Food allergies in babies: symptoms and what to do

Allergic diseases, including food allergies in babies, affect approximately 20% of the population. This percentage is growing steadily in industrialised countries, which makes it essential to make more efforts in prevention. There is still a great deal of uncertainty about how the introduction of foods affects the baby. That is why, for possible baby food allergies, our team of midwives at Happymami has written this post especially for you, with the latest update on baby food allergies.

To that end, the old recommendations, more than a decade ago, were to delay the introduction of foods with the greatest allergenic potential. These include egg, soya, peanut, wheat, nuts, or fish and seafood. These foods, together with milk, are responsible for 90% of food allergies in childhood.

Later studies showed that there is no evidence to support the idea that delaying the introduction of foods prevents the development of an allergy, and it may even increase the risk. In fact, more recent studies have shown that the early introduction, that is, between 4-6 months of age, of certain foods such as egg and peanuts may reduce the risk of developing an allergy. Especially if they are introduced alongside breastfeeding, although the impact of breastfeeding on the incidence of food allergies does not currently have strong scientific evidence and calls for further studies, especially in the long term.

Current recommendation for preventing food allergies in babies

After what we have read above, in order to reduce the risk of food allergy in the baby, the current recommendation is not to delay the introduction of these foods, starting between 4-6 months of age. Once introduced, they should be eaten regularly and in generous amounts.

There is no evidence that replacing breastfeeding with hydrolysed formula helps to prevent the development of conditions such as food allergies in babies. If breastfeeding is not possible, partially hydrolysed formulas may be better than conventional infant formulas in high-risk children, although the evidence is not yet solid and their widespread use cannot be recommended.

Prebiotics and probiotics, as well as having a very low risk of side effects, can also help, and are showing promising results, but more studies and experience are needed to recommend their widespread use.

Restricting your diet during pregnancy or breastfeeding has not been shown to reduce the incidence of food allergies in babies, and it may compromise adequate nutrition. In fact, there is limited scientific evidence that if the mother eats foods with a high allergenic risk during pregnancy or breastfeeding it may reduce the baby's risk of developing an allergy.

How much risk does a baby have of developing a food allergy?

Not all babies have the same risk of developing a food allergy. Those at high risk of developing food allergies are those who have:

1. A history of moderate or severe atopic dermatitis. The younger and the more severe, the higher the risk.
2. A family history in first-degree relatives (only parents and siblings) of food allergy, allergic rhinitis, asthma or atopic dermatitis.

But even in these babies, it is not recommended to delay the introduction of foods with a high allergenic potential. Delaying the introduction not only fails to prevent an allergy from developing, but may even increase the risk.

Although in these patients it is recommended that other lower-risk foods are introduced first (fruit, vegetables, rice). And when introducing foods with a high allergenic risk, this should be done at home under supervision (not in a restaurant or at nursery), and, if available, with an antihistamine to hand.

If these babies show the slightest suspicion of a food allergy, they must be assessed by their paediatrician.

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Fruit allergy in babies: symptoms

Recognising a fruit allergy in a baby is essential to guarantee their well-being. The symptoms of fruit allergy in a baby can include skin rashes, swelling, itching and, in more serious cases, difficulty breathing or anaphylaxis. If you notice any of these symptoms after eating fruit, it is crucial to seek immediate medical attention to confirm the allergy and receive the necessary guidance to manage it properly.

Food allergies in babies, including fruit allergy, are not extremely common, but they are not rare either. The symptoms of fruit allergy in a baby can range from mild to severe and it is important to watch for any adverse reaction after introducing new fruits into the baby's diet. Although most babies tolerate fruit well, some may develop allergies, especially to fruits such as strawberries, citrus fruits and melons. It is always advisable to introduce new foods one at a time and to observe any possible reaction in order to detect a possible food allergy in a baby.

What is the clinical picture and presentation of food allergy?

