Identifying Food Allergies

Food allergies have been a growing concern among new parents, as the medical community raises more awareness of how common they are becoming. With frightening stories circulating about sudden and severe reactions to baby foods, many parents are anxious about allergies and taking extra precautions to be prepared.

Recognizing a food allergy isn’t too difficult in most situations, although you might not realize what it is at first. The symptoms can range from mild to severe, and in the case of a truly severe reaction will require immediate medical attention.

Symptoms of a Food Allergy

Common food allergy reactions include difficulty breathing, wheezing, swelling, rashes, itching, nausea, vomiting and diarrhea. The onset of the symptoms is generally fairly quick, within a few minutes to a few hours after your child eats the allergenic food. In rare, severe cases, a food allergy can result in anaphylaxis, where the throat swells up, blood pressure drops and the child may go into shock and be as risk of death if not treated immediately. This type of reaction requires a 911 call without delay and a visit to the emergency room.

How to Determine Which Food Caused a Reaction

If the reaction occurs early in your child’s introduction to solid foods, it should be fairly easy to tell which food is the culprit. When introducing new foods to a baby, allowing a space of several days in between adding new foods will allow you to tell whether a reaction develops in response to the latest new addition to the menu.

Unfortunately, it isn’t always that easy. Some allergies can develop even if the child has tried the same food in the past with no reaction; allergic reactions can happen after several uneventful servings of the food. And in older children, who eat a much more varied diet, it can be very difficult to tell which food is to blame.

If you have a good idea which baby food caused the reaction, you should immediately remove it from your child’s diet. Even if the initial reaction was mild, a stronger reaction could occur the next time. If you aren’t certain which food is to blame, start by eliminating the most likely culprit – watch for highly allergenic foods such a dairy, strawberries, eggs and nuts as likely choices.

An allergist can perform tests to find out specifically which food your child is allergic too, but you will generally figure it out fairly quickly if you keep track of what your child ate and when reactions occurred.

What to Do If an Allergy is Discovered

First of all, you should of course prevent your child from eating that food. Next, make sure that any caregivers such as grandparents and babysitters are aware of the allergy. In the case of a severe allergy, you might be required to carry a special injectable medication that can be used in case of accidental contact with the food. You should also make sure all caregivers are ready and able to provide the injection should it become necessary.

Allergies can change over time, and your child may outgrow the allergy. Talk to your doctor about this possibility and how to go about re-introducing the food with caution. Some allergies are so severe that it is unlikely they will be outgrown and not worth taking the risk of finding out.

Identifying and Treating Constipation in Your Baby

Constipation is one of the most common reasons that new mothers call their baby’s pediatrician for advice. While babies do get constipated, many of the incidents that lead to a call to the doctor aren’t constipation at all, but rather a normal change in a baby’s bowel movements. When baby really is constipated, however, it can make for a very unhappy baby and thus an unhappy mother too.

How Long Can a Baby Go Between Bowel Movements?

It isn’t necessary for a baby to have a bowel movement every day, and a space of a few days between dirty diapers isn’t anything to be concerned about. In a breastfed baby, bowel movements can occur as little as once a week, and a space of up to two weeks can be normal. Because the body absorbs breast milk so thoroughly, there is often little waste leftover to form stool. For this reason exclusively breastfed babies rarely become constipated.

How to Recognize Constipation

Merely not having a bowel movement for a few days doesn’t necessarily mean baby is constipated, as many new mothers believe. Constipation occurs when stool becomes backed up in the intestines in a large enough amount to cause pain and discomfort for baby. This is usually noticeable in baby’s behavior and mood. A constipated baby may become fussy or even extremely upset when attempting to pass a stool. This is because the stool has become hard, dense, and difficult to pass. If your child seems to strain when having a bowel movement but is not crying or in pain and passes soft stool, constipation isn’t a problem. In this case, infrequent stool is probably normal for your child at this stage of life.

When your baby starts to pass hard, small stools that are heavy and dense, and is showing significant distress when passing them, constipation is likely, even if the stools are being passed fairly frequently.

