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If you are concerned about your little one developing a food allergy, the right time to offer something like peanut butter may be earlier than you think.
Until very recently doctors recommended that parents hold off on offering problem foods, such as peanut butter, milk, fish and eggs. But recent recommendations from the American Academy of Allergy, Asthma & Immunology suggest that these foods can be safely given to babies who are as young as 4- to 6 months -- and that offering them early might actually prevent food allergies from developing.
The new recommendations are a big departure from earlier guidelines from the American Academy of Pediatrics, which in 2000 suggested waiting till a child was 12 months old before introducing milk, 2 years before introducing eggs, and age 3 before introducing peanuts and fish. While the AAP revised its rules in 2008 and 2011, noting there was no data to support delaying problem foods, many parents and pediatricians still adhere to the early guidelines.
“The key point is that there is no reason why you can’t introduce them early for most children,” said lead author of the new report, Dr. David Fleischer, an associate professor of pediatrics at National Jewish Health at the University of Colorado. Children with moderate to severe eczema that is difficult to treat or ones who have already been diagnosed with a [different type of] food allergy are at higher risk, “so you may want to wait until they are tested before introducing peanuts or eggs,” he said.
The recommendations, directed to primary care physicians and specialists, advise parents to introduce easy foods like cereal, fruits and vegetables before offering a potentially high-allergenic choice. Milk, eggs or peanuts and fish shouldn't be the first solid foods a baby gets, Fleischer said. Potential allergens should be tried at home and increased if the child does not have an allergic reaction.
The new recommendations for very young babies were published in the Academy’s journal in January.
Reactions to food allergens can be highly varied.
“Generally, the first reaction tends to be milder,” pediatrician Dr. Alanna Levine, spokesperson for the AAP, said on TODAY Wednesday. “You can see a rash, like hives that are splotchy and cause itching. A more severe reaction would be difficulty breathing or wheezing, that feeling of throat swelling that can progress to a life-threatening anaphylaxis.”
On TODAY Mom’s Facebook page, Elaina Johnson Barbaree asked whether there is a genetic component to allergies that can be tested during pregnancy to let a woman know whether to avoid dairy foods or nuts.
“We definitely know there is a genetic component and that if a first-degree relative has an allergy, there’s an increased risk that new child with have an allergy,” Levine said. “Currently there aren’t any tests that we’re doing in pregnancy but that would be a great thing to know and study for the future.”
More research is especially important because food allergies are on the rise, although scientists don’t know why. As many as one in every 12 kids in the United States may have a food allergy, according to a 2011 study. Peanut allergies are most common, followed by allergies to milk and to shellfish, the researchers from Children’s Memorial Hospital in Chicago found.
There are several theories for the increasing prevalence, one being the hygiene hypothesis.
“We’re living in such a cleaner world now; we’re using antibiotics that are fighting infection and so the body, the immune system is reacting to things that are harmless in the environment instead of things that are harmful,” Levine told TODAY.