What parents need to know about the new federal allergy recommendations

From Good Housekeeping

In January, the United States Department of Agriculture and Department of Health released their updated set of dietary guidelines that will be in place until 2025. Many health experts have lamented that the current recommendations on added sugar haven’t really changed, among other concerns. The federal health experts behind the report, however, recommended new restrictions on added sugar in the very first set of tips for parents of babies and toddlers. According to the report, no amount of added sugar is acceptable for children under the age of 2; the authors of the guidelines cite the strong link between childhood obesity and health problems later in life as the reasoning behind their new position.

But parents (and future parents!) May raise eyebrows at a new suggestion based on data on dietary exposure to peanuts and other allergens, which is the opposite of what they may have heard. in the past.

New guidelines ask parents to introduce “nutrient-dense” foods to infants in addition to milk or formula from 6 months, including known allergens that many parents could have historically avoided. “Peanuts, eggs, cow’s milk products, tree nuts, wheat, shellfish, crustaceans, fish and soybeans should be introduced when other complementary foods are introduced into an infant’s diet.” , indicate the guidelines. “Introducing foods containing peanuts in the first year reduces the risk of an infant developing a food allergy to peanuts.

The change in advice has to do with groundbreaking research known as the Learning Early About Peanut Allergy (LEAP) study, says Sanjeev Jain, MD, Ph.D., immunologist and founder of Columbia Allergy Clinics in the Northwest. of the Pacific. In the 1980s, says Dr Jain, when food allergies started to become more and more common, allergists believed that it was necessary to delay the oral introduction of potential allergens (namely peanuts) to avoid allergic reactions later in life. The American Academy of Pediatrics had even asked parents to wait to introduce peanuts to children up to age 3, and eggs at age 2, in guidelines published in 2000. But the LEAP study , published just after the latest round of USDA diet guidelines were released in 2015, “clearly showed that the early introduction of peanuts, as early as four months of life, reduced the risk of developing peanut allergies,” adds he does.

The story continues

Always consult your child’s doctor before introducing new foods into their routine.

Allergy experts have a plethora of data that confirms a baby’s immune system and digestive tract can adapt to foreign foods, says Dr Jain – things they never have eaten before – almost naturally. “The immune system during the first six months of life is particularly malleable; he can adapt to any environmental exposure he experiences at that age much more than later in life, ”he explains.

In fact, getting a baby or toddler to ingest allergens is important if that food is found in the home environment around it. For peanuts, in particular, a baby can easily become sensitized to peanuts if their skin is in frequent contact with their antigens (or proteins) – especially if they already have eczema or another skin problem, says Michael Pistiner. , MD, member of the Asthma and Allergy Foundation of America’s Medical Scientific Council. “This [sensitization] can lead a child to develop a food allergy, “he explains, adding that other non-peanut allergies can also develop this way.” This is why it seems that when these children start to be exposed to food by mouth and by eating it can help reduce the risk of developing an allergy to that food. “

But what about soybeans, eggs, or other nuts? Robert Coles, MD, a pediatrician with the University of California San Diego Health System, says that while the evidence is not as clear for these allergens, experts treat them the same as peanuts on the basis of logic. “In view of the data specific to peanuts and eggs, we now recommend that, from an allergy point of view, complementary foods and other highly allergenic foods can be introduced into the child’s diet at any time after the ‘age four to six months,’ he explains. With a few exceptions, these can be thicker staples like peanut butter or honey, which can pose choking hazards if not properly prepared, the latter posing a risk of botulism. for babies (“Even highly processed honey can contain bacterial spores,” adds Dr. Jain).

For children outside the recommended age group of four to six months, allergy clinician Dr. Jain says slowly adding traces of nuts or small amounts of soy for toddlers is still widely recommended. “It’s never too late … You have an opportunity to present [foods] before allergies develop, “he adds.” Dermal exposure without achieving equal oral and dietary exposure is not ideal, as it leads to possible sensitization of this food.

Perhaps the most important thing for parents to remember – whether it’s those welcoming their first child or those who are anxious around the kitchen due to another child’s allergic development – is that the introduction of food for babies and toddlers at home comes with a very low risk of a serious allergic reaction. Dr Jain explains that anaphylaxis is rare in this case: “Current guidelines are that the risk of bringing your food into the home is so low when it comes to a potentially fatal allergic reaction that ‘it is considered safe to do so. “

No matter how old your child is or whether or not you’ve dabbled in new foods at home, there is always an option to do what is called an ‘oral challenge’, available for families in an office. . “We administer common allergens in the office to confirm that the child is not allergic to that food, which may take some time to identify each food, but at least we try to do that,” says Dr. Jain. Going forward, it looks like most allergists can agree on one thing: do not Feeding your toddlers allergens out of fear could lead to that dreaded food allergy.

If you are concerned about a child and potential food allergies, keep an eye out for known visual reactions to known allergens. The most common symptoms of an allergic reaction include a rash, itching or hives, swelling or puffiness, shortness of breath, stomach pain, and dizziness. For more information on common signs of reaction, and instructions for getting emergency help, visit the Asthma and Allergy Foundation of America.

You might also like