When it comes to raising plant-based families, one thing most parents feel confident about is that they don’t want to feed their kids animal products.
But there is emerging evidence that it may be prudent to introduce kids to the top food allergens during infancy, in order to prevent serious allergies from developing later on. This includes eggs, milk, fish, and shellfish.
What does the evidence say about this and how should potential food allergens be introduced to kids? Specifically, what do plant-based parents need to consider? Here are those answers and my thoughts on the subject.
Disclaimer: I am not a doctor or an allergen specialist, and this article should not be taken as medical advice. Please consult your child’s pediatrician before introducing these foods to your kids.
Food allergies affect 4-6% of children and 4% of adults.
Food allergies are unique and cannot be generalized, meaning the severity of a reaction experienced from eating one food could be much higher for one child than for another.
Most parents are familiar with the prevalence of peanut and tree nut allergies in young kids. These allergies can be extremely serious, and even life-threatening. Many pediatricians will make a point to have a conversation with parents about how and when to introduce peanuts to kids.
But what about the other common food allergens? Especially when it comes to plant-powered kids – what should you do?
The top 8 food allergens include: peanuts, tree nuts, milk, fish, shellfish, wheat, eggs, and soy. These foods account for 90% of all food allergies. Sesame and mustard seeds are emerging allergens.
From an ethical perspective, I can’t tell you what’s best for your family. From a professional perspective, I’m an advocate for considering the introduction of animal-based allergens to young kids. Early and somewhat regularly. Which ones and how much is an individual decision.
This certainly doesn’t mean that I stock our kitchen with animal products, nor do I feed our kids meat, eggs, and dairy as part of their regular diet.
But with the rise of food allergies among children in the United States, I’ve decided that it’s important to do what I can to reduce the risk of our boy’s developing any.
To be honest, this isn’t something I thought much about with my oldest son, beyond peanuts, because food allergies don’t run in our family. However, both of our boys had mild eczema during infancy, which made me think about this more in the last couple of years.
The truth is that my kids may decide to start eating animal products when they grow up. That’s entirely out of my control.
And even if they don’t move away from a plant-based diet, they could easily be exposed to animal products through cross-contamination of foods. Unfortunately, this could be extremely dangerous.
What does this mean for you?
You don’t have to expose your kids to animal-based allergens if you don’t want to, but I’d recommend considering it for the reason above.
What Does The Science Say?
A 2014 report published in Can Fam Physician discusses this very topic in depth, including the history of food allergies and best practices for introducing food allergens to children.
For a long time, the general consensus was that kids shouldn’t be exposed to potential allergens until they were 1-3 years old (cow’s milk at 1 year, eggs at 2 years, and nuts/fish at 3 years). However, this was largely based on a few early studies that suggested delayed introduction of these foods could prevent atopic dermatitis (also known as eczema).
And more recent research tells us something very different. There is actually no evidence that waiting until kids are older to introduce food allergens helps to prevent allergy. What’s more, delayed introduction of allergens could actually increase a child’s risk of food allergies.
A 2018 study in Can Fam Physician states that “Early peanut introduction reduces the risk of peanut allergy in high-risk infants from 17.2% to 3.2% at 5 years.”
Early allergen appears to be especially important for high risk infants. This means a baby who has a parent or sibling with an allergic condition like atopic dermatitis, food allergy, asthma, or allergic rhinitis.
A 2006 Swedish study published in Allergy looked at the effects of regular fish consumption of 4,089 infants during their first year of life. The researchers concluded that this was associated with a lower risk of allergy during the first four years of life.
A 2010 cross-sectional study in Australia found that waiting to introduce eggs for the first year of life put infants at a 3.4-times higher risk of developing an egg allergy than infants exposed to eggs between 4-6 months of age.
The Prevention of Egg Allergy with Tiny Amount Intake (PETIT) trial involved 147 Japanese infants ages 4-5 months with eczema. The babies were exposed randomly to either daily heated egg powder or a placebo. Researchers found that those infants who were exposed to egg had a 78% reduced risk of developing an egg allergy in the first year of life than infants given the placebo.
The Learning Early About Peanut (LEAP) allergy study was conducted in the United Kingdom. LEAP was a prospective random trial that assigned 640 high risk infants to early (4-10 months) or delayed (3 years) exposure to peanuts.
LEAP researchers evaluated the presence or absence of peanut allergies in the infants when they reached 5 years of age. At this time, 13.7% of the infants from the delayed exposure group had a peanut allergy and 1.9% of infants from the early exposure group had a peanut allergy.
When Should You Introduce Food Allergens To Kids?
Based on current evidence, the new recommendation is to introduce infants to the top food allergens between 4-6 months, when they first begin trying solid foods.
The Academy of Nutrition and Dietetics agrees. Just be sure to introduce these foods in age appropriate forms and textures.
In 2017, the National Institute for Allergy and Infectious Disease (NIAID) introduced new recommendations specifically for peanut introduction to kids.
The general guidelines are that, the more severe the eczema or if there is an egg allergy present, the earlier food allergens should be introduced (with the earliest being between 4-6 months). If it’s severe, a skin test is recommended before an oral peanut trial.
If no eczema or egg allergies are present, you can usually wait to introduce food allergens based on family and cultural preferences.
What About Food Allergen Exposure During Pregnancy?
A 2012 Cochrane review found no conclusive evidence that a mother’s exposure to allergens during pregnancy had any effect on the baby’s risk for asthma or atopic eczema.
The American Academy of Allergy, Asthma, & Immunology (AAAAI) says that it’s not recommended for pregnant mothers to avoid food allergens a ]s this has not been shown to be beneficial in allergy prevention.
The AAAAI also says that breastfeeding infants for at least the first six months of life, or using a hydrolyzed infant formula, may help strengthen a baby’s immune system and prevent allergic conditions.
What Does Regular Exposure Mean?
Regular exposure to allergens generally means several times a week. The LEAP study exposed infants to peanuts three times per week.
This doesn’t need to be huge amounts of food. For instance, it could be part of a scrambled egg, a small serving of a muffin made with eggs and milk, a few bites of salmon, a few teaspoons of dairy yogurt, etc.
Here are some general guidelines for introducing peanuts and eggs to babies. Your pediatrician should be able to provide individually tailored advice for how to introduce specific allergens to your child.
It is likely that other food allergens should be introduced in a similar way.
The main idea is to introduce one food at a time, in age appropriate form, and watch for symptoms. Start with a small amount, and gradually increase the serving size. Generally, you’ll do a first introduction over a period of several hours, to be sure that no delayed allergic reaction occurs. Most food reactions occur within two hours of ingestion. Some foods may take as long as six hours to cause a severe gastrointestinal reaction; this is usually a sign of food protein-induced enterocolitis syndrome. Often, food reactions occur within minutes.
Once your child does well with the first day of introduction, you can typically begin more regularly exposing them to that food.
Some kids will outgrow certain food allergies around the time they reach five years old, but again this is unique to the child.
As a plant-based parent myself, I understand the ethical struggle here.
I also feel at peace knowing that I’m raising my boys with ethics, compassion, and knowledge that will serve them for life – while also giving them the best chance I can at being low risk for serious food allergies later.
I encourage you to consider the research, evaluate your personal family history and risk, speak to your pediatrician, and determine what makes the most sense for your kids.
Tell Me Below:
- What other questions do you have about introducing food allergens to your kids?