Allergies

Allergies

Allergies

You may be hearing more and more about food allergies these days. Whether you know your little one has one or you're trying to figure out what's going on, your pediatrician should be your first stop for information. Check out these articles then message Dotti for an individualized appointment with one of our Registered Dietitians to learn more.

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Know about food allergies

What is a food allergy?

So, what is a food allergy? Food allergies happen when the body’s immune system reacts negatively to proteins found in a food and creates symptoms like gastrointestinal problems including abdominal pain, vomiting, colic and diarrhea. Your baby also might have respiratory symptoms such as runny nose, cough, sneezing, and breathing difficulties, or skin irritations—like rashes or hives. This article will help you understand food allergies and possible ways to help reduce risks.

You may be able to reduce your baby’s risk of developing allergies by waiting until at least 4 months before introducing food. Breastfeeding during that time is especially protective. When its time for solid foods, including potential allergens is OK for most babies, as long as the foods are developmentally appropriate. Be sure to ask your doctor about food allergens and introducing foods.

 

In unusual cases, babies may become sensitized to very small amounts of food proteins that are carried in breastmilk. If you suspect your baby is having an allergic reaction to your breastmilk, have a talk with your baby’s doctor to discuss symptoms and removing the likely triggers from your diet.

 

So, is it an allergy or an intolerance?


We know the difference is confusing. Food allergy reactions have more to do with the immune system and may happen quickly—within minutes or hours after eating—and can include symptoms such as hives, pale skin, vomiting, diarrhea and breathing problems. Reactions can happen even when only a very small amount of food is eaten, touched or even inhaled. The most common foods causing allergies in the US are peanuts, treenuts, milk, egg, wheat, soy, fish and shellfish. 



Food intolerances are reactions to foods inside the digestive system (and don’t involve the immune system). Lactose (a sugar found in milk) intolerance is an example of a food intolerance in adults. Usually, small amounts of the problem food can be eaten before symptoms appear. Some symptoms might be gas, stomachaches, bloating and diarrhea.



The only way to know what your baby is experiencing is to talk with their doctor and discuss your concerns.

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Understanding cow milk allergy

Understanding your baby’s cow’s milk protein allergy

Cow’s milk protein allergy is the most common food allergy in infants and young children 0–2 years of age.

Cow’s milk protein allergy usually shows up before baby’s first birthday. Good news is, most children may outgrow it.



Cow’s milk protein allergy happens when a baby’s immune system reacts to the proteins in cow’s milk. Formula-fed babies react to the milk protein in the formula. Breastfed babies react to the cow's milk protein in Mom's diet that are passed through her breastmilk. In both cases, the body’s immune system treats this protein as a foreign substance and tries to fight them by releasing natural chemicals, such as histamines, which cause the allergic symptoms that your baby may be experiencing.

 


What to watch for


Symptoms of cow’s milk protein allergy can vary, and they can affect different organ systems in the body. This can make it difficult to pinpoint a cause. Also keep in mind that every case is unique, so it helps to be aware of all the possible symptoms. Get in touch with your baby's pediatrician if you suspect your child has cow's milk protein allergy.

 

Talk to your baby's doctor if you should see any of these areas of concern.


Common symptoms of cow’s milk protein allergy

Organ system involved Symptoms
Digestive system Frequent spit-up, vomiting, diarrhea, constipation, blood in stool, anemia.
Skin Atopic dermatitis (allergic skin rash), hives, swelling of lips or eyelids.
Respiratory system (not related to a respiratory system infection) Runny nose, ear infections, chronic cough, asthma, wheezing, congestion… particularly if these conditions are chronic.
General Your baby may be fussy, cry inconsolably or have a hard time getting to sleep very often. You also may notice that your baby isn’t gaining the appropriate amount of weight.

 

These symptoms happen within minutes or hours after your baby has been fed formula or exposed to milk protein through other products or even mom's breastmilk. Severe symptoms like hives, difficulty breathing, and facial swelling can happen within the first half hour.

 

Will she always have a milk allergy?


The good news is cow’s milk protein allergy is one of the allergies children often outgrow. This usually happens by the time they are between 2 and 5 years old, and 80% of children will be cow’s milk protein allergy-free by their 16th birthday. Allergies to eggs, soy and wheat are also often outgrown; however, allergies to peanuts, tree nuts, fish or shellfish may be life long.

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Develop food allergies

How babies develop food allergies

With all of the talk out there about food allergies, of course you're concerned and want to understand more. Here's what you should know about how babies develop an allergy to certain foods.

Most grown ups' immune cells are found inside the digestive tract, but babies' digestive systems are still developing every day. That's why food allergies are more common in infants than other age groups.

