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I remember when I first started feeding my baby solid foods I thought, “Where is the manual? What do I feed her? How much? How often?”. This is still a common topic in the office and has become even more complicated with the increase of food allergies in children. There have been conflicting studies on whether diet during pregnancy, infancy and early childhood can impact whether a child develops food allergies. You may have been told one thing for your oldest child and the complete opposite for your youngest. So, what ARE the most current recommendations?
1. There is conflicting data on whether a pregnant/breastfeeding woman’s diet can alter the baby’s risk of food allergies. The American Academy of Pediatrics does not recommend dietary restrictions related to allergies for pregnant/breastfeeding mothers (unless of course there is a history of allergy in the mother or baby).
2. Breast feeding does help!! If your baby is high risk and you breast feed exclusively for at least four months, the baby has a decreased risk of cow’s milk and eczema in the first two years of life. If you exclusively breast feed for 3 months, you decrease your baby’s risk of wheezing in the first 5 years of life.
3. If you cannot breastfeed and your baby has a family history of allergy in a sibling or parent, there is some evidence that you can decrease your baby’s risk of eczema by using a extensively hydrolyzed formula like Alimentum®, Nutramigen® or Pregestimil® or partially hydrolyzed formula like Gentlease® instead of cow’s milk-based intact formula.
4. Soy formula does not appear to have any benefit in decreasing risk of food allergy.
5. Solids should not be started until 4-6 months of age in both breast fed and formula fed babies. Delaying the introduction of solids until after 6 months does not appear to have any benefit in preventing the development of allergies.
6. Restricting your child’s diet after the age of 6 months does not conclusively decrease your child’s risk of food allergy. Does this mean that you are going to give your 9 month old a peanut butter sandwich? NO!! You still need to consider choking hazards and developmental readiness. It does mean that after 6 months in a child without a history of food allergy, you do not have to avoid typical allergens like nuts, eggs, shellfish and wheat. It is still recommended that you avoid honey in your baby’s first year because there is a small risk of botulism.
Guidelines on Feeding Your Infant/Child
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