Before I became the parent of three allergy-prone children, I assumed people with food allergies were simply born that way.
But it turns out, despite the food allergy epidemic now affecting 1 in every thirteen children, babies are usually born allergy-free. It is combination of their genes and their experiences that sets their immune system on a course towards allergy misfortune.
This is actually great news.
It lends parents some control over allergy development. It won't work for everyone, but by altering our babies' experiences, we can now significantly minimize the risk of food allergies. (My own kids are now food allergy-free—you can read more about how we got there in my book, Allergy-Free Kids: The Science-Based Approach To Preventing Food Allergies).
Take these ten steps to help your baby stay allergy-free.
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1. Take your baby outside
Scientists speculate that the modern lifestyle, with its limited exposure to natural light and good microbes, in soil and elsewhere, may hinder the proper development of the baby's immune system, making food allergies more likely. So head outdoors–getting kids into the garden has amazing benefits—and don't worry about getting dirty. (There are plenty of ways more time in nature is good for grownups, too—here are 8 amazing ways nature can heal you.)
2. Take stock of your family medical history
And don't just ask about food allergies. Consider other conditions such as eczema or environmental allergies, including hay fever. Babies with parents or siblings that have eczema or any type of allergy are at greater risk for developing food allergies. (Here's the single biggest thing you can do for a healthier gut.)
3. Examine your infant for eczema or dry skin
Babies, as one doctor told me, should have smooth, um, baby-soft skin. Any patches of dry, sandpaper-like or itchy and red skin should be taken as a possible warning sign of coming allergies.
4. Visit a pediatrician or allergist, if necessary
If your baby has severe eczema or a significant family history of allergies, you may want to have him evaluated by a doctor before introducing allergenic foods. But don't delay. Such high-risk babies may particularly benefit from early exposure (see next step).
5. Introduce common food allergens early
As early as possible, introduce common food allergens such as dairy, eggs, peanuts, all tree nuts, soy, shellfish, kiwis, bananas and whole wheat. Introductions can start as early as three or four months old, assuming the baby is developmentally ready for food. (That is, she can hold her own head up and seems interested in food.)
Highly allergenic foods should be introduced after other complementary foods, such as rice cereal or cooked yellow and orange vegetables, and should be first given at home, rather than at a restaurant or at daycare, reports the American Academy of Allergy, Asthma and Immunology. (Here's how to make all of your own baby food at home, even if you're strapped for time.)
The research on early introduction is strongest for egg and peanut but some allergists encourage introducing as many allergens as possible. (Read more about this in these 5 science-backed tips for feeding your baby). The principle of early introduction is well supported, even if it hasn’t been adequately explored for every allergen.
6. Stay alert for allergy symptoms
Watch for signs that allergies have already begun developing, including hives, diarrhea, vomiting or a rash. A baby may also signal allergic irritation by grabbing his tongue or sticking his fist in his mouth.
Unlike later in life, in early infancy, allergic reactions are extremely unlikely to be fatal or require medical intervention. The early introduction of allergens is considered safe.
If you do notice hives or another symptom, make an appointment with your doctor. The sooner, the better. The younger the child, the more likely allergic development can be halted, or even reversed.
7. Offer babies allergenic foods frequently
Continue feeding your baby allergenic foods regularly. Assuming the introductions have gone well, offer allergens at least twice a week. Intermittent feedings are not adequate as an allergy can develop during the break in exposure.
The necessary amounts vary for each food and are still being explored by scientists. The EAT study, which found a two-thirds reduction in food allergy development as a result of early and regular introduction*, asked parents to give their babies every week, across at least two feedings, a minimum of one egg, 1 piece of whole wheat toast, ¼ of a filet of fish, ½ cup plain full-fat yogurt, 3 rounded teaspoons of smooth peanut butter and 3 teaspoons of tahini.
(*In the per protocol analysis; that is, when parents and their babies managed to actually follow through with these recommendations, there was a significant reduction in food allergy risk.)
8. Combine allergens
Make it easier on yourself—and your child—by combining allergens. Kiwi-egg-smoothie, anybody? I've honestly fed this to two of my babies. I also make a mixed nut butter by throwing roughly 150 grams of all the tree nuts (cashews, almonds, pistachios, pecans, walnuts, pine nuts, macadamias and Brazil nuts) into a large food processor, topping them with a jar of both peanut butter and tahini, and blending until smooth. I store the excess in the freezer and use it almost daily for snacks and sandwiches, relishing the fact that my little ones are being protected from 10 allergies with each bite.
9. Up the 'yum' factor
It can be hard to keep your baby's interest as she accumulates birthdays–finding the right recipes (ones that appeal to a kid's sensibilities) can help you persevere. The only way I can get egg into my 6-year-old recently is by (each pancake contains nearly a whole egg.) And one of my sons, when he was two, suddenly hated anything nutty—until I introduced Mixed Nut Butter Cookies (a tweak on a peanut butter cookie recipe.)
10. Keep going until they are 5 years old—at least
The immune system has a critical window for learning that all foods are safe. It starts closing slowly in infancy and is mostly closed by late childhood. The science is very young, but some researchers think that if a baby is regularly exposed to allergens over their first five years, they will be allergy-free for life.