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Allergy Today: My Story

Nip allergies in the bub

Dietitian and mother Barbara Stet describes her experience of having a child with food allergy and provides information on a new resource on how to introduce potential allergy-causing food to infants.

ATe Dec18 My story image-548Towards the end 1999, before the birth of our son, I was given a fridge magnet by a friend who was a member of the La Leche League. Although faded, it remains on my fridge door as a reminder of the precious gift a new born is to a whānau/family.

It reads, “A new baby is like the beginning of all things – wonder, hope, a dream of possibilities” and is attributed to Edna J. Le Shan (1922 – 2002).

A complicated start to life resulted in our son spending his first 24 hours of life away from me in a neonatal ward. Initiation of   
breastfeeding was delayed, and I consented to my newborn being fed standard infant formula for hydration and nourishment.

A healthy thriving infant, he breastfed successfully. Maternal exhaustion at four months led to Dad giving him his first bottle of infant formula at home, which he took readily. The following day he had one hive on his arm. What on earth had I eaten to have caused that hive, went through my mind repeatedly that day.

The following week a second bottle of infant formula was fed to our baby boy. This resulted in him projectile vomiting the formula and quickly developing an all-over body rash.

The feelings of guilt, anguish and distress that I had done something to cause my precious little boy to develop a food allergy took many years to fade. It was not until some years later that I understood he been sensitised to cow’s milk protein by that one formula feed before I was able to breastfeed him.

We went on to successfully wean him on to a wide range of foods by one year of age, and he became tolerant of dairy product by two years of age.

Delayed introduction didn’t stop allergies developing

At the turn of the new millennium, health professionals advised parents that withholding the introduction of the food proteins commonly associated with food allergy – dairy, soy, egg, wheat, fish, peanut and tree nut – until after the first 12 months of age might help prevent the onset of food allergies.

However, this advice did not reduce the rise in the number of children who became allergic to foods, the cause of which is multifactorial and not fully understood.

In addition, withholding a wide range of nourishing foods rich in protein, vitamins, minerals and energy from infants after six months of life places them at risk of poor weight gain, faltering growth and micronutrient deficiencies.

In Australia, one in 10 children has a food allergy and two in 10 have eczema. The Australian Government has funded a National Allergy Strategy, which is a partnership between the Australasian Society of Clinical Immunology and Allergy (ASCIA) and Allergy and Anaphylaxis Australia.

In August 2018, the National Allergy Strategy Food Allergy Prevention Project was launched at the annual ASCIA conference. The project is based on the ASCIA guidelines for infant feeding and allergy prevention, which are evidence based and include up-to-date information.

One initiative of the project is Nip Allergies in the Bub, which is available at preventallergies.org.au. This website includes information on introducing solid foods, such as when to start solids, developmental readiness for solids introduction and which foods to introduce, as well as how to identify allergic reactions, eczema care, helpful tools and information for health professionals.

The material is presented in a practical way for parents and caregivers. The information is easy to understand and organised in a colourful and uncluttered format.

Up-to-date advice

Mothers are advised to continue breastfeeding throughout the weaning process, where possible. The introduction of solids to babies is recommended around six months of age, but not before four months of age.

Foods commonly associated with food allergy are encouraged to be introduced into an infant’s diet by the time the child is 12 months of age. The importance of optimal skin care for children with eczema is also discussed as part of the strategy to reduce food allergy.

The authors stress that should an allergy occur, it is not due to something the family has done. They advise that despite this new approach to introducing solid foods into the diet of babies, some will still develop an allergy to food.

Nip Allergies in the Bub has been launched for use in Western Australia and will be assessed after a year, before being launched across Australia.
 

Barbara Stet is a New Zealand Registered Dietitian and allied health member of the Australasian Society of Clinical Immunology and Allergy (ASCIA).

December 2018