Breastfeeding
Human milk provides virtually all the protein, sugar, and fat your baby needs to be healthy, and it also contains many substances that benefit your baby’s immune system, including antibodies, immune factors, enzymes, and white blood cells. These substances protect your baby against a wide variety of diseases and infections not only while he is breastfeeding but in some cases long after he has weaned. (read more here)
Breastfeeding and infant formula
- Infants should be breastfed exclusively during the first 6 months of life.
- From 6 months of age, breast milk should be complemented with a variety of adequate, safe and nutrient dense complementary foods. Salt and sugars should not be added to complementary foods.”
- Breastfeeding is recommended for at least 6 months or ranging up to 2 years of age and beyond, for as long as mother and infant wish to continue.
- There is no consistent evidence that breastfeeding is effective for the prevention of allergic disease. However, breastfeeding is recommended for the many benefits it provides to mother and infant.
- Breastfeeding during the period that solid foods are first introduced to infants from around 6 months may help reduce the risk of the infant developing allergies, although evidence for this is low.
- If breastfeeding is not possible, a standard cow’s milk based formula can be given. There is no evidence that soy or goat’s milk formula reduce the risk of allergic disease when used in preference to standard cow’s milk based formula.
- Based on a recently published review of studies, there is no consistent convincing evidence to support a protective role for partially hydrolysed formulas (usually labelled ‘HA’ or Hypoallergenic) or extensively hydrolysed formulas for the prevention of eczema, food allergy, asthma or allergic rhinitis in infants or children.
- Regular cow’s, goat’s milk (or other mammal derived milks), soy milk, nut and cereal beverages are not recommended for infants as the main source of milk before 12 months of age.
Ref: ASCIA 2019 guidelines (this information is still current and will be updated on an annual bases ‘if guidelines change’, 2020)
Ref: WHO reference
Introducing Foods and Allergy Prevention
- Solid foods can be introduced to your baby around 6 months (not before 4 months) and when your baby is ready. If possible, breastfeed your baby while you are giving them solid foods. This advice is for all babies, even if they have severe eczema and/or food allergy, or if a parent or sibling has allergies.
- Studies show that introducing common allergy causing foods by 12 months may reduce the chance of babies developing food allergy. These foods include egg, peanut, cow’s milk (dairy), tree nuts, soy, sesame, wheat, fish and other seafood.
- Solid foods should be in a form suited for your baby’s age, such as small amounts of well cooked egg and smooth peanut butter/paste. Giving new solid foods in the day rather than at night allows you to watch your baby and respond if they have an allergic reaction.
- You can rub a small amount of food inside your baby’s lip to start with. If there is no allergic reaction after a few minutes, start giving small amounts of the food. Never smear or rub food on your baby’s skin, as this will not help to identify possible food allergies.
- If you need guidance, mix a small amount (¼ teaspoon) of hard-boiled egg or smooth peanut butter/paste into your baby’s usual food (such as vegetable puree). If there is no allergic reaction, gradually increase the amount, such as ½ teaspoon the next time.
- Continue to give the foods to your baby regularly (twice weekly) as part of a varied diet, to maintain tolerance. Trying a food and then not giving it regularly may result in food allergy development.
- Even if you follow this advice some babies may still develop a food allergy. If your baby has an allergic reaction (which mostly occur within minutes) stop giving that food and seek advice from your doctor.
- If your baby already has food allergies, see your doctor for advice, testing, treatment and an action plan. Babies with cow’s milk, wheat or multiple food allergies should also be seen by a dietitian to help maintain healthy food intake. Avoiding these foods can affect your baby’s growth and development.
ASCIA Fast Facts Introducing foods allergy prevention 2019313.65 KB
For more information visit www.allergy.org.au/patients/allergy-prevention ; www.preventallergies.org.au
Allergy & Anaphylaxis Australia www.allergyfacts.org.au and Allergy New Zealand www.allergy.org.nz are patient support organisations that offer updates and advice for people with allergies.
