food as described below. Mix a quarter teaspoon of hard-boiled egg or peanut butter into your baby’s usual food (like vegetable purée or porridge). Gradually increase the amount by half a teaspoon at a time if your baby doesn’t have an allergic reaction.

Myth bust: Rubbing food on your baby’s skin won’t help to identify possible food allergies.

Know the signs of an allergic reaction

Allergic reactions usually occur quickly, while other reactions to food may be delayed. If you notice any swelling of the lips, eyes, or face, hives or welts, vomiting, or any change in your baby’s wellbeing soon after introducing a new food, he could be having an allergic reaction to that particular food. Stop feeding your baby immediately, and seek medical advice. Call an ambulance immediately if your baby has difficulty breathing, becomes pale and floppy, or if his tongue swells after eating. “Minor redness around your baby’s mouth is usually due to skin irritation and is not usually caused by an allergic reaction from food,” says Leigh-Ann.

A word on intolerance vs allergy

“Cow’s milk protein allergy and lactose intolerance are different. Lactose intolerance is more common, takes longer to develop, and can occur at any stage during your child’s life,” explains Leigh-Ann. She adds that with lactose intolerance, your child will exhibit symptoms between 30 minutes and two hours after ingesting milk or other sources of dairy. Symptoms may include:

• Stomach ache
• Gas and bloating
• Nausea
• Loose stools and/or diarrhoea.

Leigh-Ann says a milk allergy usually only refers to cow’s milk and includes other types of milk like soya. “Although milk allergy is most common in infants and children, it can develop at any age. Many children outgrow milk allergies by the age of five years.” A milk allergy can be triggered within minutes, or it can be hours before your child shows any symptoms of an allergic reaction. Symptoms include:

• Stomach pain
• Nausea
• Diarrhoea
• Skin rash
• Swelling of the lips or throat
• Trouble breathing.

“Lactose intolerance is typically distinguished from a milk allergy by its less severe symptoms and the child’s history of problems with dairy. However, doctors aren’t always able to immediately differentiate between the two,” explains Leigh-Ann. “Your doctor may ask you to keep a food diary for a while before reintroducing a certain food to your child. If in doubt, there are lab tests that can help diagnose a food allergy,” she concludes.