Treating Constipation

Most pediatricians will recommend a small amount of fruit juice such as apple juice to get things moving. Remember to closely follow your doctor’s recommendation for the amount of juice, because too much can swing the pendulum in the other direction and cause diarrhea. In severe cases, a glycerin suppository may be recommended to soften the stool and clear out the bowels.

Treating a one-time case of constipation is usually fairly simple and straightforward. If your baby has regular, recurring constipation, however, it’s a good idea to take a look at what you are feeding. A change to a different formula is a good idea, as an intolerance for one of the ingredients in formula is a common culprit in constipation. Your baby may not be able to tolerate cow’s milk proteins and will do better on a soy formula.

If changing formulas does not seem to alleviate the problem, it’s probably time to talk to your baby’s doctor about the ongoing problem, and work together to find a solution. The constipation could be caused by a blockage or another condition affecting the bowels and causing them to fail to move stools along properly. These are rare problems, but warrant investigation if common methods fail to successfully treat your baby’s constipation.

Many babies will encounter constipation at some point, whether from a problem with formula or when starting solids, another constipation culprit. Fortunately, most cases are easily treated and do not become serious problems.

Safety for Self-Feeding

When your baby starts to feed herself, she is learning important life skills and moving towards independence. It takes a long time, however, for a baby to successfully learn to self-feed, and while she is learning you will need to be vigilant and very cautious about what she eats and how she is eating it.

Self-feeding and Choking Hazards

Although your baby might be feeling confident about her ability to handle any baby food put in front of her, remember that she also thinks it’s a good idea to put everything in her path into her mouth. Your baby can’t judge the size of a piece of food and know whether or not it could cause her to choke. When serving finger foods to your baby, you must make certain that the pieces of food are small enough and well cooked enough that they aren’t likely to become lodged in your baby’s throat causing her to choke. Foods that dissolve easily are the best choices for first finger foods as they will break down quickly and reduce the risk of choking.

There’s another choking hazard inherent in self-feeding that can occur no matter how small you cut up your baby’s food. Many babies get a little overzealous with the joy of being able to get food into their own mouths, and will continue to stuff more food in before they have had the chance to chew and swallow what is already in there. The best solution to this problem is to dole out the finger foods only a few bites at a time, but if you want to put the whole bowl in front of your baby, stay close and make sure she chews and swallows each bite before going for another mouthful.

Avoid foods that might seem like a good choice but are in fact some of the top choking hazards for babies. Raisins, grapes and nuts are all choices to save for when your baby is a little older. Although grapes can be cut up into smaller, more manageable bites, they outer skin can still be tough for a baby to handle as an early food. Hot dogs and sausages are another choice that can be made safer by cutting them into small pieces, but are probably best saved until your baby is a little older.

Safe Use of Utensils

When you introduce baby to a fork and spoon in order to feed himself, be sure that they are safe choices. Look for forks with slightly rounded tines. Plastic is an even safer choice, but plastic forks rarely work well due to their general inability to spear food effectively. Instead, choose metal, but make sure the tines can’t hurt baby – or you! Purchase baby forks and spoons rather than using regular utensils, even the smaller dessert forks and spoons you may have. A baby spoon should have a rubber tip or be made of plastic to be gentle on your baby’s gums.

Your baby isn’t all that good with the fork and spoon yet, and it may not land right where he aimed, so make sure he is holding a tool that will do the job for him, but doesn’t pose any risk of injury. You will probably need several sets, as you’ll find your baby drops his utensils a lot during the learning process, and will need a clean one!

The Most Common Choking Hazard Foods

Do you know which baby foods pose the highest risk of choking to young children? Some of them may surprise you. Make sure to learn which foods are dangerous and keep them off the menu until your child is old enough and has the right teeth and skill to chew them properly.

The AAP has identified ten foods that are the top food choking hazards for children under 4 years old. Most choking incidents involve food, although luckily most of them are not fatal. The risk is not worth taking, however, so make sure that you and everyone who cares for your children knows what these foods are, and avoids them or takes the right precautions when serving them.

