Introducing Solid Foods to Babies for Allergy Prevention

Key Points

Include Common Allergenic Foods

• Timing: Introduce by 12 months in an age-appropriate form.
• Examples: Well-cooked egg, smooth peanut butter, cow’s milk (dairy), tree nuts (e.g., cashew or almond paste), soy, sesame, wheat, fish, and other seafood.
• Evidence: Reduces the chance of developing food allergy in high-risk babies.

One Allergenic Food per Meal

• Purpose: To easily identify problem foods if allergic reactions occur.
• Method: Introduce one common allergenic food at a time.

Regular Introduction

• Frequency: Twice weekly for non-reactive foods.
• Importance: Prevents the development of food allergies by maintaining regular exposure.

Variety of Foods

• Nutrients: Ensure adequate intake of fat, protein, vitamins, and minerals (e.g., calcium, iron, zinc).
• Learning: Babies learn by watching their family eat, encouraging them to try different foods.

Texture for Development Stage

• Choking Prevention: Use smooth nut spreads and appropriate textures for your baby’s development stage.
• Examples: Smooth, lumpy, finger foods, and cut-up foods as appropriate.

Note on Allergy Development

• Awareness: Some babies may still develop food allergies despite following this advice.

Questions and Answers:

from https://www.allergy.org.au/patients/allergy-prevention/ascia-how-to-introduce-solid-foods-to-babies

Q1: Why Should Egg and Peanut Be Introduced by 12 Months of Age?

• Recommendation: All babies should be given common allergenic foods by 12 months, including egg and peanut, in age-appropriate forms (e.g., well-cooked egg, smooth peanut butter/paste).
• Inclusion: This applies to babies with eczema, another food allergy, or a family history of allergies.
• Concerns: Parents may worry about giving egg and peanut due to their allergenic potential.
• Regular Introduction: It is best to offer well-cooked egg and smooth peanut butter/paste regularly (twice weekly) before 12 months of age.
• Evidence: Delayed introduction of these foods increases the chance of developing food allergies.

Q2: How Should Egg and Peanut Be Introduced?

• Small Amounts: Start with small amounts of well-cooked egg and smooth peanut butter/paste.
• Monitoring: Introduce these foods during meals soon after waking to monitor for allergic reactions.
• Mixing: Mix a small amount (¼ teaspoon) of hard-boiled egg or peanut butter/paste into baby’s usual food (e.g., vegetable puree).
• Gradual Increase: If no allergic reactions occur, gradually increase the amount (e.g., ½ teaspoon next time).
• Lip Test: Rub a small amount inside the baby’s lip as a starting point; if no reaction occurs, continue with small amounts.
• Avoid Skin Tests: Do not smear or rub food on the baby’s skin as this does not help identify allergies and may increase allergy risk.

Q3: What Should You Do if Your Baby Has an Allergic Reaction?

• Signs of Reaction: Look for swelling of lips, eyes, face, hives, welts, vomiting, or changes in behavior (e.g., becoming very unsettled) after giving a new food.
• Immediate Action: Stop feeding the food and seek medical advice if an allergic reaction occurs.
• Severe Reaction (Anaphylaxis): Call an ambulance if there are signs of severe reaction such as:
  • Difficult/noisy breathing
  • Baby becomes pale and floppy
  • Tongue swelling
• Timing: Allergic reactions usually occur within minutes to two hours; other reactions may be delayed.
• Skin Irritation: Minor redness around the mouth is often due to skin irritation, not an allergic reaction.

Q4: What to do if baby already has food allergies?

• Medical Advice: Ensure accurate diagnosis and follow an ASCIA Action Plan.
• Dietitian Consultation: For cow’s milk, wheat, or multiple food allergies to maintain nutrition.
• Tolerance Testing: Continue giving baked forms of cow’s milk or egg if tolerated.
• Nutritional Replacement: Replace allergenic foods with nutritionally similar options.

Q5: What if other family members have food allergies?

• Introduce Allergens: Still introduce allergenic foods to your baby if possible.
• Safety Measures: Use high chairs, wash hands and face, use separate utensils, and consider timing when allergic family members are not home.
• Consultation: Discuss with a dietitian or allergy support organizations.

Q6: How to know if baby is ready for solid foods?

• Signs of Readiness: Good head/neck control, interest in food, reaching for food, opening mouth for a spoon.
• Timing: Start around six months, not before four months.
• Breastfeeding Benefits: Exclusive breastfeeding for the first 3-4 months reduces allergy and eczema risk.

Q7: How to introduce solid foods?

• Patience: Learning to eat takes time.
• Family Meals: Encourage by offering the same foods as the family.
• Texture Progression: Smooth foods from six months, lumpy/finger foods by eight to nine months, cut up foods by 12 months.
• Persistence: Reintroduce foods if initially rejected.

Q8: Order of introducing solid foods?

• Iron-Rich Foods: Include iron-rich foods around six months.
• One Allergen at a Time: Introduce one common allergenic food per meal.
• Regular Exposure: Continue giving non-reactive foods regularly.

Q9: Importance of a variety of foods?

• Nutrient Intake: Ensure adequate intake of essential nutrients.
• Regular Introduction: Regularly give introduced foods for a varied diet by 12 months.
• Food Groups: Cereal foods, dairy, meat/alternatives, vegetables, and fruits.

Q10: Preventing choking on hard pieces of food?

• Avoid Hard Pieces: Do not give raw apple, carrot, or whole nuts.
• Prepare Safely: Grate, cook, puree, or mash hard foods.
• Suitable Finger Foods: Use steamed vegetables, soft fruits, bread, and crackers.
• Supervision: Always supervise eating.

Q11: Drinks for your baby?

• Primary Drinks: Continue with breast milk or formula.
• Introduce Water: From eight months, offer water in a cup.
• Gradual Transition: Transition to solid foods without replacing milk feeds too quickly.