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FAQs

Allergies

GF FAQ Allergies Image

Is there such a thing as waiting too long to introduce solids?

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Yes, there are a number of reasons why delaying the introduction for too long can be potentially disadvantageous. 

  • Smaller window of opportunity to create healthy eating preferences It is well known there is a window of opportunity [5] between 5 and 7 months, whereby babies are very accepting and receptive to new flavors and experiences. [9, 42, 45] 
  • Nutrient deficiencies By 6 to 7 months babies start to need extra nutrients [14] in order to optimize growth and development.[72] These extra nutrients can no longer be sustained by milk alone and so must be provided by the solid foods he eats. It is therefore important that, by 7 to 8 months, babies have established the ability to accept a wide variety of nutrient-dense [23] solid foods. 
  • Increased risk of allergies The late introduction of solids (7+ months) may actually increase the risk of food allergies. Mounting evidence has suggested that the earlier the exposure, within guidelines, [45] the decreased risk of development of allergies. 
  • Delayed motor development Learning to chew, through exposure to a wide variety of textures, [42] is a developmental milestone that all babies must learn in order to learn to eat. These motor skills are also important for the development of speech. Delaying the development of these motor skills, much beyond 7 months, can therefore incur future developmental delays.[66]
  • Food fussiness Missing the window of opportunity [5] to develop healthy eating preferences can increase the chances of food pickiness.[14, 43, 66]

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Are there foods that aren’t safe to give baby?

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Apart from the obvious ones of sugar and salt, there are a number of other food products you should avoid in the first year of life. [75] These include:

  • Honey due to the risk of botulism
  • Fennel due to unknown levels of estragole, a naturally occurring carcinogen
  • Rice drinks due to risk of exposure to arsenic, a first-level carcinogen
  • Fruit juice [52]

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What if baby chokes?

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This is the number-one fear for all parents when starting babies on solids. The truth is, choking is not as common as you may think, especially if you take precautions to prevent it [41]. What is more common is gagging. [56] It can be no less frightening for parents, however, it is important to know what the difference is and a plan of action if required. [56]

Signs of gagging include:

  • Noisy cough and splutter
  • Eyes may water
  • May push their tongue forward or out of their mouth
  • May make a retching sound
  • May vomit
  • Generally not too fazed

Gagging is normal. In young infants the gag reflex is very prominent. This natural automatic response is actually a protection mechanism to prevent choking. This strong tongue-thrust reflex, when food stimulates the back of the mouth, is why you should wait until at least 4 to 5 months before introducing solids. Even still, this can make those early feeding sessions quite difficult (and messy!) until he gets used to moving food to the back of the throat. As he gets older, this sensitivity in the back of the mouth will slowly diminish and he will be able to manage larger and more complex texture more independently. 

It is important we don’t intervene when he is gagging as this can actually interrupt his ability to cough/gag food back up and may even cause food to dislodge further down into his airway. Rather, offer praise and support and don’t show any anxiety or fear. Remember, we want to foster a good relationship with food and mealtimes. Showing our own anxieties unnecessarily can be detrimental in overly sensitive children. 

Signs of choking include:

  • Trouble breathing
  • Cough or gasp as they try to draw a breath in
  • Look scared 
  • Unable to make a sound
  • May start to go blue in the face
  • If no action is taken to dislodge the object he may go limp and/or unconscious

Choking, on the other hand, is a lot more serious and it is important we all know what to do if it does happen, before it happens. Choking happens when something is stuck in the back of the throat and he is unable to cough/gag it back out. As it can obstruct the airway and stop the ability to breath, it can be life threatening. It is therefore strongly recommended that caregivers are skilled in knowing what to do in the unlikely event of a choking episode. [56] 

  • If you can see the item that is stuck, try and remove it. If you can’t see anything, or can’t easily remove it, do not repeatedly poke your fingers into his mouth as you can accidentally push the object further in.
  • If he starts to cough loudly, leave him to it as this may be enough to dislodge the object.
  • If this is not helping, or he starts to go silent (but still conscious), try back blows. Sit down, lay him face down on your thighs, supporting his head with your hand. Try and get his head lower than his bottom. With the heel of your other hand, give 5 sharp back blows between the shoulder blades, checking him in between each.
  • If this has dislodged the object, turn him over and lay him face up across your thighs, supporting his head with your hand and his head slightly lower than his tummy.
  • Place two fingers on his breastbone and apply 5 sharp chest thrusts, assessing him in between each.
  • Repeat if this has been unsuccessful but only if he is still conscious.
  • If he falls unconscious immediately call for help and commence CPR. [57]

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How do you avoid choking?

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  • Always ensure he is sitting up right at a 90-degree angle, and never in a recline position (stroller, couch, leaning back when sitting on your lap).
  • Always supervise him when he is eating, preferably in front of him so you can watch his face.
  • Beware of foods that can be choking hazards. These include grapes, peas, chickpeas, cut-up apple, cherries, whole nuts and seeds, popcorn, hard vegetables, chunks of peanut butter, large pieces of meat. 
  • Cut up problematic foods (e.g. grapes, peas, cherries) and ensure all food offered as finger food is smooshable. That is, if you were to place it between your thumb and forefinger you can easily squash it.
  • Ensure you/they do not put too much food in at once. Watch for the chipmunk! Some babies are masters at storing food in their cheeks! 
  • Know the difference between choking and gagging. [56]

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What are the most common food allergies?

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There are many foods that can stimulate an allergic response. The most common are:

  • Peanuts
  • Egg
  • Fish
  • Tree nuts
  • Shellfish
  • Soy
  • Milk
  • Wheat

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When and how is it safe to introduce potentially allergenic foods?

