Feeding your baby

• Breast milk is the best food for most babies.
• Try to breastfeed your baby for the first 6 months of life.
• Babies are ready to start solid food at about 5 or 6 months.

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Many parents are concerned about food allergies in their children. About 4 out of 100 children have a food allergy. For most children with a food allergy, the best thing to do is avoid the food that causes the allergic reaction.

What is a food allergy?
When a person has a food allergy, the body overreacts as if the food were harmful. The body fights the substance in the food that triggers the allergic reaction.

A person can be allergic to any food. Although some people are allergic to food additives (such as food dye and artificial sweeteners), natural foods cause the most food allergies. Almost all food allergies in children are caused by these foods:

• Cow's milk
• Eggs
• Peanuts
• Soy
• Wheat
• Nuts from trees (such as almonds, walnuts and cashews)
• Fish
• Shellfish (such as lobster, shrimp and crab)

Sometimes a child is allergic to more than one food.

What are the symptoms?
Here are common signs of an allergic reaction to food:

• Hives (itchy, red bumps on the skin)
• Swelling of the face, legs or arms
• Itchy skin
• Coughing
• Trouble breathing
• Wheezing
• Tightness in the throat
• Runny or stuffy nose
• Red rash around the mouth
• Diarrhea
• Pain in the belly
• Nausea or vomiting
• Fainting

Skin reactions are the most common signs of a food allergy. Sometimes people with food allergies develop long-term health problems. The most common asthma and eczema (itchy, scaly red skin).

Avoiding the food that causes the problem
If your child has a food allergy, she should avoid the food. Read food labels carefully. For instance, some foods that you don't expect contain peanuts or peanut oil. The label will tell you. At restaurants and at other people’s homes, ask if the dishes contain the food your child is allergic to.

Treatment
When children have food allergies, health care providers may recommend that they take certain medicines. Examples include inhalers and liquids or pills called "antihistamines."

Danger signs
Anaphylaxis is a serious allergic reaction. It can occur if a person has a severe food allergy.

Anaphylaxis comes on quickly and can be life threatening. The person has a hard time breathing. Her blood pressure may drop quickly, causing her to faint or go into shock. The person must be treated quickly.

Before anaphylaxis can occur, the person must have eaten the food that causes an allergic reaction at least once before. In other words, a child allergic to peanuts will not have anaphylaxis the first time he eats peanuts. But sometimes it's hard to know if a child has already eaten the food.

If your child has a severe food allergy, his health care provider may give you special "pens." If your child has an anaphylactic reaction, you can use a pen to quickly give him medicine. Baby sitters, child care workers, family members and others who spend a lot of time with your child will also need to know how to use the pens.

Do children outgrow food allergies?
Children usually outgrow allergies to cow's milk, eggs, soy and wheat. But they do not usually outgrow allergies to peanuts, tree nuts, fish and shellfish.

Can food allergies be prevented?
Medical research on prevention of food allergies is limited and incomplete. After reviewing a wide range of medical research, the American Academy of Pediatrics has made these recommendations about food allergies in children:

• Avoiding certain foods in pregnancy does not appear to prevent food allergies in children.
• We don't know for certain if breastfeeding can prevent or delay food allergies. For infants who have a parent, brother or sister with a food allergy, drinking only breast milk for at least four months may reduce the risk of allergy to cow's milk. Certain formulas that do not contain cow’s milk may also reduce the risk.
• Soy-based infant formula does not appear to prevent food allergy.
• Doctors recommend that most babies start eating solid foods between 4-6 months of age. Some people have thought that food allergies might be prevented if parents delayed giving their babies certain solid foods (for instance, fish, eggs, peanut butter). But current medical research does not support this idea.

Medical research about food allergies is continuing. If you have any questions about food and your baby, ask your child's health care provider.

October 2009