The Top Ten Choking Hazard Foods

While some of these might be obvious, others may not have occurred to you. The ten foods most likely to cause choking are as follows:

  • Hot Dogs: Their round shape can easily lodge in a child’s small airway, and they are too heavy to easily cough out. Hot dogs can be served, but should be cut up into small bites by quartering each round slice carefully.
  • Nuts and seeds: These may seem obvious to some people, but remember that it isn’t just a bowl of nuts that pose the risk. Nuts and seeds can appear in all kinds of baked goods, so keep an eye out for them
  • Chunks of meat or cheese: Meat should be cooked thoroughly and served in very small bites. Cheese is best sliced thin or even shredded, and never served in cubes.
  • Whole grapes: The skin can be very hard to break through, especially without teeth. Grapes should be cut into quarters before serving.
  • Hard, sticky candy: This one isn’t all that surprising to most people, and you might never think of giving your baby hard candy – but make sure well-meaning grandparents and others know the rule as well. As your child gets older, hard candy is still not a good idea – keep candy a rare treat and serve only soft options.
  • Popcorn: Most parents are surprised by this one; after all, popcorn is a soft, fluffy bite that melts in your mouth. Unpopped and partially popped kernels, however, pose a serious risk.
  • Chunks of peanut butter: If you have ever gotten peanut butter stuck on the roof of your mouth, you can imagine how this could become a problem. Serve smooth peanut butter in a very thin layer, and try spreading it on warm toast so that it melts.
  • Raw vegetables: Until your child is able to chew very effectively, don’t offer raw vegetable such as carrots which are hard and can pose a choking hazard. Cook vegetables at least partway before serving.
  • Chewing gum: You might never offer chewing gum to a baby or young child, but that doesn’t mean they might not get their hands on it. Keep it safely out of reach.

Knowing this list and using caution with these foods is a good step towards avoiding choking hazards. It’s also a good idea to make sure you know what to do in case your child does choke. The Red Cross and other organizations offer training for parents in choking and CPR. Make sure you keep your skills up to par, so that you will be able to provide your child with help if it should be required.

Foods Your Baby Should Avoid in the First Year

During the first year of your baby’s life, there are some baby foods that you should be careful to avoid for several reasons. Your baby’s digestive system is not yet able to handle some foods, while others may pose a risk of a serious illness. Other foods should be avoided simply because your baby is not yet able to chew them and the risk of choking is high. While most foods are safe enough for your baby in the first year, keep this list handy to avoid problems.

Baby’s Digestive System Isn’t Ready!

There are some foods your baby’s digestive system just isn’t ready to handle for various reasons. For the first six months, your baby’s tummy can really only handle breast milk or formula, but once solids are started there are still some choices that can cause digestive problems.

Among other reasons, cow’s milk should be avoided in the first year because your baby’s body can’t digest the proteins easily, leading to gastrointestinal distress. Cow’s milk also blocks the absorption of iron, which can cause your baby to become anemic.

The same goes for wheat, which can be hard for young babies to digest and could lead to celiac disease, or gluten intolerance. While there are differing opinions on how soon babies should have wheat, it can’t hurt to wait out the first year to be safe.

Choking Hazards

Some foods are unsafe for babies under a year old because they are difficult to chew or are just the right shape and size to pose a threat of choking. While some of the top choking hazards such as grapes can be cut up to minimize the risk, there are other foods that should be avoided altogether. Don’t give your baby nuts – they are very easy to choke on and your baby won’t be able to chew them until molars appear. Nuts were once off the list due to allergies, but the new stance on allergenic foods only means nut butters are now alright for baby (unless there is a history of allergies). Whole nuts are still a poor choice under one year old, and often well into the second year.

Another major choking hazard is raisins, which can become very gummy, stick together and get caught in baby’s throat. Wait until after a year old to introduce them, and watch your baby for signs of readiness for such chewy foods.

Foods that Can Make Baby Sick

Babies under a year old should never be fed honey, as it can contain botulism spores. In a baby’s undeveloped digestive system, this can quickly form a toxin that leads to infant botulism, a serious illness.

Extra salt should never be added to baby’s food. Excess sodium upsets the balance of fluids in the body, and it can also damage your baby’s kidneys which are not yet able to process salt effectively. There is no reason to season your baby’s food with salt, and any food containing high levels of sodium should be avoided during the first year. Even into the second year, use caution with salt.

