When should I offer my child wheat, eggs, or nuts?

Food allergy is more often found in children than in adults. In one report in North America, approximately 5% of children under the age of five were noted to have a food allergy.

For many years, healthcare professionals recommended that some of the most common allergy-causing foods (including soy, wheat, eggs, fish, tree nuts, shellfish, cow’s milk, and peanuts) should not be included in the diets of young children until at least one year of age. For certain foods, the advice was to wait until the age of two or three. However, this practice of delaying the introduction of foods known to cause allergies may have contributed to the rise in cases of reported food allergies. 

New thinking

In recent years, recommendations have changed and scientists have discovered that, when your little one is developmentally ready, there is no need to wait before giving these foods to your healthy child, once they have started complementary feeding. Studies have found that delaying offering young children allergy-causing foods, beyond six to ten months of age, may increase the risk of food allergy. It has been suggested that introducing these foods early, and eating them regularly in small amounts, may help your child’s immune system better tolerate some of these foods, and help prevent allergic reactions.

New guidelines recommend giving peanuts (ground, in age-appropriate texture) and foods containing gluten to healthy children around the time you start complementary feeding. Whole peanuts should not be given to children younger than four years because of the risk of choking. Gluten is found in foods made from wheat, rye, and barley—for example, breads, pasta, cereals, and crackers. 

If your child has eczema, a family history of allergy, or any current food allergy, be sure to speak with your healthcare provider before introducing potential allergy-triggering foods.  

Wait and watch

Offer your little one their first taste of these foods individually, then wait a couple of days before trying another, so that you’ll be able to identify if a certain food causes a reaction. Cow’s milk is not recommended before the age of one year, although other dairy products, such as yogurt, can be offered after six months of age.  

It is also believed that breastfeeding may offer some protection against allergies, so continue to breastfeed your child for as long as you can, especially if there is a family history of allergies.

Sources

• https://www.cdc.gov/nchs/data/databriefs/db10.htm (Accessed December 18, 2017)
• Du Toit G, Sayre PH, Roberts G et al. Effect of avoidance on peanut allergy after early peanut introduction. N Engl J Med 2016; 374(15):1435-43.
• Du Toit G, Roberts G, Sayre PH et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. N Engl J Med 2015; 372(9):803-13.
• Fewtrell M, Bronsky J, Campoy C et al. Complementary feeding: A position paper by the European society for paediatric gastroenterology, hepatology and nutrition (ESPGHAN) committee on nutrition. J Pediatr Gastroenterol Nutr 2017; 64(1): 119-32.
• Ierodiakonou D, Garcia-Larsen V, Logan A et al. Timing of allergenic food introduction to the infant diet and risk of allergic or autoimmune disease. A systematic review and meta-analysis. JAMA. 2016; 316(11):1181-92. doi:10.1001/jama.2016.12623. 
• Togias A, Cooper SF, Acebal ML et al. Addendum guidelines for the prevention of peanut allergy in the United States: Report of the national institute of allergy and infectious diseases-sponsored expert panel. J Allergy Clin Immunol 2017; 139(1):29-44.

Last revised:December,2017