Preventing allergies in babies and issues such as colic, eczema, asthma and digestive problems are growing priorities for many parents.
One of the most common topics that parents want to discuss in my practice is regarding the process of food introduction with their infants.
I believe when to introduce foods is changing as new evidence has many of my colleagues and I making new recommendations to our patients.
The evidence is showing that introducing small amounts of food much earlier, even highly allergenic ones, can prevent future allergies.
Despite the growing body of evidence, many parents are still waiting extended periods to introduce new food groups.
In 2003, the American Academy of Pediatrics (AAP) released a statement on the prevention of food allergies in children that recommended delaying the introduction of cow’s milk until one year of age, eggs until two years of age and peanut, tree nut and fish until three years of age. In 2006, the American College of Allergy, Asthma and Immunology followed in the AAP’s footsteps.
However, in 2008, five years after the AAP released the above statement, they reversed their initial recommendations regarding food allergies in infancy.
Since 2008, there has been mounting evidence demonstrating that the introduction of most foods after nine months of age can actually increase the risk of allergies, including those that are particularly allergenic such as wheat, dairy, eggs, fish and nuts.
In December 2013, the Canadian Pediatric Society (CPS) published a position statement on allergy prevention in high-risk infants that stated: “There is no evidence that delaying the introduction of potential allergens like peanuts, fish or eggs beyond six months helps to prevent allergy.”
Thus, there would be no reason to delay introduction of these types of foods in low-risk infants.
Indeed, this is contrary to recommendations of the AAP as recent as a decade ago.
The evidence available now is certainly strong enough to consider small challenges with particular foods once thought to be dangerous; as it appears that early food introduction can decrease sensitivity later in life.
Yet, it is still difficult to consider introducing these foods to an infant too early, especially in those with current allergies, asthma and/or eczema, as well as those with a strong family history of allergic sensitization.
It also remains unclear whether early food introduction to those severely sensitive or anaphylactic to eggs or other foods may be alleviated with early introduction, since the safety of a child remains top priority.
However, it is apparent that the type of food, dose, frequency, age of introduction and heritable background of the child may all play important roles.
Although we do not yet have all the answers, we continue to learn and appreciate this new evidence, which should be taken into consideration when approaching food introduction with infants.
For more information on the appropriate timing of introducing foods based on your child’s specific needs, talk to your naturopathic doctor.
Dr. Shane Johnson ND was born and raised in Red Deer and is the owner of Aspire Natural Medicine. He completed his naturopathic medical training at Bastyr University, and is among only a handful of naturopathic doctors in Alberta to complete an additional one-year residency in family medicine. For more detailed information on naturopathic medicine visit www.aspiremedicine.ca.