 

Here’s how it works:

 

  1. A food allergy develops when a baby’s immune system becomes “sensitized” to an allergen or protein in a certain food. This may happen the first time the baby is exposed to the food, but can also come later.
  2. Once sensitized, the baby‘s body makes antibodies—little proteins that “lock” onto foreign invaders—that are ready to react to that food the next time it’s eaten.
  3. These antibodies then trigger immune cells to make histamine, a chemical that causes allergy symptoms—rash, wheezing, diarrhea, etc.

 

Feeding choices may be able to lower your baby’s chances of developing a food allergy. That's why experts suggest having your baby drink only breastmilk for at least the first 4 to 6 months of life and waiting until they're at least 4 months old to start appropriate solid foods.

 

Atopic dermatitis

 

The most common symptom of food allergy in babies is atopic dermatitis (AD), a type of skin rash or eczema that most often appears on the face, scalp, limbs and knees. The number of infants with AD has gone up 2 to 3 times over the past 30 years, and nearly 1 in 5 infants will develop AD by 6 months of age. While any baby may develop AD, if the baby's parents or siblings have ever had symptoms of allergies such as hay fever, asthma or AD, or if the parents or siblings have diagnosed food allergies, then they may be at increased risk.

 

Cow’s milk protein allergy

 

Cow’s milk protein allergy affects as many as 2–7% of babies. Baby formula is the most common culprit, but babies can also react to the cow’s milk protein that Mom has in her diet, which can be passed through to her breastmilk.



If you think your baby may have a food allergy, talk to your pediatrician as soon as possible to see if allergy testing might be a good idea. They will usually suggest a change to a hypoallergenic formula prior to any additional testing.

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Allergies and solids

Watching for allergies when starting solids

It's no fun for you or your little one, but as your Supported Sitter starts to try new foods, you may discover that they have a food allergy or sensitivity. Reactions to foods may be common during infancy, although only 8% of children 1-18 years have a food allergy. Here's a little info to make figuring things out a bit easier.
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aah with an allergy

Nutrition for babies with food allergies

Starting a baby on solids can make any parent a little anxious, even without food allergies. For babies with cow’s milk protein allergy, you may also worry if your child will have other allergies. Children that already have at least one food allergy are at risk for others, so careful planning is important. That’s why it’s a good idea to work with your baby’s doctor or dietitian to plan the best approach for starting solids. Having a plan in place will give you the confidence you need to be able to relax and enjoy the journey.
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Nutrition for toddlers

Nutrition for Toddlers with food allergies

About 8% of children (1-18 years old) have a food allergy. The most common food allergies are milk, eggs, peanut, tree nuts, soy, wheat, fish and shellfish. The only treatment approach for food allergies is to avoid the food altogether.
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hypoallergenic_formula.png

The ins and outs of hypoallergenic formula

Your baby’s doctor may recommend a hypoallergenic infant formula If cow’s milk protein allergy is suspected. Hypoallergenic or "HA" formulas are made with proteins that have been broken down into very small pieces called “peptides” and/or “amino acids”. These smaller proteins in infant formula greatly lower the chances of causing an allergic reaction. These types of infant formulas have been used to manage cow’s milk protein allergy for over 50 years.

In order to be labeled “hypoallergenic,” studies must show that babies with cow’s milk protein allergy are able to drink the formula with a low risk of having an allergic reaction.

 

Different proteins, different formulas

 

There are two types of formulas usually recommended for cow’s milk protein allergy: Formulas made with extensively broken down proteins and those made from amino acids, very small compounds that are the building blocks of proteins.


Extensively hydrolyzed formula

 

Extensively hydrolyzed infant formulas go through a process called “hydrolysis” to extensively break proteins down into very small pieces. It’s basically a form of “predigesting” these proteins in order to lower the chances that the proteins will cause an allergic reaction. For most infants and young children with an allergy to cow’s milk protein, this type of formula is effective and well tolerated.

 

Amino acid formula

 

Amino acid formulas, sometimes also called elemental formulas, contain amino acids which are the building blocks of protein. Amino acid infant formula may be a good option for babies who are more sensitive to milk protein, have multiple food allergies or if their symptoms are not improving on an extensively hydrolyzed infant formula

 

Regular milk-based
infant formula
Milk-based partially
hydrolyzed formula
Milk-based extensively
hydrolyzed formula
Amino acid formula
Not hypoallergenic Not hypoallergenic Hypoallergenic Hypoallergenic

 

Always use hypoallergenic formulas under doctor supervision

 

Hypoallergenic formulas are lactose-free, and some even contain a special type of fat called “medium chain triglycerides” or MCTs, which are easily absorbed by babies. In some cases, formulas with MCTs can even help fat absorption in babies whose digestive system has been damaged from the allergy. This makes hypoallergenic formula with MCTs a good option for babies who may have cow’s milk protein allergy.



Soy-based infant formulas are not recommended for infants with cow’s milk protein allergy, because many infants with cow’s milk protein allergy will also have an allergy to soy protein. 

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Did you know?
Experts do not recommend restricting baby foods with potential allergens after 4-6 months of age when served in a developmentally appropriate form.

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