15 Apr Introducing Solids and Preventing Food Allergies
Last week we had the pleasure of joining Dr Hayley Worth live on our Instagram! In case you missed it, you can see the full video here or read the transcript below:
Hi everyone! So, in preparing for this talk, I did a Google search and trawled through a few of the websites that came up just to see what information is out there, and boy oh boy, there is a lot of conflicting and confusing stuff! I’m going to try to streamline it for you guys. I would highly recommend having a look at the website preventallergies.org.au. It’s run by all of the major Australian allergy organisations, so it’s evidence-based, trustworthy info. Raisingchildren.net.au is another very good website.
When should I introduce solid foods to my baby?
Anytime between the ages of four to six months is perfect, depending on when your baby seems like he or she is ready. Ideally, they would be able to sit supported in a highchair, and they may have shown some interest in the food that you’re eating. If you’re not sure if they’re ready, it doesn’t hurt at all to just give it a go– choose a day where you’re not too busy or stressed out (if you’ve got older children, then that’s probably never!), sit them in a highchair, and try to feed them a very small amount of thin puree on the end of a soft teaspoon. It’s very normal for them to push their tongue out so that the food comes out, just simply scoop up the food and try again. They should eventually get the hang and realise that their tongue needs to go the other way in order to swallow! If it’s not working, call it a day and try again in another couple of weeks or so.
What food should I start with and in what order?
This is probably my favourite question! You can really start your child on any food or combination of foods. My daughter started on pureed pumpkin and tofu– tofu is still one of her favourite foods! You do not need to space out new foods several days apart when you’re introducing them and there is no particular order necessary either. This is old advice. So you can ignore all of those fancy colour coded food introduction charts on Instagram! What I would aim for is nutrient-dense foods and really great variety. So, lots of different fruits, vegetables, proteins, grains, nuts and pulses. Cook them nice and soft and then puree to quite a thin consistency.
After a few months you can start to add very small amounts of flavours such as spices too. This is to encourage your child to develop a full and varied palate, and helps with reducing fussy eating later on. Babies have tastebuds which are naturally attuned towards sweet foods (breast milk and formula are sweet!), so try to minimise pure fruit purees such as apple puree – it is very sweet and you risk them rejecting your delicious savoury purees following this, which is what I would probably do too!
We don’t recommend adding sugar or salt to your baby’s food, they simply don’t need it. There’s plenty of time for that later!
Should I be making all of my baby’s food from scratch?
Only if this is something that you want to do! If you have the time and energy, then homemade food is fantastic, and babies will often get a lot more exposure to different flavours that way. You’ll notice that a lot of the pureed baby pouches have similar flavours, the companies have got to make money so they tend to choose the flavours that they know kids will love! In saying that, I always have a few on hand for desperate times. Just check the ingredients list on the back and try to make sure there isn’t any sneaky added salt or sugar in there.
What about baby-led weaning?
So, this is when the baby chews or sucks on finger foods rather than puree. It’s thought that this may widen the child’s palate and reduce fussy eating later on. It’s certainly ok to consider this option if it fits in with you and your family, I would just have a look at how much food your child is actually consuming at each meal, and if it’s not much then it may be worthwhile supplementing their meals with a small amount of nutrient-dense puree.
Is a vegetarian or vegan diet safe for my baby?
So try to remember that iron is one of the most important nutrients for your growing baby. Iron deficiency in children is common and can affect how their brain develops, and it also affects their sleep quality! A vegetarian diet can be very good, as long as your child is receiving lots of other sources of iron-rich foods. A vegan diet can also be fine, it’s just a little trickier. If you are considering a vegetarian or vegan diet for your child, please do work together with a dietician to ensure your child is receiving all of the iron and other nutrients that they need.
Are there any foods that I shouldn’t give my baby?
Don’t give your child honey before the age of 12 months, there is a very small risk of botulism. Try to avoid any foods that they could choke on like whole nuts, whole grapes, popcorn etc. Avoid very salty foods and try not to give any sugary foods or drinks, including juices and soft drinks.
Some foods naturally contain high levels of arsenic and other heavy metals. This isn’t such a problem for us but it is a problem for little developing brains. These foods include tinned tuna and other large fish, rice and rice products like rice cereals, puffed rice snacks and teething rusks, sweet potatoes and carrots, and fruit juice. It doesn’t mean that they can never have these foods, just try not to have them as a staple of their diet.
What happens with breast or bottle feeding once they start solids?
It’s important that your child continues to get either breastmilk or formula. Up until they are 9 months old, milk is more important nutritionally so give them milk before solids, and then after 9 months, food becomes more important nutritionally so give them milk after their solids. Once they are 12 months old, they can be safely transitioned onto full-cream cow’s milk. Just try not to give them any more than 600-700mL of milk per day from aged 1 as this can lead to iron deficiency.
When do I start giving my baby water to drink?
Anytime from around 6 months you can start offering boiled, cooled water in a sippy cup. Try to encourage them to be drinking out of an open cup from around the age of 12 months (this is important for their dental health), and they can have normal tap water from this age too.
What can I do to prevent my child from developing food allergies?
Now we get to the interesting stuff! You can significantly reduce the chance of your child developing food allergies by introducing allergenic foods early, ideally well before the age of 12 months, and continuing to expose your child to them on a weekly or twice weekly basis. I totally acknowledge that this is so much to remember, so just do the best that you can!
So firstly, what are the allergenic foods? They are: Wheat, Egg, Cow’s Milk (only if your child hasn’t had formula), Soy, Fish, Shellfish, Sesame, Peanut and Tree nuts. That’s a lot of foods to remember! I think the easiest way to approach this is to write down each of the allergens, and then beside each one, write the dates that you have given your child each one, and try to remember to keep giving each of them weekly or twice weekly. The first couple of times you give egg, make sure it’s well-cooked, such as baked in the oven, and same with fish and shellfish. The easiest ways to introduce nuts is either by nut butters or ground nuts like almond meal etc.
Have a look at preventallergies.org.au, they have some great recipe ideas on there too.
What if we have a family history of food allergy?
If your child has a family history of food allergy, then it does mean they have a higher risk of developing an allergy themselves, but that is even more reason to introduce allergens early to reduce this risk.
What does a food allergy look like?
Most children will develop a reaction immediately after eating the suspect allergen. This might look like a red rash on their face and they may have swelling of the face too. If this happens, stop feeding them the food and see your GP for a referral to an allergy specialist. If they start to develop any swelling of the mouth or difficulty breathing, please call 000 immediately and explain that your child is having a serious allergic reaction.
Take note, that a lot of children will have what we call a “Contact dermatitis” to acidic foods like tomatoes or oranges. You will see redness around their mouth only where the food has come into direct contact with their skin. My daughter had this reaction to eggplant. It’s not a true food allergy, you can safely continue to feed them this food, but consider putting a nick thick barrier cream on the skin beforehand to reduce the contact, or feed them directly into their mouths with a spoon.
Just a little word about a different type of food allergy called FPIES. If your child profusely vomits or has diarrhoea after eating a particular food, please see your doctor about whether they may have this condition.
Is there anything else I can do to prevent my child from developing food allergies?
Yes – do not apply any product on their skin that is food-based, until they have actually eaten the food. So do not smear peanut butter on their skin, do not apply any sort of nut oils or nut products onto their skin. This can significantly increase the risk of them having an allergic reaction later down the track when they do eat the food.