For many families, weaning a new baby onto solid foods is a monumental milestone and provides great enjoyment. For families weaning baby who already has allergies or eczema, or for families where another child or parent has an allergy, then this can be time of anxiety and worry. Every time a new food is given, families will be on high alert, looking for signs of an allergic reaction and struggling to rationalise what is a normal variant and what is a reaction.
Guidelines from the British Society of Allergy and Clinical Immunology show the importance of early weaning for infants particularly with food such as peanuts and eggs, especially in individuals who we would class as high risk for having an allergy (those with eczema or other food allergies). Whilst a useful fact sheet has been created to help families with this weaning process, it does not take away the anxiety that can occur.
Across our free Facebook group, Dr Helen regularly helps families with the introduction of foods and gives encouragement and support for families to keep going with weaning, even when an allergic reaction may have happened to something else.
Many families who have a child with an allergy already or a child who has eczema, wonder if private allergy testing may be the answer to helping guide which foods can be safely introduced to the diet. Sadly, this is not usually the case. Allergy testing should always be done in conjunction with an allergy history and of course if weaning has not even begun yet, there will be no history available to interpret the test. Test results can be negative and yet, when a child is introduced to a food, at some point down the line they may start reacting to it. This can happen for any of us through our lives. On the other hand, an allergy test can be positive, and this is a particularly common experience for children with eczema, and yet this does not tell us whether an allergy is truly present or not. It is well-known that children with eczema often have a lot of false positive results and foods can then be excluded indefinitely from the diet, potentially without good reason. We now know that for children with eczema, it is important to be giving foods such as peanut (in the form of peanut butter or flour) and eggs, regularly from six months of age. If we delay this introduction, it can allow allergy to form. Therefore, if we delay weaning because we are waiting for allergy skin prick tasks, or because they have had a positive test (but in the absence of ever having given the food) then we potentially allow allergy to form. Understandably this can feel like an utter mindful for families who do not know what to do for the best.
Dr Helen always tries to encourage families to introduce foods at home rather than have allergy testing. Whilst severe allergic reactions can of course occur at weaning (and Dr Helen understands first-hand how scary this can be), deaths have never been reported in a weaning individual. This is important to hold onto for families as they proceed with this journey. For each allergen, particularly for families who are anxious, Dr Helen suggests giving just a small dot into the mouth on the first day. The baby should then be monitored for the next hour to two, to see if any reactions occur that would be suggestive of an allergic response. This might include hives (a nettle sting type rash), swelling, vomiting, diarrhoea, runny nose or itchy runny eyes or anaphylaxis (breathing difficulties, change to conscious level, coughing or a hoarse voice). If everything has gone well, later that day or the next day, a tip of a teaspoon amount should be given. If this goes well, the next day Dr Helen would recommend increasing this to half a teaspoon and the next day a whole teaspoon. Once an allergen (food which you can be allergic to) has been safely introduced, Dr Helen (and the guidelines) would recommend keeping this in the diet at least three times a week to prevent allergy from forming. This is particularly important when it comes to egg and peanut where it is recommended that a heaped teaspoon of peanut should be given three times a week to prevent an allergic reaction developing in the future.
Sometimes despite best efforts allergies can occur even when a child is eating this food regularly. Dr Helen is here to support you on this weaning journey and you can join Dr Helen’s free Facebook group or follow her on Instagram for more tips and support in this process.