news item: food allergy advice for kids

Okay, I will be the first to admit that food allergies for kids is something that has never really been on my radar. My husband and I have no history of food allergies in our families, so I suppose it’s one of those dangers that hasn’t felt very real to me. I had heard the general “avoid shell fish, eggs, nuts and honey until 1 year of age” advice from our pediatrician, and other than that, I am (still) clueless. Also, I am the Mom whose kid was eating eggs daily for breakfast at seven months (which I had honestly forgotten was not recommended until I started writing this post – I knew I introduced yolks only at 6 months and then whites for a reason) and devouring cocktail shrimp at a friend’s party at 10 months old, and it wasn’t until someone commented that I “must not be worried about shell fish allergies” that it occurred to me that shrimp was a shell fish. My husband also recently revealed that he has been routinely giving our daughter bites of his peanut butter sandwich since she was around 11 months old. Oops. Basically, we were 1 for 4 on remembering the recommendations of foods to delay introducing before one year of age.

That being said, I’m also learning that there are parents out there whose kids have very real allergies to certain foods who cannot just “forget” to be vigilant about those foods – and that those allergies were discovered at a young age. This makes me quite curious to hear their opinions on this article in the Wall Street Journal that I came across last week.

Parents trying to navigate the confusing world of children’s food allergies now have more specific advice to consider. Highly allergenic foods such as peanut butter, fish and eggs can be introduced to babies between 4 and 6 months and may even play a role in preventing food allergies from developing.

Say what? First off, most parents I know don’t even introduce solid foods until at least six months, but that’s a whole ‘nuther bag of worms. Maybe the writer was just trying to make a point that you can introduce those foods earlier than one year of age? It goes on to say:

“There’s been more studies that find that if you introduce them early it may actually prevent food allergy,” said David Fleischer, co-author of the article and a pediatric allergist at National Jewish Health in Denver. “We need to get the message out now to pediatricians, primary-care physicians and specialists that these allergenic foods can be introduced early.”

It’s always a bit startling and concerning to me when two respected organizations (like the American Academy of Allergy, Asthma & Immunology (AAAAI) and the American Academy of Pediatrics) issue conflicting statements. Who do you believe?

Obviously there is still a lot of research being done on this particular topic, but it gets me thinking about a few things…

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Did/do you delay introducing common allergenic foods to your kid(s)? Why/why not?

Does your child(ren) have any allergies to foods? If so, how do you protect them from people (like me) who know so little about the dangers of certain foods?

How do you decide which recommendations to follow when there are conflicting schools of thought about an issue like this?

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Comments

  1. As a general rule, I believe in following the specialists over the generalists. Pediatricians (and the AAP) need to know a little about a lot. Specialists (AAAAI, etc) need to know a lot about a little. They’ll be more up on the current research, more in tune with the impact of that research, and more knowledgeable about the biological processed to be able to interpret that research. There’s been a study around for years about early peanut introduction being correlated with fewer peanut allergies. There’s been research on treating allergies with supervised small exposures to the allergen. They didn’t come up with the recommendations overnight. It makes sense to me knowing what I do about allergies and immunology.

    We’re lucky enough to not personally deal with food allergies (just a couple intolerances) so far. But I’m always glad to see more research go into what’s causing the uptick.

    • Good point. I work in a small family practice med center, and the two providers are both absolutely great. They are also the first to admit that they know a little bit about a lot of stuff….and not vice versa. That’s basically the definition of a family doc, right? Thankfully they have no problem referring patients to specialists if an issue goes beyond their scope of knowledge, but I don’t believe that all providers are as honest about their shortcomings.

  2. We did delay giving Lexi the common allergenic foods – some consciously others not so much, more because they aren’t things that we eat regularly (if at all) so they weren’t on our radar to introduce. We still haven’t given her honey – though I am sure it has been in something she has had…I don’t know (although I had heard that honey was due to a live bacteria that was in it that could make babies really sick). We did this based on the AAP recommendations.
    I saw this article last week when it came out and was curious about it – I tend to think that the specialists know what they are talking about. It very well could change how we introduce foods to our next one, time will tell.
    So far, Lexi has no food allergies, though she hasn’t had shellfish – it isn’t something we eat regularly (me at all because I don’t like it).
    As for whose recommendations to follow – we do the research, see what is said about it and make our best judgement as to whose advice to follow. No real rhyme or reason to it, just go with out gut (after doing research of course).

  3. There’s so much conflicting information out there, it’s hard to know what to do! I’ve been going with my instincts with regards to food allergies. My mother-in-law is allergic to seafood, citrus, strawberries and nuts (though not peanuts).
    I breast fed exclusively until six months and then started introducing solids (via baby led weaning) following the three day rule for new foods. I’m a great believer in the power of breast milk to reduce the incidence of allergies, but am going to wait the suggested time for nuts and strawberries. Everything else is fair game!

  4. My Pediatrician told me just to move forward with feeding Raegan whatever when I told her we were doing baby led weaning. She said giving it early isn’t going to cause an allergy and could in fact prevent a sensitivity. So the only thing I waited on was peanuts/peanut butter because my nephew has a peanut allergy. And we haven’t had any bad reactions, even after the peanut butter exposure. My brother and his wife are also pediatricians and have given me lots of advice on how to expose Raegan to as many foods as possible. I went with my gut on holding back the peanut exposure, but everything else I listened to my “experts” and just gave Raegan what ever she wanted. We’ve been lucky and I hope to continue on this lucky route. I do wonder though how there are SO many more known food allergies in kids these days. I don’t remember having anything like this when I was growing up….