Nut Butters
According to the recent guidelines from the American Academy of Allergy, Asthma and Immunology, potentially allergenic foods like nuts are safe to introduce to babies as young as 6 months of age, once they have had exposure to a few typical first foods like cereals, fruit and vegetables. This is great news because nuts and nut butters like peanut, cashew, and almond are nutrition powerhouses, providing protein, beneficial fatty acids, vitamin E and minerals like manganese, potassium and iron. Lumps of nut butters are a choking hazard for small babies so try mixing it in foods or spread a thin layer over a long strip of toast to serve as a finger food.
Eggs
Eggs are a great first food! They are easily digestible, and they offer the important nutrition your baby needs including iron, folate and choline, high-quality protein, plus vitamins A, D and E. Eggs are also a quick and easy meal to prepare. Just hard-cook an egg, make eggy bread, your could also mash the yolk and thin it with breast milk make it a dressing over foods etc. Hard-boiled and chopped egg white is a perfect finger food, as are scrambled eggs or omelets cut into thin strips.
Wheat Products i.e. Bread and Crackers
There are some parents that may think to limit gluten in their baby’s diet in the hope to reduce risk of developing celiac disease later in life. But although more research is needed on how to prevent celiac disease, there is now some evidence that keeping wheat away from babies is not helpful and may even increase their risk for this autoimmune disorder.
Cold-water Fish
Introducing fish to your baby is simple, you can bake it, pan fry it or steam a boneless fillet. Cold-water fish including salmon, herring, canned salmon, canned tuna light or sardines are a great source of DHA in a babies diet. DHA plays a crucial role in retinal and brain development and is especially important for children in the first two years of life. (note: ensure all bones are removed from fish as they may be a choking hazard).
The Environemental Defense Fund (one of the world’s largest environmental organizations, with more than 1.5 million members and a staff of 500 scientists, economists, policy experts, and other professionals around the world) looks at safety of canned tuna and fish. There are two main kinds of canned tuna: chunk light and solid or chunk white (albacore). Most canned white tuna is albacore. Its mercury levels are almost three times higher than the smaller skipjack, used in most canned light tuna.
The following are recommendations based on EPA guidance and estimates of mercury in the most popular canned tunas:
- Canned white, or albacore (0.32 parts per million of mercury). Children under six can eat up to one 3-ounce portion a month; children from 6–12, two 4.5-ounce portions a month. Adults, including pregnant women, can safely eat it up to three times a month (women, 6-ounce portions; men, 8-ounce portions).
- Canned light— the safer choice (0.12 parts per million of mercury). Children under six can eat up to three 3-ounce portions per month. Older children and adults can safely eat it once a week. But look out for “gourmet” or “tonno” labels. They are made with bigger yellowfin tuna and can contain mercury levels comparable to canned white.
- A better alternative is canned salmon(mostly sockeye or pink from Alaska), which is low in contaminants and high in heart-healthy omega-3s. It’s also sustainably caught in Alaska and similarly priced, making it a great choice all around.
Governing authorities & bodies around the world:
- World Health Organisation (WHO)
- American Academy of Pediatrics (AAP)
- The Murdoch Children’s Research Institute
- Australiasian Society of Clinical Immunology and Allergy (ASCIA)
- National Health Serve UK (NHS)
References & articles:
- 2019 ASCIA Infant Food Allergy Guidelines (Note: The Infant Feeding guidelines on the ASCIA website are the current versions (updated in 2019). The ASCIA resources are reviewed annually, however the documents will only be updated if there are changes in the literature).
- UK guidelines for baby led weaning
- What to feed your kids so they don’t get food allergies
- New Foods to Feed Babies
- AAP article Breastfeeding Benefits your babies immune system
- Mercury Levels in Canned Tuna
- ASCIA guidelines on this webpage are for parents and health professionals.
- Food service providers (such as childcare centres) should refer to the ASCIA guidelines for prevention of anaphylaxis in schools, preschools and childcare services: www.allergy.org.au/schools-childcare
