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INFANT FEEDING AND ALLERGIES

Dr Joseph Mizzi MD MRCP

Allergies are not uncommon in babies and young children. These include food allergies, coeliac disease, eczema and wheezing. The current recommendations by paediatricians are based on numerous studies.

1. Should I avoid certain foods to reduce allergic problems in my child while Im breastfeeding?

There is no convincing evidence from scientific studies that dietary restrictions are effective in reducing the risk of allergic disease in children. There is no point for breastfeeding mothers to eliminate specific foods from their diet.

2. Does exclusive breastfeeding reduce allergic problems in children?

Yes, breastfeeding up to 4 months of age reduces the risk of eczema in high-risk infants. Breastfeeding also provides some protection against wheezing in infants and toddlers.

4. Should I delay the introduction of solid foods to reduce the risk of allergic disease?

Different studies give conflicting results, but overall, there is no convincing evidence that delaying food beyond 4 to 6 months reduces allergic conditions in children.

5. When should I start weaning my baby?

Complementary feeding should be started between 4 to 6 months of life, but not before or after this period. An infant is ready to start solid food when he can support his head, shows interest in food, and is able to eat from a spoon. It is customary to start with a rice cereal, moving on to vegetable puree and fruits, followed by chicken, meat and fish, as well as yogurt and cheese.

6. Should I delay the introduction of potentially allergenic foods, such as fish and eggs, especially if my baby is at risk of allergy?

Postponing such food items after the first birthday has not been shown to reduce allergies even in those who are considered to be at high risk. Wheat-based foods, well-cooked eggs and citrus fruit may be introduced after 6 months.

7. Can I use cows milk before my baby is one year?

Cows milk should be used after one year because it is a poor source of iron. However, small amounts of cows milk may be added to complementary foods before one year of age.

8. When is the best time to introduce wheat to prevent coeliac disease and wheat allergy?

Avoid both early (less than 4 months) and late (more than seven months) introduction of gluten. Wheat and other gluten-containing foods should be introduced gradually, ideally while still breast-feeding, at about 6 months of age.

References:

Complementary Feeding: A Commentary by the ESPGHAN Committee on Nutrition, Journal of Pediatric Gastroenterology and Nutrition. 2008; 46:99110.
Greer et al. Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children, Pediatrics. 2008; 121(1):183-91.

August 2008

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