As your child starts to eat table foods, you may be concerned about food allergies — and whether you can do anything to prevent them. Not all food allergies can be prevented, but there are things you can do to help.
In the past, some people believed that it was best to introduce foods that commonly cause allergies later, when the child was older. More recent studies show that it’s best to introduce these foods early — on the same schedule you introduce other foods. See the following text for guidelines, and read this handout for more details.
What are the signs of food allergies?
When a child has a food allergy, the body treats a particular food as though it’s harmful. As a result, the immune system releases chemicals to try to protect you. These chemicals trigger allergic reactions, which may include:
- Skin problems, such as itchy red bumps on the skin (hives), or itchy, dry rashes (eczema).
- Respiratory problems, such as runny or stuffy nose (hay fever), sneezing, coughing, asthma, or shortness of breath.
- Digestive problems, such as abdominal pain, nausea, vomiting, or diarrhea.
- In rare cases, Anaphylaxis (a sudden and serious reaction), which can cause breathing problems, drop in blood pressure, and loss of consciousness.
How do I know if my child is at risk?
Children have a greater risk for developing allergies if they have asthma, skin problems (such as eczema), or a parent or sibling with a documented allergic condition.
Children may have a lower risk for developing allergies as they build up immunity to the germs around them. You can help build children’s immunity by letting them be exposed to some germs. For example, keep your child’s hands clean, but don’t wash them with an anti-bacterial soap, which kills a broader range of germs.
Which foods cause allergies most often?
A child could be allergic to any food, but about 9 out of 10 allergies are caused by these foods:
- Cow’s milk
- Tree nuts (such as almonds, cashews, and walnuts)
- Fish (such as tuna or cod)
- Shellfish (such as shrimp, crab, and lobster)
Should I have my child tested?
Most children do not need to be tested for allergies. Your child’s doctor may recommend skin testing if your child has skin problems that are difficult to control or has a strong family history of allergies, or other symptoms.
Introducing table foods to your child
If possible, feed your child nothing but breast milk for the first four to six months. This can reduce the risk of skin problems (like eczema), asthma, and cow’s milk allergy in some children.
If this is not possible, regular infant formula is fine for most babies. If your child is at high risk for developing allergies, your doctor may recommend trying different types of formula. Talk to your doctor for ideas.
- Introduce table foods between ages four months and six months, if your child can hold up his or her head. (A child who doesn’t yet have good head control could choke on food more easily). There’s no evidence to show that waiting longer than 6 months helps. Research shows that for allergy prevention, it’s best to start early.
- Start with single-ingredient foods. First foods in the U.S. are usually:
- Rice cereal or oat cereal
- Yellow or orange vegetables, such as sweet potatoes, squash, and carrots
- Fruits, such as apples, pears, and bananas
- Green vegetables, such as peas and spinach
- Meats, such as chicken and beef
- Give the food every day for three to five days before starting a new food. This will let you see if your child has a reaction to the food.
Note: Acidic fruits and vegetables, such as berries, tomatoes, oranges, and grapefruit, and so on, sometimes cause rashes. In most cases, these are not allergies. They are short-term reactions to the juice.
Introducing foods that commonly cause allergies
- Don’t give your child regular cow’s milk for the first year. Give breast milk or formula instead. Giving only cow’s milk before 12 months does not cause allergies — but it could increase your child’s risk for anemia.
- Introduce a few other foods before starting with the foods that commonly cause allergies. Once your child has tried a few different foods, go ahead and start with these.
- Introduce foods that commonly cause allergies on the same schedule as other table foods. The risk of developing allergies is lower if these foods are introduced early.
- Give your child a first taste of the food at home. Don’t start one of these foods at day care or a restaurant. For some foods, such as peanuts, reactions usually occur in response to the first taste. If your child does not have a reaction after the first few tastes, you can give the food in increasing amounts and away from home.
- If your child does not have a reaction to the food, give that food every day for three to five days. If there is still no reaction, you can start another food.
What about the mother’s diet?
During pregnancy or breastfeeding, mothers don’t need to avoid the foods that commonly cause allergies foods. If the child shows signs of allergies shortly after birth, however, the doctor may recommend that the mother avoid certain foods.