As you introduce new foods into your baby’s diet, you might find yourself worrying about your child experiencing allergic reactions. And that’s a valid concern, given that two million people in the UK are living with a food allergy, according to the Food Standards Agency.
The foods most likely to cause allergies in a baby’s first year are peanuts, eggs and cow’s milk. Experts now believe that babies exposed to these foods at an earlier stage have a lower risk of developing allergies to them later in life. The NHS recommends introducing foods such as peanut and egg from around 6 months.
Read on for common questions parents ask as they start introducing foods into their baby’s diet and for insights into food allergy signs and symptoms, steps to take in an emergency and where to go for support.
What is a true food allergy?
According to NHS Scotland, a food allergy is “when the body’s immune system reacts unusually to specific foods”. Food allergies can be further subdivided into IgE-mediated reactions (develop within 60 minutes) and non-IgE-mediated allergies (develop over hours or days). Food allergies, however, are not the same thing as having “food intolerance”, a problem digesting a particular food such as lactose. The difference can be confusing, but generally, what we’re most likely to think of when we think of a food allergy is an IgE-mediated reaction with the potential to be life-threatening.
How can you safely introduce common allergenic foods into your baby’s diet?
The NHS advises giving your child one new food at a time and in small amounts. Whole cow’s milk is not recommended before your baby’s first birthday. After introducing each new food, watch for any allergic reactions (more on what those might look like in a moment), and seek medical advice if they occur.
Parents should also exercise caution and seek guidance from a health care professional when introducing new foods to babies with eczema, an existing food allergy or a family history of food allergies, eczema, asthma or hay fever — as they are more likely to be allergic to certain foods.
What are common signs of food allergies in babies?
The data shows that most allergic reactions in infants are relatively mild and tend to involve the skin. In a 2018 study, researchers discovered that babies who do have allergic reactions tend to have:
- hives 94% of the time,
- stomach issues 89% of the time,
- vomiting 83% of the time and
- breathing difficulties 17% of the time.
It’s a good idea for parents to keep an eye out for subtler symptoms, too. Unexpected, unreasonable irritability or sudden changes in behaviour immediately after eating may be early indicators of an allergic reaction to food. Meanwhile, symptoms of IgE-mediated food allergies such as rashes, hives and itching tend to appear within a few minutes or up to two hours after eating.
While any food can potentially cause an allergic reaction, some allergies, such as to egg or milk, may go away over time, according to the NCT. Some allergies, like peanut and seafood allergies, however, are more persistent and can be lifelong. In many cases, genetics play a role in the immune system mistakenly identifying peanut proteins as something harmful.
How are baby food allergy symptoms treated?
If your baby’s symptoms are mild, a doctor may recommend treating them with an antihistamine; close monitoring may be necessary for more severe symptoms such as swelling in the mouth or throat, wheezing, cough, shortness of breath and difficult, noisy breathing. With such a small respiratory system, even a small amount of swelling can make it very difficult for a baby to breathe.
If you suspect your baby is having a serious food allergy reaction and is struggling to breathe, this is an emergency — you should call 999 immediately.
All A&E departments have protocols for how to treat potentially life-threatening allergic reactions or anaphylaxis. At any age, epinephrine, a hormone that reverses anaphylaxis by constricting blood vessels to increase blood pressure and opening airways to help with breathing, is generally the first line of defence.
How are babies officially diagnosed with a food allergy?
A child’s GP or specialist allergy doctor or nurse will decide on the best way to approach food allergy testing for babies. IgE-mediated food allergies are generally diagnosed by means of a skin prick or blood testing.
Another form of food allergy testing, considered the “gold standard” according to Allergy UK, is something known as an “oral food challenge”. This is where small amounts of a food are given to the patient in a medical setting, who is then closely observed by health care professionals for signs of an allergic reaction. These are often used to confirm a suspected food allergy where test results are unclear, or to determine whether an existing allergy has been outgrown.
What is a food allergy action plan?
A written food allergy action plan can help guide caregivers on when to use epinephrine versus an oral antihistamine. If a baby has a confirmed food allergy, this document (also known as an “anaphylaxis action plan”) may include details such as:
- Strict avoidance of the food or foods in question, not only at mealtimes or snack times but also during activities such as art projects or at playtime
- Instructions on how to manage a food allergy reaction
- Whom to notify in an emergency and/or call with questions or concerns
- Guidance on when to use emergency medications like oral antihistamines, auto-injectable epinephrine and inhalers (if prescribed)
Everyone who cares for a child should be trained in how to use their epinephrine auto-injector device, if they use one, and reminded to clean all plates, cutlery and surfaces they eat on before use.
Can a registered dietitian help with baby food allergies?
Registered dietitians can be helpful when you’re struggling with how or what to feed your baby. Your health visitor or GP may be able to refer to you to a registered dietitian to advise you on nutrition for children with food allergies. Allergy UK also offers a dietitian service.
In a recent study, mothers of children with food allergies reported higher levels of anxiety and poorer health compared to mothers of children without food allergies. Parents and caregivers with safety concerns may benefit from tailored nutrition support as a helpful guide.
The bottom line on signs of food allergies in babies
It’s best to attempt to prevent food allergies from developing in the first place with early introduction of peanut, egg and other foods at around 6 months. If you have any doubts or concerns about this approach, seek medical advice, but try not to delay introduction.
While the data shows that severe allergic reactions are uncommon in infants, all parents should know what to look for and should be prepared when introducing new foods. Seeking support from a trusted medical professional and exploring resources offered by organisations such as Allergy UK can provide invaluable help for parents navigating the world of food allergies.
