May 18, 2015 Post By: Children's Health

Food Allergies: Early introduction may not be bad after all

Our biggest worry with feeding Emmy now is how to clean her up, not if she'll have an allergic reaction.

“She has you wrapped around her finger.” As the new dad of a daughter, I’ve heard that phrase nearly as many times as I’ve heard “hello” in the past 11 months. And it’s a fact – Emmy already has me moving on every one of her whims. I want her to be as happy as possible and to give her everything I can.

However, when it comes to food, I’ve been withholding. Writing about children with food allergies the last several years has caused me to develop what some (my family) call “obsessive paranoia” concerning Emmy’s possible reactions to certain foods. After all, I know what anaphylaxis means.

And, much to my family’s chagrin, I blocked most attempts to give Emmy new foods.

“Can I feed her eggs?” my mother asks. “No,” I say. “What about peanut butter?” my dad asks. “No, that could kill her,” I say. “Strawberries?” my wife tosses out there. “No, I don’t know what that will do,” I say.

You see, I was playing it more conservative than the LSU offense. I thought that was what the official guidelines said to do. But, in true Craig Foster fashion, I was mistaken – not on one, but two fronts. I was following old guidelines, and I misunderstood the intended recipients of those guidelines.

What the guidelines really say

Prior to 2008, most guidelines did recommend that parents be ultra-conservative with the introduction of allergenic foods: Wait to introduce cow’s milk until a child turns 1; eggs until a child is 2; peanuts, tree nuts and fish until a child is 3. But those recommendations weren’t intended for all children. They were intended instead for children with a family history of allergies (either their parents or siblings had allergic rhinitis, asthma, eczema or food allergies).

In 2008, the American Academy of Pediatrics (AAP) came out with new guidelines – or, maybe better said, the absence of guidelines. They said that there was no longer a recommended time of introduction for allergenic foods.

The AAP changed their stance because several studies came out indicating that delayed introduction of allergenic foods might not only be unhelpful, but may actually be detrimental – possibly making it more likely that children will develop food allergies.

But, in 2012, the widely held standard among new parents we know – with or without a family history of allergies – still seems to be that we should delay the introduction of allergenic foods. Are we all just overly cautious? Or is there some legitimacy to delaying the introduction of allergenic foods – a better-safe-than-sorry justification, at least?

You heard it from an expert

For clarity, I went to Dr. Drew Bird, the leader of the Food Allergy Center at Children’s and a member of the state advisory board that crafted food allergy guidelines for Texas schools. I wanted to hear from him if it was really okay for me to abdicate my reign as food tyrant.

His answer: “I suspect from all the information we have that it might be more beneficial to introduce allergenic foods early,” he said. “But there’s no recommendation change yet. And I’m not telling families who come to see me to introduce allergenic foods earlier.

“What I’m telling families is, ‘Based on the recommendations we have now, if you feel comfortable introducing things like peanut butter or scrambled eggs to your 6-month-old, it’s fine with me. There’s nothing that says you can’t do that.’”

I could feel my food-tyrant crown crumbling with that answer. Then, with one last gasp, I asked, “Surely, there are some children who should wait to try allergenic foods?”

He confirmed that was sort of correct. “The children you should be concerned about introducing foods early to are the ones who have severe eczema and/or show signs of having bad allergies. Those children need to be seen by their pediatrician and/or an allergist before introducing them to allergenic foods.”

Emmy has had dry patches on her skin since she was born. So, I asked him if that meant she should refrain from trying allergenic foods. He said the type of eczema that would be concerning involves constant itching and puss-filled infections, which Emmy has never had.

My food tyranny ended with a poof. Since then, Emmy has tried scrambled eggs, fish and peanut butter. And she hasn’t had a reaction to any of them.

The only foods that I won’t feed her, per Dr. Bird’s advice, are honey (bacteria in it can cause infant botulism) and things that would be too difficult for her to chew with her 7-and-a-half teeth.

That doesn’t mean that I am encouraging every parent to rush the introduction of allergenic foods – not at this point, at least. Like Dr. Bird said, that’s up to the parent.

But isn’t it great to not have to worry as much about it?