How will I know if my child has a food allergy?

Babies are more likely to develop allergies if there’s a history of eczema, asthma, hayfever or food allergies (known together as ‘atopy’) in the family.

Call triple zero (000) for an ambulance if you think your child is having a reaction to food or drink. They could be having a severe allergic reaction and will need urgent medical attention.

Infants with no family history of atopy can also develop allergies, so the recommendations for introducing solids are the same for all families, including families where a parent or siblings have an allergy. If your baby already has an allergic disease such as severe eczema or food allergy, talk to your doctor before introducing solids.

If you’re not breastfeeding,  you don’t need give your baby hydrolysed (partially and extensively) infant formula or soy or goat’s milk formula to try to prevent allergy. Standard cow’s milk based formula is fine.

When you start introducing solids (weaning) at around 6 months, but not before 4 months, include common allergy-causing foods by 12 months in an age appropriate form, such as well-cooked egg and smooth peanut butter/paste. Studies show that this may reduce the chance of developing food allergy. You could introduce the foods that commonly cause allergies one at a time so that you can spot any reaction. These foods are:

• milk
• eggs
• wheat
• nuts
• seeds
• fish and shellfish

Introduce foods according to what the family usually eats. If your baby tolerates the food, continue to offer it as part of a varied diet. If possible, continue to breastfeed while you are introducing solids, as this may reduce the risk of allergies developing.

If your baby has severe eczema and/or is allergic to eggs, giving peanut regularly before they turn 1 can reduce the risk of developing peanut allergy. There is also evidence that introducing cooked egg before 8 months can prevent egg allergy. Discuss this with your doctor.

Many children outgrow their allergies to milk or eggs, but a peanut allergy is generally lifelong. 

How will I know if my child has a food allergy?

An allergic reaction can consist of one or more of the following:

• diarrhoea or vomiting
• a cough
• wheezing and shortness of breath
• itchy throat and tongue
• itchy skin or rash
• swollen lips and throat
• runny or blocked nose
• sore, red and itchy eyes

If your child has an allergic reaction, don’t be tempted to experiment by cutting out a major food, such as milk, as this could lead to your child not getting the nutrients they need. Talk to your doctor, who may refer you to a registered dietitian.

Severe allergic reaction to food

In a few cases, foods can cause a very severe reaction (anaphylaxis) that can be life threatening. Anaphylaxis to food can cause wheezing or breathing difficulty, swelling of the tongue, loss of consciousness, vomiting or becoming pale and floppy. Anaphylaxis is rare in babies. Hives or swelling around the mouth are more common.

Anaphylaxis is a medical emergency that needs urgent attention. The recommendation is to use adrenalin injected by a health professional or via a self-loaded device, such as Epipen.

Peanut allergy

Allergies to nuts, nut products and some seeds affect 1 to 2% of the population. Your child has a higher risk of developing a peanut allergy if they already have a known allergy (such as eczema or a diagnosed food allergy), or there’s a history of allergy in their immediate family (such as asthma, eczema or hay fever).

If this is the case, talk to your doctor or health visitor before you give peanuts or food containing peanuts to your child for the first time.

If you would like to eat peanuts or foods containing peanuts (such as peanut butter) while breastfeeding, you can do so unless you’re allergic to them or your health professional advises you not to.

You don’t have to delay introducing peanuts. Foods containing peanuts include peanut butter, peanut (groundnut) oil and some snacks. Don’t give whole peanuts or nuts to children under 5 years old because they could choke on them.

Read food labels carefully and avoid foods if you’re not sure whether they contain peanuts.

Food additives

Food contains additives for a variety of reasons, such as to preserve it, to help make it safe to eat for longer, and to give colour or texture.

All food additives go through rigorous assessments for safety before they can be used. Food labelling must clearly show additives in the list of ingredients, including their name or ‘E’ number and their function, such as ‘colouring’ or ‘preservative’. Testing for allergy to preservatives is very difficult.

Very few people have proven adverse reactions to some food additives, but reactions to ordinary foods, such as eggs, milk or soy, are much more common.

Processed foods are more likely to contain additives and high levels of salt, sugar and fat. Therefore, it’s best to avoid eating too many of these foods.

Sources:

Australasian Society of Clinical Immunology and Allergy(Food allergy), Australasian Society of Clinical Immunology and Allergy(Allergy prevention), Australasian Society of Clinical Immunology and Allergy(ASCIA Guidelines – Infant feeding and allergy prevention)