Serenity turns 11 months old tomorrow ~ only one more month and she can eat anything the rest of us can eat!
Oh wait… That was the rule. But then the recommendations changed. Five years ago.
In 2008, the American Academy of Pediatrics
(AAP) released a report
that indicates that they do not know if delaying allergenic foods (peanuts, milk, eggs, wheat, soy, strawberries, shellfish, etc) helps to prevent allergies
from developing in children.
“Although solid foods should not be introduced before 4 to 6 months of age, there is no current convincing evidence that delaying their introduction beyond this period has a significant protective effect on the development of atopic disease [allergies] regardless of whether infants are fed cow milk protein formula or human milk. This includes delaying the introduction of foods that are considered to be highly allergic, such as fish, eggs, and foods containing peanut protein.”
And in 2009, another study was released that indicates that Israeli babies who are routinely given peanut products under a year old are more than 10x less likely to develop peanut allergy than their Jewish counterparts in the UK who do not eat peanut products until after their first year of life.
“Until recently, dietary avoidance of peanut during pregnancy, breastfeeding, and early childhood was recommended in the United States. This article prompts us to question our practices and recommendations in terms of introduction of peanut into our children’s diet and how it may affect their propensity to develop [peanut allergy].”
released in 2009 indicates that delaying introduction of wheat in babies past 6 months of age may actually increase
the likelihood of developing a wheat or gluten allergy.
“Delaying exposure [to wheat] until after 6 months was associated with an increase risk of wheat allergy, not a protective effect.”
So why did our pediatrician tell us to delay these foods, in 2012 and 2013??
Simple. The results of these studies are inconclusive. While evidence suggests that delaying allergenic foods may not actually provide any additional protection against children developing allergies, further studies are needs in order to firmly rule out the possibility. Many health care professionals err on the side of caution, despite the fact that the AAP actually changed their recommendations as a result of these findings.
It is important to remember that not all recommendations for delaying certain foods stem from the risk of allergy.
Honey, for example, poses the risk of botulism in infants under one year of age. Citrus or acidic foods (lemon, tomato, etc) may cause digestive upset. Cows milk is difficult to digest for babies under a year old, and it also hinders the absorption of iron, which is critical to infant development. Grapes do not pose an allergy risk, but are a serious choking hazard. And while the recommendation is now to introduce peanut and nut products (like butters) between 6-12 months, these foods are still choking hazards (both in whole form, and as butters that can gum up a baby or child’s throat), and should be carefully supervised until at least age three.
Another extremely important thing to note is that the new recommendations are not intended for children and babies who already have an atopic disease (including asthma and eczema), or for “high risk” individuals (children who may not themselves have allergies, but who have a parent or sibling with an allergic condition)
. These children are at greater risk for developing allergies in general, and should therefor be more closely monitored, and perhaps have some allergenic foods delay. If your child falls into either of these categories, consult your pediatrician before acting on these new recommendations.
So what’s a parent to do? Do we introduce allergy foods right away, on the grounds that delaying them does not appear to actually help prevent allergies? Or do we err on the side of caution, and delay them anyway, but run the risk that we may actually do more harm than good by doing so? Every parent will have to choose the best course of action for their own family. As with anything, the most important thing you can do is consult the experts by keeping up to date with studies and research, consult a trusted medical professional (preferably your pediatrician or family doctor – if you don’t trust yours, it is probably time to find a new one), and trust your instincts. In the face of conflicting medical data, it is easy to become overwhelmed, and second guess everything. Remember, you know your child better than anyone else.
|Enjoying a chicken, mozzarella and avocado
sandwich with mayo and honey mustard. Yum!!
For us, the answer was pretty simple. We are already working hard to limit sugary and refined foods, eliminate processed and prepackaged foods, and eat as many whole foods as our budget will allow. In light of these new recommendations, and because neither of us have any food allergies, we decided to go ahead and introduce allergy foods now, instead of waiting another month for her to turn one. The only ones we have not yet given her are shellfish (we don’t eat it often, so the opportunity has not yet arisen), and peanut butter or nuts (I keep forgetting).
I am a little baffled by the fact that this information is five years old, and yet so many health professionals (including my own pediatrician) and child care resources (books, etc) still instruct parents to follow the old recommendations. I am also more than a little upset about it, since the same research indicates that by delaying these foods, we may actually be contributing to the development of allergies. At the very least, I would have hoped to see pediatricians and other resources letting parents know that the studies are inconclusive, giving them all of the facts, and allowing parents to decide for themselves which way to go. In the absence of conclusive results, parents should always be the final decision makers for their children’s health care options. And so far, that is not happening in this situation.
So, what do YOU think about all of this??
I was not compensated for writing this article. All opinions are my own, and may differ from the opinions of others. I am not a medical professional, and this information is not intended to be substituted for your own research and advice from medical professionals. Specific information provided in this post was gathered from the linked sources, and from various medical authorities such as private pediatricians, the AAP, the AAFP, and the WHO. Remember, always consult with your pediatrician regarding introducing solid foods to your baby and specifically discuss any foods that may pose allergy risks for your baby.