Allergic reactions to foods are abnormal responses of the immune system that occur when the body identifies certain food proteins as harmful, even though they are not. Normally, these allergic reactions can vary in severity. One of the most critical aspects of allergic reactions to foods is that the most dangerous ones usually occur shortly after eating the triggering food.

Allergic reactions in babies

Normally, the most dangerous allergic reactions to foods usually appear early after eating that food. The most frequent symptoms are digestive, such as vomiting/diarrhoea, abdominal pain (irritability or crying), or oral pruritus/angioedema (itching/swelling of the mouth); or skin symptoms, such as dermatitis, reddening of the skin, or hives (raised pinkish lesions on the skin, whose colour disappears when pressed, which usually itch or hurt. They look like insect bites).

More rarely, they can also cause respiratory symptoms, such as nasal pruritus (itching of the nose), nasal congestion, sneezing, watery rhinorrhoea (abundant, clear mucus in the nose), or bronchospasm with cough, dyspnoea and wheezing (fatigue and wheezing).

Less frequent still, but more serious, are cardiovascular symptoms, such as paleness, dizziness or syncope (fainting).

What should I do if my baby has an allergic reaction to a food?

What should I do in the event of an allergic reaction? If this happens, the food suspected of causing the allergy must be stopped immediately; any leftover food must be carefully cleaned from the baby's mouth, hands, face or neck; and a medical appointment must be sought:

1. If your baby's food allergy symptoms are mild, limited to the skin or the mouth, and the baby is well, an ordinary appointment with their paediatrician will be arranged.
2. But if your baby shows a worsening of their general condition; very frequent vomiting or diarrhoea that does not settle; intense abdominal pain or inconsolable crying; difficulty breathing, with a lot of coughing or wheezing; paleness, dizziness or loss of consciousness; or excessive drowsiness or lethargy, you must go to A&E.

Food allergies in babies: What about gluten?

There are always doubts about food allergy in babies and gluten. The current recommendation for gluten is to introduce it at any time between 4 and 12 months. Introduce it gradually, although the recommended amounts have not been established. Breastfeeding, according to current evidence, does not seem to influence the risk of developing coeliac disease.

Dermatitis in breastfed babies

Babies can develop a form of dermatitis related to breastfeeding, known as atopic dermatitis or infant eczema. This condition is a chronic inflammation of the skin that usually appears in the first months of life and can affect babies fed both breast milk and formula. Atopic dermatitis appears as patches of dry, red, itchy skin, which can ooze fluid and form scabs if scratched.

The exact causes of atopic dermatitis are not fully known, but they are believed to be related to a combination of genetic and environmental factors. In babies, allergens present in breast milk (from the mother's diet) or in formula can trigger or worsen atopic dermatitis. It has also been observed that babies with a family history of allergies, asthma or eczema are more prone to developing this condition.

To manage atopic dermatitis in breastfed babies, it is important to keep the skin well moisturised, use mild, fragrance-free soaps, and avoid the use of detergents and personal care products that could irritate the skin. In some cases, it may be necessary to adjust the mother's diet or change the baby's formula under medical supervision. If the dermatitis is severe or does not improve with basic skin care measures, it is essential to consult a paediatrician or dermatologist to receive appropriate treatment.

Conclusion: update on food allergies in babies

So, how can you prevent food allergies in babies? As we always say, every baby is unique, and you will have to adapt your introduction of foods to your situation. The most important and newest thing: do not delay the intake of potentially allergenic foods, and know how to act if you suspect food allergies in babies. Lots of courage, and patience at this stage, because that is what they are: stages.

To minimise the risk of food allergies in babies, it is advisable to introduce foods one at a time and to observe any reaction for several days before presenting a new food. This makes it easier to identify which specific food could be causing a reaction. In addition, it is important to have antihistamines prescribed by the paediatrician to hand and to be informed about the symptoms of an allergic reaction, which can range from mild to severe. Consulting a health professional regularly is also key to receiving guidance and support throughout this process

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