Experts weigh in with advice every parent should know.
Is your baby at risk for developing a food allergy? It’s a question that concerns many new and expectant parents as food allergies are becoming more common.
The Centers for Disease Control and Prevention reports that 4 to 6 percent of all children in the United States have a food allergy, which is when the body has an adverse immune response to specific foods. (Think of it as your body tricking itself into believing normally harmless food is trying to hurt you, and promptly defending against it.)
While allergic reactions are typically mild, there’s reason for parents to be worried, as some reactions can be severe and life-threatening.
There are 8 common foods that account for 90 percent of serious allergic reactions: cow’s milk, peanuts, shellfish, eggs, wheat, tree nuts, soy, and fish.
Kids with food allergies are two to four times more likely to develop asthma or other allergic conditions, the CDC says.
Allergies can’t be cured, but doctors say there’s a way they can be avoided.
Exposing babies (who are at risk for developing common food allergies) to allergenic foods at an early age could help sidestep parental concerns, especially down the line when their kids have to navigate the food options at the school lunch table.
Dr. Brian Schroer, pediatric allergist at Cleveland Clinic, told Healthline that the best age for parents to start introducing their baby to allergenic foods varies from child to child.
“When it comes to recommendations for introducing your baby to allergenic foods, it should be based on individual preferences from you and your family physician,” Schroer said.
In 2017, the National Institutes of Health announced recommendations for the best times to introduce peanut-containing food to infants in order to prevent an allergy. They suggested that infants who seem at high risk for developing the allergy (those who have severe eczema, a common itchy skin rash that can show up as an allergic reaction commonly in early childhood), an egg allergy, or both, should have peanuts introduced as early as 4- to 6-months old.
The NIH also recommended that babies with mild or moderate eczema have peanuts incorporated into their diets at around 6 months, while those who show no allergy risk can have peanuts introduced to their diets at any time.
However, this points only directly to peanut allergies.
What about the others? Schroer said that most of the research out there has zeroed in on peanuts versus other common food allergies.
“There really are no specific recommendations for when to introduce egg or milk, for instance,” he explained. “Studies do show that early introduction of eggs can delay or prevent egg allergies. Some studies also suggest the early introduction of milk may prevent allergies to milk.”
He said that while the research and government guidelines for the other seven common allergies aren’t as prevalent as they are for peanuts, the peanut guidelines can be a common template that parents can use with their family pediatrician and allergist to expose babies at risk for allergies to allergenic foods.
“Unfortunately, there are not-as-strong evidence-based studies on the other allergies as there are for peanuts,” Schroer said.
Why is this the case? He said part of it could be due to the fact that it’s difficult to get parents to enroll their children in randomized studies.
“Are you going to say ‘let me sign up my baby for a randomized study and he or she may be randomly put into one group where they are analyzed for being high risk, and then this other kid will be put into another group?’ Most parents will hear that and say ‘no way!'” he said.
“In my clinic, I do recommend that people introduce other high-risk foods beyond peanuts, where there are no clear guidelines. Always ask your physician and evaluate on a case-by-case basis based on your child.”
Dr. Purvi Parikh, pediatric allergist at NYU Langone Health, echoes that advice. She told Healthline that “it is important that babies have an evaluation by an allergist. Allergist testing is important.”
She said that while a person’s immune system is “very nimble” throughout life, it’s just developing in infancy. This means that a baby relies on his or her mother’s immune system to defend against germs in the first few months of life, which is the best time to figure out if there is a possible food allergy.
“This period kind of dictates what will happen throughout the rest of life. We recommend introducing these foods earlier in life, because we find that if we wait too long, sometimes it can be detrimental and lead to higher rates of allergies as that child gets older,” Parikh said.
Parikh said that many factors account for why a child might develop a specific food allergy.
“In highly industrialized, Western cultures, as a society, we have become too clean, and too processed. The immune system is sometimes not getting exposed to the good bacteria that the body needs,” she said. “We counsel parents that they don’t need to use sanitizer on everything, for example. It doesn’t have to be overly clean, and in fact, could do harm to a child by not exposing them to good bacteria that is out there.”
She pointed out that processed foods and junk foods are linked to the greater presence of allergies and asthma as well.
What about women who are expecting? Are there any foods they should avoid if they’re worried about their kids developing a future allergy?
“Pregnant women should not avoid any food that is out there to prevent their baby from getting an allergy. Eat peanuts during pregnancy if you want to eat peanuts. Eating peanuts while pregnant will have nothing to do with your son or daughter becoming allergic,” Schroer stressed.
Parikh agreed, adding that there are “old school myths” that pregnant women need to avoid certain potentially allergenic foods before birth.
However, Schroer advises caution for expectant parents who have another child at home with a food allergy.
“If you are eating the food in your home, that food is there. I think a more important point to make to parents is to know that the food is not only on your dinner plate, but can be found on your carpet or in your bedding or in your couches. Be careful and vigilant about what is in your home if you have a child who is allergic to a certain type of food.”
One study published this year in the Journal of Allergy and Clinical Immunology: In Practice looked at the impact parents’ behaviors could have on their kids who have allergies.
The researchers out of the Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai in New York studied 100 parents of children between the ages of 6 months and 18 years. These children had all been diagnosed with food allergies.
The researchers found a link between the parents’ risky behaviors and their kids having an allergic reaction, with 72 percent of the children in the survey experiencing at least one allergic reaction, and 38 percent experienced 3 or more over the survey year.
Parikh also pointed out that there has been research on C-sections potentially putting children at risk for allergies. A child who is born through the birth canal is exposed to the naturally occurring, protective flora that is in the mother’s body. Children who don’t experience this are born directly into the more sterile environment of a hospital room and not exposed more directly to allergens.
“I want to emphasize that this shouldn’t be a deterrent to women who need to have a C-section. This is more a concern for those who have elective C-sections,” she added.
Parikh said the biggest thing all parents should be able to recognize are the “emergency signs.”
“They should know the signs of an allergic reaction. Their baby might not be tolerating a certain food, and that might show itself in a rash. It could be hives or eczema. It could be flushing skin or scratching on the skin. That combined with other symptoms could be signs of a more serious reaction,” she cautioned. “If a child starts vomiting along with a rash, or starts coughing and showing breathing problems, or starts not acting like themselves within an hour of eating the food, seek out medical treatment.”
Schroer also stressed that people should always consult their physicians about when to introduce their babies to allergenic foods, and not consult people who comment on social media forums.
He said, while there can be helpful information from medical professionals online, there are a lot of people who spread false or misleading information.
Schroer also pointed out that just because one child has an allergy, doesn’t mean his or her siblings are at greater risk.
“If your 3-year-old has a peanut allergy, will his baby sister have a peanut allergy? Is she at higher risk? Well, if the other child does not have eczema or another food allergy, and she is showing no other signs, then she is not considered higher risk than the general population,” he said.
“My older son is milk-allergic, he’s 8. My 5-year-old would kill me in my sleep if I took away his cheese sticks,” Schroer joked. “He is not at a higher risk because his brother has the allergy.”