When to Introduce Foods to Infants
For the prevention of allergies and asthma in children, expert bodies recommend exclusive breast feeding for the first 4-6 months followed by gradual introduction of solid foods. Historically, the recommendation was to delay the introduction of dairy until 1 year of age, eggs until 2 and peanuts and fish until the child turned 3. It has become clear that delayed introduction increases the risk for food allergy. This handout will provide you with our current understanding and recommendations.
IMPORTANT: These recommendations are not meant for children already showing signs of any allergic conditions (eczema, asthma) or with strong family history of allergies (particularly food allergies)
Breast Feeding
Exclusive breast-feeding for the first 4-6 months of age is recommended. While breastfeeding for at least 4 months has shown the most benefit in preventing eczema and improving the immune system, not every mom is able to breastfeed their baby. There are studies that show a partially hydrolyzed milk-based formula such as Nestle Good Start has some protective effect on the development of eczema.
There is some data that shows total duration of breast feeding for 9-12 months has a positive effect on the development of asthma.
When to introduce Grains?
New studies suggest that wheat, rye, oats, and barley cereals should be introduced between 5 and 5 1/2 months of age. This seems to show some benefit in reducing the risk for asthma and nasal allergies by 5 years of age without an increased risk for eczema.
When to introduce Peanut?
A recent landmark study showed introduction of peanut at 4-11 months of age to high risk children decreased the chance of developing peanut allergy by over 80%! All children were skin tested first and up to 20% were already sensitized/allergic so this needs to be approached with caution especially in children with eczema and any signs of food allergy.
When to introduce Egg?
Introducing egg between 8 and 11 months of age shows some benefit in reducing both allergic and nonallergic forms of asthma as well as nasal allergies and overall allergic sensitizations.
When to introduce Fish?
A recent study shows that introducing fish at 6-9 months of age decreases the chance of nasal allergies and overall allergic sensitizations by age 5.
When should I introduce other foods?
Provided there is no evidence of allergic conditions, after the above foods are introduced, dairy would be transitioned into the diet at approximately 9 months of age in the form of baked goods then gradually cheese or yogurt. All other foods may be introduced at or around 1 year of age.
What can an Allergist do to help?
We offer skin testing to all foods including a safe and rapid test for egg, milk, wheat, soy and peanut that is applied as a single ‘stamp’ on the back and offers results in 15 minutes. We are happy to assess your infant for food allergy and work with you to safely introduce the above foods and/or guide avoidance measures if needed.
Please note that ongoing research continues to answer more questions about allergies and asthma. The information in this handout is current as of February 2015. Make sure you stay up-to-date on new information by talking to your allergist.
This is a handout from the Asthma and Allergy Affiliates reviewing current data on introducing foods to infants. These handouts are intended for our patients and are not a substitute for discussing your (or your child’s) unique situation with one of our physicians.