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Testing food allergies early in children

Food allergies can cause strain for both parents and children. It can create a sense of unease around every meal if there are exposures to food allergies in new places like restaurants, friend’s houses and even schools. As many as 1 in 13 children are affected by food allergies, and that number is growing. Studies have shown that, for at least some children, early introduction of food can help children to avoid the development of food allergies, whereas avoidance of allergenic foods can potentially increase the risk of development of food allergies. Here’s what introducing those foods can look like.

When to start

"Early" introduction can sound vague, but it really means introduce foods as soon as babies are able to tolerate "solid" foods, even baby purees, which can be anywhere from 4 to 6 months old. In general, early introduction is prior to 11 months of age.

If children are over this age, it is still important to introduce foods rather than avoiding them, even if the early introduction period has passed. If after this period, you can discuss food introduction with your pediatrician to ensure your child would not be at higher risk to develop a food allergy.

How to introduce foods

When deciding how to introduce potentially allergenic foods, there are a few considered to be the most common allergens; however, it is possible to be allergic to other foods. Most common allergens include:

  • milk
  • egg
  • peanuts
  • tree nuts
  • wheat
  • soy
  • fish
  • shellfish

The goal with food introduction is to introduce one food at a time, spread apart by 3 days. Generally, you start with a very small amount, even a lick, and give progressively more of the food every 15 minutes or so until a serving is reached, or your baby becomes full.

We recommend starting this in the morning (not just before a nap), when the baby is with a parent or guardian and we recommend the introduction of only 1 food for 3 days. After the introduction of each food, it is important to keep it in a regular rotation in the child's diet, so the child will hopefully remain tolerant of the food.

What to look for

After testing the food, there are a few signs and symptoms to watch for. These include mild symptoms like hives, itching of the tongue or lips, sudden runny nose or mild nausea or gut discomfort.

It can also appear with severe symptoms like widespread hives or redness, rash, itching, swelling of the tongue or lips, trouble breathing or swallowing, drooling, vomiting, turning blue, coughing, difficulty breathing, wheezing or loss of consciousness.

These symptoms can appear within minutes and up to 2 hours. If symptoms are severe, or there is more than 1 mild symptom, call 9-1-1. If symptoms are mild, discuss with your pediatrician.

Treating food allergies

Avoiding the allergen is the primary treatment for food allergies. There are also available oral immunotherapy options available for some food allergies.

Whether you notice a sign or not, it’s a good conversation to have with your pediatrician, especially if it has not been brought up by the 6-month appointment. As a parent, it can be intimidating to try something new with your children, but it is important to remember that, by introducing foods early, you are trying to help your child avoid food allergies which have a significant impact on wellbeing and quality of life. If you do have concerns, however, address them at your well-child checkup so if any intervention is needed prior to introducing foods, your pediatrician can help get a specialist involved.

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Allergy/Immunology