Saturday, October 30, 2010

Those Dangerous Foods

I am often asked when it is safe to introduce foods such as eggs, peanuts, and fish to an infant.  These foods can cause allergic reactions in some children, so parents are understandably anxious about introducing them to their infant or toddler.  My answer:  it is safe when she is old enough to eat it without choking on it. 

Choking?  What about the allergy risk?  Well, we just do not know when is the right time to introduce foods that may cause allergic reactions.  Despite the strong opinions you might encounter on the topic, there is very little scientific evidence that delaying the introduction of a certain food will decrease the chance of having an allergic reaction.  In fact, there is some evidence, although not conclusive, that early introduction of a food may actually decrease the risk of developing an allergy to that food. 

In 2000, the American Academy of Pediatrics recommended withholding foods such as peanuts and shellfish until a child was 2-3 years old.  The AAP also recommended that pregnant women and breast feeding mothers avoid these foods.  In 2008, the AAP revised this recommendation, stating that there is little evidence that the previous recommendations made any difference. 

Everyone has an opinion, and this is mine.  After 12 months old, I give parents free reign to introduce any foods that the parent eats.  I also warn parents to use common sense in terms of choking hazards.  Is it possible the child may have an allergic reaction to peanut butter?  Yes, but it is also possible the family could be in an auto accident driving home from the grocery store where they purchased the peanut butter.  There is risk to everything we do.  It is important to realize that delaying the food does not affect this risk.

If there is a family history of severe allergic reactions to foods, I may tailor my recommendations a little.  There are rare cases where I will recommend allergy testing before giving a child a certain food because of previous reactions or family history.  For most families, I recommend what I have done with my own children.  After a year old, if I am eating it, he or she can eat it.

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