Managing Food Allergies
Once diagnosed, food allergy is managed by complete elimination of all sources of the offending food from the baby's diet. A diet excluding the offending food must be carefully developed. It is best to get advice from a doctor/dietitian with experience in managing paediatric food allergies, who will ensure your baby’s diet remains nutritionally adequate for growth and development.
Where offending foods are removed from the diet, they will be replaced by nutritionally equivalent alternatives. If your baby has a reaction to a food or formula, stop the offending food and seek medical help as soon as possible. Always discuss with your doctor or dietitian before offering the food to your baby again.
The diet of a baby and young child with food allergy consist of 2 major components:
Breast milk
Breast milk is the best food for babies: it provides all the essential nutrition, including antibodies that protect from infection as the newborn immune system matures and allows for close bonding between the mother and the baby. Exclusive breast feeding for the first 6 months of life is recommended to help avoid or delay the onset of food allergy.
Babies can experience allergic reactions to traces of food allergens from the mother’s diet found in breast milk. If you are breastfeeding a baby with a severe food allergy, discuss with your doctor or dietitian if changes to your diet would be beneficial to your child.
Hypoallergenic infant formula If breast feeding is not possible, a specialised hypoallergenic infant formula for children with food allergies should be used, such as:
Soy formulas are sometimes advised as a first step, because they are readily available and taste more similar to standard infant formula. About 1 in 2 infants with an allergy to standard cow’s milk formula will also develop an allergy to soy formula.
However soy formulas should not be recommended for infants under 6 months with cows milk allergy. These children will require an extensively amino acid formula or hydrolysed formula (partially hydrolysed formula are not suitable for infants with cow’s milk allergy).
Of these, amino acid formulas are least likely to cause an allergic reaction. The ingredients of amino acid formula are broken down to their simplest and purest form and are therefore the easiest for the body to process and digest. Amino acid formula are made from the basic building blocks of all protein.
Other formula use whole protein or whole protein fragments such as extensively hydrolysed formulas and can cause an allergic reaction in children with severe food allergies. Your child’s doctor or dietitian can provide you with more information on formulas.
Solid foods
Children need to learn to eat, including chewing and swallowing lumps or textured foods, as part of their development. Solid foods should be introduced when your baby is around 6 months.
The basic principles of introducing solid foods are slightly different for a food allergic child. New foods must be introduced one at a time and extra care must be taken to ensure the diet does not include foods to which your child is allergic.
It is equally important not to unnecessarily restrict your baby’s diet. This is why it is important to discuss the introduction of solid foods with your doctor or dietitian.