When introducing allergens to your infant, there is a lot to know! Here are some important facts to consider during the allergen introduction phase. Food allergies are nothing to mess with; read below to be in the know. For additional training try our newest online class, Childhood Allergy Safety, for parents and caregivers alike!
Trying an allergen once with no reaction does not mean you are in the clear.
The reaction likely won’t happen on the first exposure. The body needs to be sensitized to the food before it can mount an immune response. If an infant is going to develop a food allergy, the first exposure will sensitize the body, and the second exposure will deploy the response. It is important to watch closely the first few times your infant tries an allergen, not just the first time.
Atopic dermatitis (Eczema) increases one’s risk of developing food allergies.
Food sensitization can occur through the skin, and is more likely to lead to food allergy than exposure through the digestive tract. In children with compromised skin integrity, this exposure can be more direct. Eczema is something you should bring up to your doctor before introducing allergens to your infant. Children with Eczema are at a higher risk of developing allergies.
In addition, one set of researchers suggested that handling allergenic foods (specifically peanuts) and then handling a child without washing your hands may lead to exposure through the skin. If you have sticky peanut butter on your hands, you may want to take the time to wash it off before scooping up your baby. The goal is to have the child’s first exposure through the digestive tract.
Introduce early!
Current guidelines recommend introducing allergenic foods to infants between 4-6 months of age (given the infant is developmentally ready to eat solid food). We are seeing debunking of old guidelines which recommended waiting beyond 12 months of age.
The basis for early introduction of allergens comes largely from a well known study called LEAP which focuses on peanuts. This study found that, among infants at a heightened risk for developing a peanut allergy, the introduction of peanuts between 4-11 months of age decreased the incidence of allergy when compared to infants who waited beyond 11 months.
Although the evidence supporting the efficacy of early egg introduction is limited, a study called EAT found that early introduction of egg did not increase a child’s risk of egg allergy. Notably, another study called PETIT found that introducing egg to infants at 6 months, along with aggressive Eczema treatment was effective in lowering the incidence of egg allergy, in the study population.
If you give a child an EpiPen and the reaction resolves, they still need to go to the hospital.
EpiPens can work almost immediately and create the illusion that the food allergy reaction is over. This is not the case! Epinephrine can wear off and the symptoms of the reaction can return. It is important to have help on the way even if the child looks completely fine.
At the hospital, the child will be monitored and the medical provider may prescribe a regiment of Benadryl and steroids over the next few days. Always follow the directions of the pediatrician, they will know best how to keep your child safe while they recover.
Communicate the incident to any caregivers over the next few days.
Very rarely anaphylaxis can be bi-phasic, meaning that the reaction may seem to disappear only to reappear within the next 72 hours, without re-exposure to the allergen. If your child goes to daycare, for instance, it is important to let the teachers know if they are still within this 72 hour window, so that any returning reaction can be quickly recognized. Again, this is VERY rare and does not always lead to full anaphylaxis.
As always, your pediatrician knows best and you should refer back to them for questions and guidance about food allergies. Don’t forget to check out the online allergy safety class for additional training and knowledge!
About The Author
Fiona is a registered nurse who recently graduated from Northeastern University. She primarily focuses on newborn and postpartum care, and loves working as a newborn care expert with BBNN. Before her time as a nurse, she studied newborn genetics at Boston Children’s Hospital. In addition, Fiona participated in the Harvard Neonatal Student Research program. Fiona strives to develop meaningful relationships with every family she cares for. She loves watching children and families thrive with the proper care and support.
