Dietitians’ Advice on Introducing Other Risky Solids to Baby

in Basics, Fish & Shellfish, Food Allergy, Milk & Egg

This is a sidebar to Allergic Living’s feature: Baby Meets Risky Foods: Parents Struggle to Adapt to New Food Allergy Guidelines

Dietitian Carina Venter works with families with food allergies, and was part of the expert panel that developed the new National Institute of Allergy and Infectious Diseases (NIAID) guidelines for introducing peanut to infants.

She and Rosan Meyer, a U.K.-based dietitian, share the following suggestions for introducing foods, other than peanut, that are associated with allergies. Their advice, which applies to all infants (except those with a confirmed allergy), is based on practical experience and takes the new NIAID guidelines into account.

These suggestions are intended as guidance, but are not in any way a formal recommendation. Venter, an associate professor of pediatrics at the University of Colorado, stresses that if your child already has one diagnosed food allergy, first speak to your doctor. Get the doctor’s advice before starting the baby on other commonly allergenic foods.

The Foods in Question

Milk: If you have not given your baby infant formula, the two dietitians suggest starting with milk in baked foods or yogurt. (Cheese can be given later – from around six to seven months old.)

Egg: Give fully cooked or baked egg to start with – in foods such as low-sugar cookies, muffins or pancakes. They would not begin with soft-boiled or poached eggs, raw egg powder or pasteurized eggs, which have led to reactions in babies.

Soy: The dietitians say to offer your baby soy milk, soy yogurt or tofu. They avoid soy sauce (it’s salty and doesn’t contain much protein).

Fish: With more than 700 species of fish and shellfish, they note that it’s impossible for your baby to sample all. Instead, they recommend feeding a few portions of the fish species that your family tends to eat, and to keep such feedings regular. (Note: the FDA says not to give more than two portions of fatty fish per week.)

Sesame: Try hummus and tahini with infants, while older children can eat sesame-containing candy on occasion (but be aware of the sugar content).

Wheat: The pair suggests softly cooked pasta, strips of toast (if you already started to give wheat in egg-containing baked goods, continue with these as well). The dietitians say while there is no specific order to introducing allergenic foods, the team behind the LEAP research introduced wheat last in a related study. Venter says to offer your baby new foods early in the day, to provide a chance to watch for a possible reaction. When you’re introducing a food, do it slowly.

Watch out for:

Symptoms of an allergic reaction in an infant might include hives near the lip or some lip swelling. Another common symptom is vomiting after a baby eats a small amount. If any of these occur, stop the feeding and contact your doctor.

If your baby is getting really fussy, irritated, starts making wheezing noises or is having trouble breathing, pediatrician Dr. Ruchi Gupta says: “Those are emergencies where 911 needs to be called and epinephrine needs to be given.”

When to Introduce Peanut to Baby