  5. As a mom of a peanut allergic child (whoah, I’m still getting used to THAT label!) this topic is obviously near and dear to my heart. I actually had just finished writing a post on the allergy thing (it’s in the trackbacks here) but to respond more directly to some of your questions, Josey…

    We did delay introducing all the major allergens until our girls were 1. They had “the infamous first taste” of peanut butter a few weeks after they turned one. I was following the newer guidelines that if you had tried other foods without a reaction, (they were eating eggs, strawberries, etc. at that point) and had no family history, you could try nuts at 1 year. I will never forget calling the advice nurse when Juju broke out in hives after eating the PB and having her scold me for giving her PB “so young”. I had to take time out from getting medical advice for my child to SCOLD HER for not knowing the updated guidelines. Oh I was so pissed. Our allergist later validated our decision and has said that there was no reason for us to not have tried peanut butter at that time, that we did NOT cause her allergy, etc. I still struggle with guilt over this though all because of that stupid advice nurse. At the end of the day I had to accept that there is just so much we don’t know about allergies, what causes them, why they’re on the rise. The fact that I have identical twins, one with a peanut allergy and one without, is a massive conundrum in itself. There’s genetics and exposure right there that were virtually identical and yet one developed the allergy and the other didn’t. For now, I agree with the comments above about doing the research and then going with your gut. And be prepared for a possible reaction. Have benadryl in the house. Know the correct dose to give just in case. Don’t feed your kid new foods right before bed when you can’t monitor their effects.

    As far as protecting the kids from people who aren’t as aware of allergy risks… well, I try to educate when possible. I explain kindly to the mom at the park who is offering my kid her kid’s peanut butter snack crackers why she maybe shouldn’t offer any kid a snack without asking the parent first. I have a fat PEANUT ALLERGY – EPI PEN INSIDE button on our stroller and on our diaper bag, and Juju wears a bright orange peanut allergy bracelet. I hope that these things give people reason to pause. If their kid just ate a PB&J, maybe they’ll wonder if they should start washing their kids’ hands after meals like that. But at the end of the day, I have to acknowledge that keeping my kid safe is my job. I can’t rely on any one else to be as vigilant as we are. That’s just the reality of it.

    I recommend the FARE (Food Allergy Research and Education – formerly FAAN – Food Allergies and Anaphylaxis Network) website http://www.foodallergy.org/home to anyone looking for more information on food allergies. Also, to parents of food allergic kids, the book Don’t Kill the Birthday Girl, for a down to earth picture of life lived with food allergies as we learn to balance letting our kids live with managing our own fears.

    • It’s so crazy that identical twins could have different reactions to foods. Kind of mind blowing, actually. Just another piece of the puzzle that shows how much even the experts really don’t know. On that same note though, SHAME on that nurse for lecturing without making sure her info was correct. Not cool. Health care providers like that should be extra-vigilant about knowing the correct advice to give!!!

      I had never before thought about my kid eating a PB&J and then touching another child with a peanut allergy. Hm… I’m going to have to do some thinking about all of this!

  6. I have lots of allergies, so my allergist recommended waiting until at least 9 months to try anything I have trouble with and also dairy/shellfish (so that included nuts and soforth) and we waited longer for things I can’t have (peanuts). We also gave a 5 day break between foods and no combinations with a new food. We figured out at about 15 months that the kid had a cow’s milk allergy, but we tried it again when she was about 2 and it had gone away (phew) but about then we discovered a strawberry allergy. I put on every form everywhere that the kid is allergic to strawberries and peanuts (since I am that allergic to them that she can’t bring them home) and I avoid sending her to other people’s houses unless I know what will be eaten (and I tell everyone about her allergy). I also have taught her to tell people she’s allergic to strawberries and that she can’t have peanuts, and this has stopped at least two occasions of her getting peanuts. With the baby, I’m hoping to introduce “scary” foods sooner because when I read those studies, they seemed pretty sound to me. We’ll still wait on strawberries until she’s older than 9 months though. That said, aside from reminding people the first time (or maybe a second time) about her allergies/can’t have items, I don’t fret that much because I know another allergy mom who won’t let her kid out of her sight like to go to an after-school event (even when food isn’t a scheduled part of it). It gets to be too much to obsess. I stress it’s serious once and usually that works, and I trust it will work It’s easier now that the kid can tell everyone about what she can’t eat and much less scary because I trust her and know she gets how important it is too.

    I absolutely agree on having liquid benadryl in the house when you start solids and ask your pharmacist for the right dose (you need to know your kid’s weight to get it the most correct) and trying new things only at lunch so there’s plenty of time to catch a reaction.

    • Yikes, it literally has never occurred to me to buy Children’s Benadryl – I will be doing that this weekend! Also, I somehow missed the strawberry/allergen memo. Stella ate them in the beginning around 8 months, and now she doesn’t like them so she stopped. Oops.

Trackbacks

  1. […] numbers of children are diagnosed with severe allergies daily – was brought up today over on PAIL (which reminded me to finish off this post and publish it!). Head over there to read more of the […]

  2. […] a news article highlighting a changing view on food and allergies for kids. Check out the article and definitely read the comments for some insight from parents who have allergies/kids with […]

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