6-9 Months: Ready for Food - Understanding Allergies

Food allergies are on the rise, but still remain uncommon in little ones, and are very often outgrown. It helps to be aware of the symptoms, and to know where to turn. The best advice is not to panic, and to talk to your doctor if you have any concerns.

How will I know if my baby has a food allergy?

Food allergies are much more common among children in families
with a history of allergy. Babies who suffer from eczema are
particularly at risk—and the more severe the eczema, the more likely
there is to be a food allergy. Some food allergies are fairly easy to
spot—as soon as the food is eaten, often for the first or second time, a
reaction occurs (see Immediate food allergies).

Delayed allergies
may also be a problem for infants. In the past, these were sometimes
called food intolerance, but this isn’t the correct term, because an
intolerance doesn’t involve the immune system. Delayed allergic
reactions do involve the immune system, but parts of it that take longer
to respond. This means it can be difficult to pinpoint a particular
food as the problem, as sufferers may continue to eat and drink it.
Milk, soy, egg, and wheat are often the main culprits, and symptoms
include eczema, reflux, colic, poor growth, diarrhea and constipation
(see Delayed food allergies ).
These get better only when the food is removed from the diet. However,
all of these symptoms commonly occur during childhood and an allergy is
only one possible explanation. You’ll need the help of an experienced
doctor to diagnose a food allergy (see How are allergies diagnosed?).

We have a family history of allergies; should I avoid certain foods?

A If you have a history of allergy in your family (including
asthma, hayfever, eczema, as well as food allergies), and your baby
suffers from eczema, she is more likely to have food allergies.

It was thought that
potentially allergenic foods (milk, eggs, tree nuts, shellfish, seafood,
wheat, and soy) should be avoided until babies are a year old, and
peanuts for the first three years of a child’s life. However, some
recent studies have suggested that there is no value in delaying the
introduction of these allergenic foods.

The jury is still out
regarding what the best weaning policy is for babies at risk of food
allergies, and more research is required. If your baby is in this
“high-risk” category and you’d like more advice, it is a good idea to
see your doctor or a dietitian.

How are allergies diagnosed?

If you suspect an allergy, you must see a doctor with experience
in allergy. There are many private allergy tests available, such as hair
analysis and kinesiology, however these are costly, inaccurate, and can
put your baby’s health at risk.

The best way
to diagnose immediate allergies, where the reaction occurs within two
hours, is with a skin prick test and/or a blood test. These determine
which foods, if any, are triggering allergic symptoms by detecting the
presence of antibodies called IgE—which help to identify the problem
foods. The allergens that will be tested are usually those about which
you have expressed concern, although your doctor may also test other
foods in the same group, other common foods (from the “big eight,” for
example: cow’s milk, wheat, soy, fish, shellfish, eggs, peanuts, and
tree nuts), or anything else that appears possible. The results must be
interpreted by an experienced doctor.

What about delayed food allergies? Are these very difficult to diagnose?

If your baby experiences a delayed reaction to a food (where
symptoms take up to 48 hours to appear), the best way to diagnose the
allergy is for you to keep a food and symptom diary, and eliminate the
suspected food or foods for a minimum of two weeks, and see if the
symptoms cease. The foods need to be reintroduced under the supervision
of a doctor or dietitian who are experienced in allergy. It’s never a
good idea to try an elimination diet without support from an expert,
because the nutrients lost in key parts of your baby’s diet are crucial
to his growth and development, and will need to be replaced.

Immediate food allergies

Moderate symptoms

These typically affect the skin, the respiratory system, and the gut. Seek medical advice.

A flushed face, hives, or a red and itchy rash around the mouth, tongue, or eyes. This can spread across the entire body
Mild swelling, particularly of the lips, eyes, and face
A runny or blocked nose, sneezing, and watering eyes
Nausea, vomiting, tummy cramps, and diarrhea
A scratchy or itchy mouth and throat

Severe symptoms (anaphylaxis)

This an emergency—call 911.

Wheezing or difficulty in breathing
Swelling
of the tongue and throat, restricting the airways. This can cause noisy
breathing (especially on breathing in), a cough or a change in your
baby’s cry or voice
Lethargy, limpness, or collapse

Delayed food allergies

Symptoms include:

Eczema
Reflux
Poor growth
Swelling in the small bowel
Constipation and/or diarrhea
Raising knees to chest with tummy pain
Frequent distress and crying