A Word on Allergies

If allergies run in your family, especially in the immediate family, you will need to strike a few more foods off the list in baby’s first year. Babies with a family history of allergies should avoid highly allergenic foods such as eggs, nuts, strawberries, and seafood for the first year and in some cases beyond. Discuss the introduction on allergenic foods with your baby’s doctor.

Which Foods Should be Withheld from Babies?

Choosing the right baby foods for your baby can be a little complicated. In addition to choosing foods that are easy to digest, you also need to be on the lookout for potential allergens and some foods that are just downright dangerous. Fortunately, it’s fairly easy to clear up the mystery of which foods baby can have early on, and which you should wait to offer until baby is a little older.

Introduction of Allergenic Foods

Some foods are known to carry a higher risk of an allergic reaction than others. Many of these foods are also more likely to result in a serious allergic reaction, rather than a mild one. Until recently, new parents were advised to delay the introduction of such highly allergenic foods as strawberries, eggs, peanuts and peanut butter in all children to avoid potentially serious allergic reactions. Recently, however, the AAP has changed their stance on this based on the new research. There is no indication that delaying allergenic foods has any impact on allergic reactions. Introducing these foods earlier may in fact be beneficial to babies.

There are exceptions to every rule, including every feeding rule. If there is a history of severe food allergies in your immediate family, especially yourself, your spouse or a sibling of the baby, it’s still a good idea to wait on potential allergens. Talk to your baby’s doctor about when to introduce these foods and how to do it safely.

Unless you have reason to be concerned, however, most children can be safely introduced to allergenic foods right along with other foods.

Cow’s Milk

The AAP recommends that you wait to introduce your baby to cow’s milk until after one year of age. There are a few reasons for this, but they are mostly related to nutrition and your baby’s immature digestive system. The balance of nutrients in cow’s milk does not meet your baby’s needs in some areas, and may exceed them in other areas. The protein in cow’s milk is very difficult for a baby’s digestive system to handle. Cow’s milk also blocks the absorption of iron in the system which can lead to anemia. It can cause widespread problems throughout your baby’s system.

After one year of age, as your baby weans off of breast milk or formula, it is ok to start giving cow’s milk. Stick to whole milk, which provides the fat your baby needs for proper development.

Other dairy products, such as yogurt and cheese, are ok to serve to baby prior to turning one. Because they are processed and broken down, they won’t cause the same problems as drinking milk can.

Avoiding Honey

Although a great natural sweetener that has been proven to have numerous health benefits, honey is unsafe for children under one year of age. It can contain botulism spores, which are generally harmless to older people, but can make a baby very sick and even be lethal.

After one year of age, it’s safe to start giving your baby honey as a sweetener or a very effective cough medicine.

If you are ever in doubt about the safety of a food for your baby, it’s best to check with your pediatrician before you try it. As babies have underdeveloped digestive and immune systems, things that don’t affect adults can make them very sick. Better safe than sorry is always the best rule of thumb.

Formula Sensitivities in Babies

Formula, while it does provide all of the necessary nutrients to help your baby grow, is not what nature intended for your baby to eat. A baby has a very delicate digestive system, and breast milk is designed to accommodate that system and provide it with the easiest to digest and most complete source of food possible.

Because infant formulas will never be able to replicate the composition of breast milk, it will never be as easy on a baby’s system. Most babies, however, do tolerate it well. In some cases though, a baby may be sensitive or even allergic to ingredients found in formula.

Milk Allergies and Lactose Intolerance

Most baby formulas are made with a cow’s milk base. The proteins in this base are harder for the baby to digest, but this is not the most serious problem babies may encounter when being fed a milk-based formula. Some babies are allergic to cow’s milk, or may be lactose intolerant. These are not the same thing, but both can mean a cow’s milk formula won’t be tolerated by the baby.

Lactose intolerance occurs when the body is not able to process lactose, a form of sugar found in milk and milk products. This is caused by a lack of the enzyme lactase, which is responsible for breaking down lactose. People who are lactose intolerant experience a great deal of gastrointestinal distress when they consume milk products.

A milk allergy occurs when the immune system responds strongly to something in the milk and can be very serious. Signs may include hives, eczema, diaper rash and also gastrointestinal distress. Any signs of a response to a milk-based protein should be reported to your doctor immediately.

