Introducing foods can be a pretty daunting task, particularly if you suspect an allergy or an intolerance.
The task isn’t made lighter when strong evidence demonstrates early infant nutrition has a major impact on the immediate health and long-term health of the child.
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Firstly, understanding the difference between intolerances and allergies is a pretty good place to start. Sometimes these words are mistakenly used interchangeably, however, there is a distinction between the two.
Allergy:
An allergy occurs when the immune system reacts to a food that is usually harmless, these may be immediate (IgE-mediated), or delayed (IgG- mediated).
Symptoms of an IgE allergy usually appear within seconds or minutes but can appear up to 2 hours of ingesting the triggering food. A histamine response may cause swelling, inflammation, hives, itching skin, difficulty breathing, throat tightening, anaphylaxis.
The top 9 allergens are:
Eggs (chicken)
Peanuts
Tree nuts
Sesame
Fish
Shellfish
Soy
Cow’s milk
Wheat
While these foods are not responsible for every allergy, they are responsible for 90% for food allergies in children. It is recommended that all these foods be introduced between 6 and 12 months (but not before 4 months) to reduce the risk of developing an allergy. Once an allergen has been introduced between 3-4 times, in increasing amounts with no reaction, this food should become part of their weekly diet to prevent an allergy from developing. Allergens may, but not always, run in the family, for children considered high-risk work with an allergist or gp to map out a plan to safely introduce these foods. Skin prick test won’t always delivery accurate results.
Food Sensitivities:
Non-IgE-mediated reaction, or food sensitivity are delayed reactions where the immune system produces IgG antibodies which can lead to inflammation. Symptoms can appear from a few hours to 3 days of consuming the triggering food/s, and include diarrhoea, constipation, bloating, nausea but also, anxiety, depression, acid reflux, fatigue, mood changes etc. Prolonged exposure is linked to certain conditions, asthma, eczema, IBS etc.
IgG testing isn’t always accurate and eliminating/ monitoring/ diet histories and the best form of diagnosis and care.
Common IgG foods:
Wheat
Cow’s milk
Egg white
Barley
Soy
Please note: This list is not exhaustive and the ‘most common’ causes may change depending on location.
Intolerance:
An intolerance doesn’t involve the immune system and are usually caused by an absence of enzyme needed to digest a particular food. Symptoms are similar to food sensitives (IgG mediated). Intolerances occur through breastmilk; some infants may tolerate a small amount and most outgrow intolerances after 2-3 years of age. Cow's milk, soy, eggs, oats are all common intolerances, however many foods can cause reactions such as, diarrhoea, frequent and excessive spit ups, discomfort, gas, infant acne etc.
Food sensitives (IgG) and intolerances may damage the gut lining, food elimination, repairing the gut and food reintroduction should be done under the guidance of a healthcare professional (like me).
FPIES
Just to throw another spanner into the mix, you may have also heard of FPIES (Food protein-induced enterocolitis syndrome), which is a severe non-IgE immune reaction in the gastrointestinal system to one or more specific foods. This reaction is characterised by profuse vomiting and diarrhoea, between 2-8 hours after consuming the triggering food (s), the most common FPIES triggers are cow’s milk (dairy) and soy, however, it can be any food.
FPIES reaction do you usually occur through breastmilk and typically occurs when the child has directly ingested the trigger food(s). The majority of children will outgrow this type of reaction, typically by age 3, until they have outgrown it the best course of action is to avoid the triggering food(s).
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Please note: This article is designed to be a brief overview of the types of reactions an infant can experience and is not individual medical advice.
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