Preventing Baby Food Allergies: Common Mistakes You Should Avoid!




I have a question for everyone: if the eldest child in the family was allergic to eggs when they were little, and the second child is about to start on complementary food, how can we reduce the risk of the second child being allergic to eggs?


Here are some common practices:


Postpone adding eggs, for example, add egg yolk at 8 months, and egg white after 1 year old;


Before adding, first rub the egg on the skin to see if there is any reaction. If there is redness or rash on the skin, it indicates allergy and should not be added;


Before adding, do an allergen test for egg white to see if the baby is allergic.


All three practices have perfectly stepped into the minefield, especially the first two, which actually increase the risk of the second child being allergic to eggs. Why is that? The truth is as follows.




Truth One: Foods that are prone to allergies should be added in time


Regarding the prevention strategies for food allergies, the medical community has gone through five periods, and the recommendations have changed greatly. However, many doctors and parents are still stuck in the concepts of more than twenty years ago.


1. Before 1990


For foods that are prone to allergies, it is not only recommended to delay the addition for babies, but also to restrict pregnant women and nursing mothers.


2. 1990-2000


During this period, the diet of pregnant women and nursing mothers was no longer restricted, but it was still recommended to delay the addition of foods that are prone to allergies for babies.


3. 2000-2010


The strategy began to relax, suggesting that the decision to delay the addition of foods prone to allergies should be based on the baby’s allergy risk.


4. 2010-2015


Correction began, suggesting that introducing foods prone to allergies in a timely manner may have a protective effect, but no clear cause-and-effect relationship was established.


5. 2015 to present


The milestone LEAP (Learning Early About Peanut Allergy) study found that the risk of peanut allergy in infants who were introduced to peanuts early was reduced by 80% at the age of 5.


In addition to peanuts, evidence for the early introduction of other foods prone to allergies, such as fish, eggs, shrimp, soy, wheat, nuts, and crustaceans, is accumulating. Although the evidence is not as sufficient and significant as that for peanuts, many national guidelines have already begun to recommend the early introduction of such foods – starting at 6 months of age, not earlier than 4 months.


Therefore, if the eldest child was allergic to eggs when they were little, the second child should add eggs when starting complementary food at 6 months old.


Try egg yolk and egg white separately, observe if there is any allergic reaction. If there is a suspected allergic reaction, consult a pediatric allergy doctor to confirm. If it is determined that there is an egg allergy, do not eat eggs for at least 6 months. After 6 months, consult a pediatric allergy specialist again to determine whether you can try eating eggs and what precautions to take.

If the second child does not have a reaction to eggs, eat eggs regularly (at least once a week) to maintain tolerance to eggs. Children who were not allergic to eggs before, if they do not eat for a long time, may lose immune tolerance and develop allergies.


Therefore,
it is not recommended that children avoid certain foods for a long time without medical indications. The Canadian Society of Allergy and Clinical Immunology (CSACI) suggests that if foods prone to allergies are not common in the family and cannot be eaten regularly, it may be more appropriate not to eat them. There is now evidence that only eating once or occasionally may increase the risk of sensitization and development of food allergies.




Truth Two: Skin tests should not be used to determine food allergies


Never apply or rub food on the skin, as this will not only fail to identify food allergies but may also increase the risk of food allergies.


If you want to be more cautious, apply a small amount of food to the mucous membrane inside the lips. If there is no allergic reaction, you can eat a small amount after a few minutes to observe.




Truth Three: Allergen tests are not recommended to predict allergies


The practice of doing an allergen test in advance to worry about the baby being allergic to eggs is not recommended. This is because the test may have false positives, which can cause anxiety and unnecessary dietary restrictions for parents; the test may have false negatives, and parents also need to observe closely when adding eggs to babies with negative results.


Are allergies indicated by abnormal allergen tests?


Therefore, even if the baby is likely to be allergic to eggs, it is still recommended to start adding eggs when introducing complementary food, without delaying the addition, not doing allergen tests beforehand, and not rubbing on the skin to see if there is an allergy.


If the baby is not allergic to eggs, eat eggs regularly, at least once a week,
do not avoid eggs for a long time without medical indications.


What other rumors about food allergies have you heard? Please tell us in the comments section.




References

1.Greenhawt M, Abrams EM, Shaker MS, Conway AE. Food allergy prevention through the decades: An ounce of humility is worth a pound of cure. J Allergy Clin Immunol Pract. 2023;11(1):27-43.

1.Greenhawt M、Abrams EM、Shaker MS、Conway AE。几十年来的食物过敏预防:一分谦逊胜一分治疗。J 过敏临床免疫实践。2023;11(1):27-43。

2.ASCIA. (2024). ASCIA Information on how to introduce solid foods to babies for allergy prevention. Allergy & Anaphylaxis Australia. https://www.allergy.org.au/patients/allergy-prevention/ascia-how-to-introduce-solid-foods-to-babies

2.ASCIA。(2024)。ASCIA 有关如何向婴儿引入固体食物以预防过敏的信息。澳大利亚过敏和过敏反应。https://www.allergy.org.au/ Patients/allergy-prevention/ascia-how-to-introduce-solid-foods-to-babies

3.Du Toit G, Roberts G, Sayre PH, et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. N Engl J Med. 2015; 372:803–813.

4.de Silva D, Halken S, Singh C, Muraro A, Angier E, Arasi S, Arshad H, Beyer K, Boyle R, du Toit G, Eigenmann P, Grimshaw K, Hoest A, Jones C, Khaleva E, Lack G, Szajewska H, Venter C, Verhasselt V, Roberts G; European Academy of Allergy, Clinical Immunology Food Allergy, Anaphylaxis Guidelines Group. EAACI guideline: Preventing the development of food allergy in infants and young children (2020 update). Pediatr Allergy Immunol. 2020 Oct;31(7):813-826.

5.Abrams EM, Ben-Shoshan M, Protudjer JL, Lavine E, Chan ES. Early introduction is not enough: CSACI statement on the importance of ongoing regular ingestion as a means of food allergy prevention. Allergy Asthma Clin Immunol. 2023;19:13223.

5.Abrams EM、Ben-Shoshan M、Protudjer JL、Lavine E、Chan ES。早期介绍还不够:CSACI 关于持续定期摄入作为预防食物过敏手段的重要性的声明。过敏哮喘临床免疫学。2023;19:13223。



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