Is it possible to prevent your baby from developing food allergies? Or at least lower the risk of allergies in children?
If you and your family do not have a history of allergies, delaying feeding your child dairy or not eating peanuts during pregnancy will not lower the risk of your child developing allergies. Current research shows that elimination diets and delayed introduction of foods have no effect on the risk of developing food allergies in most children.
If, however, you have a “high-risk” child – one with at least one parent or sibling with allergies – it may lower the risk of food allergies or delay their development to follow the American Academy of Pediatrics (AAP) guidelines.
Should you avoid allergenic foods while you are pregnant?
A 2006 Cochrane review of four medical studies found no link between the diet of mothers during pregnancy and later allergic eczema in their babies. This study and others led the AAP to change their guidelines for pregnant and nursing mothers in 2008. The AAP now recommends that mothers do not restrict their diet during pregnancy.
If you are allergic to a certain food, you should not eat it when you are pregnant, or at other times. But if you do not have food allergies, eating foods that are common allergens such as milk or peanuts is not likely to increase the chance of your baby having food allergies later in life.
Should you breast or bottle feed your high-risk infant?
Breast milk may contain food allergens, such as peanut or cow’s milk proteins. Some infants may be sensitive to these allergens and have reactions. And yet, breastfeeding has a protective effect on high-risk babies and may delay the development of allergies.
The AAP reviewed eighteen studies that compared breastfeeding to formula feeding for high-risk infants. Taken together, the studies showed that breastfeeding for at least four months can lower the risk of your baby developing allergies as compared to feeding your baby cow or soy milk formula during those months. If you supplement with formula, special prescription formulas also lower the risk of allergies, though not as much as breastfeeding.
These studies also found that if you avoid major food allergens while breastfeeding, it does not prevent your baby from developing food allergies. But if your baby already has skin reactions (eczema), avoiding highly allergenic foods while you are breastfeeding may help your baby to have fewer flare-ups.
When should you feed your baby solid foods? Dairy? Peanuts?
The AAP used to recommend a lengthy delay in introducing allergenic foods to high-risk children. But researchers have found no decrease in rates of allergy from long delays, even for highly allergenic foods like peanuts.
The AAP and the American Academy of Allergy, Asthma, and Immunology (AAAAI) both still recommend delaying introduction of solid food until six months for high-risk babies. Their guidelines recommend that you should start your six-month-old on foods such as fruits, vegetables, and cereal grains. Introduce new foods one at a time, in small amounts.
Consider lotions, soaps, and shampoos to be an introduction of a new “food” as well. One study found that using skin lotion made from peanut oil increased the risk of peanut allergy later in childhood.
Chafen JJ, et al. Diagnosing and managing common food allergies: a systematic review. JAMA. 2010 May 12;303(18):1848-56.
Lack G, Fox D, Northstone K, Golding J; Avon Longitudinal Study of Parents and Children Study Team. Factors associated with the development of peanut allergy in childhood. New England Journal of Medicine. 2003;348 :977 –985
Greer FR, Sicherer SH, Burks AW; American Academy of Pediatrics Committee on Nutrition; American Academy of Pediatrics Section on Allergy and Immunology.Effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas. Pediatrics. 2008 Jan;121(1):183-91.
Kramer MS, Kakuma R. Maternal dietary antigen avoidance during pregnancy and/or lactation for preventing or treating atopic disease in the child. Cochrane Database Syst Rev. 2006;(3) :CD000133
Sicherer SH, Burks AW. Maternal and infant diets for prevention of allergic diseases: understanding menu changes in 2008. Journal of Allergy and Clinical Immunology. 2008 Jul;122(1):29-33.
Thygarajan A, Burks AW. American Academy of Pediatrics recommendations on the effects of early nutritional interventions on the development of atopic disease. Curr Opin Pediatr. 2008 Dec;20(6):698-702.
Vadas P, Wai Y, Burks W, Perelman B. Detection of peanut allergens in breast milk of lactating women. JAMA. 2001;285 :1746 –1748