The ‘A’ Word

When I decided I would be giving my son solids for the first time, all the talk of allergies around me had me thinking that my son would break into hives or stop breathing in the event that I didn’t wait the requisite 3-4 days after giving him a piece of strawberry or nibble on a piece of gluten-laden toast. It didn’t help matters that I was presented with a plethora of food schedules, each providing me with the ‘right’ way to introduce my son to food groups. All so that I would be able to identify the culprit food responsible for sending my child into the very worst version of anaphylactic shock.

Although food allergies are relatively common in babies and young children, the good news is that life threatening allergies aren’t. What’s important to know is how to identify an allergy and how to deal with one.

So, what exactly is an allergy?

It is the physical response of the immune system to an allergen (the protein portion of the allergy causing food) that has either been eaten, touched or breathed in the environment.

This allergen invades the body, resulting in the release of antibodies to attack it and that is when the symptoms of the allergy make themselves known. Babies are more likely to develop an allergy when they have been exposed to solids prior to their immune systems being fully developed. All the more reason to wait until you baby is good and ready to embark on their solid food adventure (For more on when to start solids read here: Solids & When To Take The Leap.)

 What should you be looking for?

Symptoms of an allergic reaction range from the more severe (loss of consciousness, anaphylactic shock and difficulty breathing) to the less severe (including nausea, hives, rash, running nose, itching and abdominal pain). Responses can either be immediate or delayed (which is much less common), so it is important to keep track of your child’s reaction to new foods introduced to their diet.

A medical professional should be the person to diagnose a food allergy and advise on the treatment. Don’t self diagnose and make the call on what to remove from your child’s diet. That means never removing important foods such as milk or wheat (or any other nutritionally beneficial food) from your child’s diet without first consulting with your paed.

Even if your child isn’t at high risk for developing an allergy and they suddenly exhibit allergy-like symptoms, it is important to understand how to deal with the situation. If you would like to know more about the symptoms you should look out for and how to manage your baby or toddler’s food allergies read further here http://www.foodallergy.org.

How can an allergy be avoided?

Although some children grow out of certain allergies, good old genetics are proven to play a role here: if both parents have an allergy, then your baby is more than likely to ‘inherit’ one too. Babies with severe eczema under three months are also more likely to develop a food allergy.

High-risk foods (or the foods most likely to trigger an allergic reaction) include the main offenders;  peanuts, eggs fish, soy, wheat/gluten, milk, tree nuts and shellfish. Other allergy-prone foods include; peas, chocolate, berries, tomatoes, sesame seeds, kiwis, corn, beans and even some spices.

Although mommies are told to wait at least a year before introducing their baby to high-risk foods (specifically eggs, fish and peanuts), The American Academy of Paediatrics published a report in 2008 that showed that waiting longer than the four to six month time frame for starting solids, does not decrease the risk of developing an allergy to a specific food. Basically, if your child is likely to be allergic to peanuts (or anything else), introducing peanuts to their diet at either six months or at twenty months is not going to make a difference. The benefit of exposing them to a wide variety of foods when they first embark on their solids journey (between the four and six month mark) means that they are probably more likely to be adventurous little eaters.

The picture is a little different for anyone with a family history of allergies. These guys (including the ones with a family history of eczema) should first consult with their paediatrician prior to introducing their child to high-risk foods  (or any other food for that matter, which has led to an allergy in the family).

It is also recommended that parents with babies at high risk for developing an allergy should follow these guidelines:

  • Solids should be started no earlier than 17 weeks (between the 4-6 month mark) to potentially decrease the risk of developing food allergies in the first three years.
  • These babies should be exclusively breastfed for the first six months or breastfed for up to a year.
  • A more gradual introduction to new foods (where a new food is introduced only every week and fed consecutively for that week).

The verdict:

In a nutshell – excuse the pun – unless you have a family history of allergies or eczema, it is safe to introduce whole foods to your little one without sticking to any kind of food schedule.

That said, if you want to ensure that you are able to narrow down the culprit food that may have resulted in an adverse reaction (and potentially one you were totally unprepared for), introduce no more than one new food per day. If anything, at least you’ll  get your baba on board the adventurous-eating-food-train (as you get them to sample new tastes and textures) and you’ll get some much needed peace of mind too.

My advice should never replace the advice of your paediatrician, GP or nurse.

Lactose Intolerance 101

After six years of being married to someone who is in complete denial that they are lactose intolerant – “There must be something wrong with that chocolate mousse” or “I think I just ate too much ice cream” – I was convinced that my son had inherited this not-so-nice trait from his Dad.

When I started breastfeeding my little guy and he struggled with wind in those early weeks, I was still convinced (Like most mothers, I fall into the trap of  freaking out at the first sign of a ‘symptom’ I heard about through the mommy grapevine).  It was only at his first check up with the paed that my mind was finally put at ease.

What I have learned since then, is that the majority of adults have some degree of lactose intolerance. It is extremely common and it is something that can be managed but it all starts with understanding what you are dealing with.

An intolerance is often mistaken for an allergy. Lactose intolerance and cow’s milk allergy are not the same thing. Unlike an allergy, which is the reaction of the immune system, an intolerance is the inability of the body to break down a specific food. Common symptoms include diarrhoea, headaches, bloating, abdominal discomfort and gas and many of these are also symptoms of cow’s milk allergy. Your health care provider may rule out an allergy by means of a skin prick test in which case you’ll know for sure which one of the two you are dealing with.

Lactose intolerance occurs when the enzyme lactase is lacking in the body to assist with the breakdown of the sugar component of milk aka lactose. It takes a little while for sufficient lactase to build up in a baby’s digestive system to effectively digest lactose (which is the reason that so many newborns get labelled as lactose intolerant).

There are varying degrees of lactose intolerance and can be onset at varying ages. Be mindful of the symptoms and if you think that your child may be lactose intolerant, monitor them closely after drinking milk (including cow–based formula) or after eating dairy products. Symptoms may appear within only a few minutes.

Note that even some lactose intolerant babies and children will be able to tolerate small amounts of whole milk (including small amounts used in cooking or baking) but this should always be monitored closely.

You may notice that your child has a less severe reaction (if any reaction at all) to yoghurts or cheeses compared to cows’ milk. This is because the lactose in these products has already been significantly broken down from whole milk (this is often the reason why so many parents initially think that their child can tolerate lactose only to be surprised later on).

What’s important is understanding how to deal with a lactose intolerant child:

  • Consult your paediatrician or nurse to help find a new formula for your little one (including low lactose or even soy varieties)
  • Consider the likes of a lactose support aid (like Lactaze) when eating or drinking lactose-containing foods
  • Increase calcium intake in low lactose diets through calcium fortified foods (including orange juice, cereals, veggies and yoghurts) and through calcium-rich foods such as spinach, kale, almonds, salmon, sesame seeds and oranges.

If your child happens to be lactose intolerant remember that there are some excellent dairy substitutes available on the market including; almond milk, coconut milk, soy milk, rice milk, tofu, cashew nut cream (provided your child doesn’t have an allergy to any of the above).

These options can all be used in the same way you would dairy to add different flavours and textures to your child’s diet. So lactose-free living by no means has to mean unadventurous eating.

*The information on this blog should never replace the advice from your GP, Paediatrician or nurse.