Other Allergies

Babies who are allergic to milk may also be allergic to soy, which is the second most popular protein base for infant formula. The signs of an allergy are similar to the reactions to milk based formulas. If you have tried both and your baby can’t seem to tolerate either, talk to your doctor about switching to a more specialized formula.

Hypoallergenic Formula

Formula designed for babies who are sensitive, allergic, or lactose intolerant is available and is known as hypoallergenic formula. Talk to your doctor before making the switch to one of these formulas. They can be very expensive, and it’s best to be sure that your baby’s symptoms are indeed caused by the formula before putting a lot of money into trying pricey hypoallergenic versions.

Some babies simply have very sensitive tummies. It isn’t necessarily an allergy or lactose intolerance, but simple a digestive system that isn’t up to the task of digesting formula. You may need to try numerous formulas before finding one that is tolerated well. Some formulas for sensitive babies now exist, which are easier to digest.

The best way to avoid formula sensitivities is to breast feed your baby. Breast milk is not only healthier for baby, but it is the easiest baby food to digest. It was made for your baby’s body, and as hard the formula companies try, they simply can’t replicate what nature has created for your baby.

For babies who can not tolerate formula but whose mother is unable to provide breast milk, especially premature babies, donated breast milk is available. Talk to the hospital or your doctor about using banked milk for your baby.

The AAP’s New Stance on Food Allergies

About 50 million children in the US suffer from allergies, some of them very severe. Many new parents are extremely concerned about potential allergies in their children, and how to proceed cautiously with potentially allergenic foods, such as peanuts, shellfish, milk and eggs. As food allergies tend to be the most severe and potentially life-threatening, a great deal of research has been focused on how to reduce the risk. The AAP offers several recommendations.

When to Introduce Allergenic Foods

The AAP previously recommended delaying the introduction of potentially allergenic foods to a baby to prevent allergies. Recent research, however, refutes this. Previous recommendations were to avoid allergenic foods during pregnancy and through the first 2 years of life. In fact, the results might be the opposite – eating these foods during pregnancy and introducing children to them earlier may actually reduce the risk of allergies in the child. The current evidence at the very least does not support any benefit to avoiding these foods.

There is an exception to these guidelines; if there is a family history of severe food allergies, especially if the parents or siblings have allergies, it’s still a good idea to follow the old rules, and avoid exposure. Children with a genetic predisposition to food allergies should try the baby foods in question cautiously and at an older age, when they are stronger and more able to recover from a reaction.

If you are concerned about allergies, talk to your doctor to find out what the best path is for you, both during pregnancy and when your baby is born. Every case is a little different, and talking to your doctor can help you make sense of how the recommendations apply to you.

One of the best things a mother can do to prevent her baby from developing allergies is to breastfeed the baby for at least the first four months. Babies who are breastfed are less likely to have not only food allergies, but other types of allergies as well. This effect is most pronounced in children with a high risk for allergies. There is also no evidence that avoiding allergenic foods during lactation prevents or reduces the risk of allergies in the baby.

Does Your Baby Have an Allergy?

It can be hard to tell if the reaction is mild, so if you suspect an allergy, see your baby’s doctor. Not all allergic reactions will be serious or life-threatening, but an initial mild reaction does not mean that the next reaction won’t be stronger. If you notice anything strange after your baby has eaten a new food for the first time, such as a diaper rash, rash on the skin, upset stomach including strange bowel movements or vomiting, call your baby’s doctor. Avoid the food in question until you have talked it over with a medical professional.

In order to make it clear which foods are the culprits, be sure to introduce new foods one at a time, and wait a few days in between new foods. This way, you can tell which food is responsible for the reaction. You may not see a reaction the first time your baby tries the food, either. Sometimes the allergic reaction does not occur until the second or third time the food is ingested, which is why several days should be allowed in between adding to baby’s diet.

If your baby does develop an allergy, you may not have to avoid the food forever. Many childhood allergies are outgrown in time, but be cautious about re-introducing the food, should you choose to do so. If your child has not outgrown the allergy, a strong reaction is possible.