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Although it can feel daunting to introduce potentially allergenic foods, research now shows us that leaving it for too long can actually exacerbate the problem. Evidence affirms that the early introduction of potential allergens, even in high-risk infants, can actually help protect against the development of an allergy [1]. In light of this, most guidelines around the world advise to introduce all potential allergens in the first year of life, but not before 4 months. [34, 36, 37, 55, 77]

However, if someone in your baby’s immediate family (mother, father, sibling) is known to have a severe allergy to any of the food groups, please consult with your pediatrician first.

The American Academy of Pediatrics (AAP) New Guidelines for Infant Food Allergy Prevention

What Families Need to Know 

  1. The AAP guidelines recommend early “purposeful” introduction of allergens to help reduce your baby’s food allergy risk. 
  2. Introduce foods like peanut, egg, and milk when baby is 4 to 11 months old, regardless of baby’s risk for food allergies. 
  3. Families with infants at high risk for peanut allergies (due to family allergy history and/or severe eczema) should introduce peanuts into their baby’s diet at 4 to 6 months. 
  4. Breastfeeding alone is not enough to prevent food allergies, although it may help prevent eczema. 
  5. Feeding your baby hydrolyzed formula will not reduce your baby’s food allergy risk.

How to Introduce Allergenic Foods

  • Only introduce one new ‘allergenic food’ at a time so that if a reaction does occur, the problem food can be more easily identified. 
  • Try the food at a convenient time, earlier in the day if possible (in case there is an allergic reaction).
  • Ensure the child is otherwise well.  

Peanuts
Rub a small amount of smooth peanut butter (a good-quality peanut butter without added salt or sugar) on the inside of the infant’s lip (not on their skin). 

  • If there is no allergic reaction after a few minutes, increase to 1⁄4 teaspoon and observe for 30 minutes. 
  • If there is no allergic reaction, give 1⁄2 teaspoon and observe for a further 2 hours. If there is going to be an allergic reaction it will occur with 2 hours of exposure. If there is no allergic reaction, parents should continue to include peanuts in their infant’s diet in gradually increasing amounts at least weekly. Regular exposure helps to build immunity and decrease chances of allergies.
  • If there is an allergic reaction at any step, stop feeding peanuts to the infant and seek medical advice.

Egg
Repeat the steps above but with well-cooked egg. You can mix a small amount (1⁄4 teaspoon) of mashed hard-boiled egg with a liquid such as breast milk or formula, or into the baby’s usual food (such as vegetable puree). There is no need to separate the white and yolk.

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What does an allergic reaction look like?

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In general, if there is going to be an allergic reaction to a certain food, it will most likely occur when he is eating, or shortly after. Very occasionally it doesn’t show up for several hours so it is important to keep a close eye on him for potential signs, especially when introducing the common allergens. It is always a good idea to have a chat with your health professional before you introduce the most common allergens (peanuts, egg, fish, dairy). They may advise to have some medication on hand in case it is required.

Signs of a mild to moderate allergic reaction

  • Swelling of lips, face, eyes
  • Hives (reddish, swollen, itchy areas on the skin)
  • Eczema flare (a persistent dry, itchy rash)
  • Tingling mouth
  • Redness of the skin, particularly around the mouth or eyes
  • Itchy mouth or ear canal
  • Odd taste in mouth
  • Nasal congestion, runny nose, sneezing, cough
  • Abdominal pain, vomiting, distress
  • Diarrhea

Signs of severe allergic reaction (anaphylaxis)

  • Difficult/noisy breathing
  • Swelling of the tongue
  • Swelling/tightness in the throat
  • Wheeze/cough
  • Pale and floppy
  • Loss of consciousness

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Can an allergic reaction happen after subsequent exposures to a food baby has previously had no reaction to?

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Yes. Allergic reactions do not always occur on the first exposure to the new food. Monitor him if it is a common allergen (e.g. peanuts, egg, dairy) for at least 6 exposures. Once introduced, it is a good idea to keep exposing him to that food on a regular basis (once a week is good) as this helps to build up his immune system to that particular food.

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What is the difference between a food allergy and a food intolerance?

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A food allergy stimulates an immune response and can result in these symptoms [46] within 2 hours of exposure. A food intolerance, on the other hand , results in a range of mainly digestive symptoms, including abdominal bloating, wind, diarrhea, nausea, and indigestion. However, a food intolerance can also result in eczema flare-ups and/or asthma. Sometimes these symptoms can mimic other medical conditions and it’s advised you follow up with your pediatrician. 

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My baby has reflux, are there any foods I shouldn’t give him?

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Generally, by 5 to 6 months reflux starts to improve as the gastrointestinal tract starts to mature. Sometimes, starting him on solids can actually help with reflux. However, to start off with you might want to avoid highly acidic foods such as citrus and tomato. Here are some more tips for a baby prone to reflux:

  • Always feed him in an upright position.
  • Do not lay him down directly after a feed.
  • Avoid dairy products, milk, cheese, and yogurt as well as high-acid foods.
  • Space out both solid and milk feeds.
  • Smaller more frequent feeds are better than fewer larger ones.
  • Offer single foods and wait a couple of days before introducing a new one. All babies react differently to different foods. You might find certain foods exacerbate his reflux so avoiding them, for the time being, can help. Remember to try again in a couple of weeks. As his gut matures he will most likely tolerate a wider range of foods. 

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Disclaimer: The information provided is the opinion of Good Feeding, it has not been evaluated by healthcare professionals, and is for educational purposes only.  Before starting any new foods or feeding practices, please consult your baby's healthcare professional.