Allergy UK Planwell House LEFA Business Park Edgington Way Sidcup Kent DA14 5BH

Transcription

1 Weaning Your Baby on to Solids The Department of Health (DH) recommends that all babies should be exclusively breast fed or given infant formula milk until around 6 months of age. Once they are able to stay sitting, hold their head steady, and co ordinate their eyes, hands and mouth, they can be introduced to solid foods. The introduction of solids into a baby s diet is known as weaning. The NHS website has lots of useful advice about weaning your baby onto solid foods. This can be found at When should I wean my baby? Babies are more likely to develop allergies if there is a family history of eczema, asthma or hay fever (known as atopic conditions) or allergic reactions to foods, pets etc. New research shows breastfeeding may not protect against allergy as previously thought, although it is still recommended for the first 6 months of life due to other health benefits. Current research, however, is exploring the ideal time to introduce solids. There is some evidence to suggest that introducing solid foods while breastfeeding between the ages of 5 7 months may have a protective effect against developing food allergies. If you feel that your baby does need to be introduced to solid food before 6 months, it is important that you follow the recommendation that the earliest a baby should be weaned is 17 weeks of age. Delaying weaning beyond 6 months is not advisable for any baby as: Babies need additional energy, protein, vitamins and minerals such as iron They will miss the window for accepting a wide range of tastes and textures (lumps and finger foods), resulting in food refusal It may increase the risk of allergy and other diseases. What foods should I start with? Irrespective of when you introduce solid foods, it is important to start with low allergenic foods (foods least likely to cause an allergic reaction). The following is a suggested order of introduction of low allergenic foods, also see chart on page 4: First foods: Root vegetables e.g. carrot, swede, sweet potato, parsnip, butternut squash (mashed or pureed depending on age/ ability) Fruits pureed e.g. apple, pear, banana, plum, peach, apricot, avocado Spinach, broccoli, green beans, courgette, cauliflower Potato, yam, green banana Allergy UK Planwell House LEFA Business Park Edgington Way Sidcup Kent DA14 5BH 1

2 After a few weeks: (Introduce these one at a time to spot any reaction) Rice e.g. baby rice, cooked flaked rice Ground quinoa Cornmeal, polenta (good for finger foods) Breakfast cereals and pasta/ noodles based on rice, corn and quinoa Red meats (lamb, beef), pork and poultry (pureed or finely shredded and chopped) Lentils and pulses e.g. haricot beans, kidney beans, butter beans (mashed) Any of the above in cooked tomato or fruit based sauces. Try later as finger foods: Fresh tomatoes Other fruits including citrus, kiwi, berry fruits. How should I introduce foods that commonly cause allergies? The DH recommends that high allergenic foods: Milk, eggs, wheat, gluten, soya Fish, shellfish Peanuts, tree nuts, seeds. Can be introduced from 6 months of age. There is no evidence to support delaying introduction of these foods after 6 months. They should be introduced one at a time, with a gap of 3 days in between each new food, so that it is easier to identify any food that causes a reaction. Make sure your child is well at the time of introduction, i.e. not when they have a temperature, just had a vaccination, or have a cough or a cold. Once your baby has had several attempts at eating the individual foods, you can start mixing them to increase the variety and enjoyment of eating. It may be helpful to keep a food and symptom diary to identify any foods that may have triggered a reaction. Using jars or packets of food is very convenient, but it is best to try out each ingredient individually first. The ingredients list can be found on the jars/ packets with the 14 most allergenic foods (highlighted in bold). The Food Standards Agency has produced a helpful leaflet on allergy labelling: leaflet.pdf As time goes on, your baby will hopefully just be eating what you eat, with no added salt or sugar and you won t need to be preparing or buying special foods for them. By the age of 12 months at the latest, your baby should have been introduced to all the major allergenic foods (where appropriate). Allergy UK Planwell House LEFA Business Park Edgington Way Sidcup Kent DA14 5BH 2

3 Babies at risk of food allergies Your baby is at greater risk of developing food allergy if there is a history of food allergy or atopy in the family, or if they have developed eczema in the first few months of life. The most common foods that trigger eczema are cow s milk, egg and peanut. If this is the case, parents should consult their GP, health visitor or allergy doctor before giving these foods. Many children outgrow their allergies to milk or eggs, but peanut allergy is generally lifelong. A referral to an allergy specialist is recommended for any baby/child where their allergyfocused history or allergy testing suggests they are at risk of an allergy reaction. Symptoms commonly caused by immediate (IgE mediated) reactions to food include: hives (urticaria), swelling (angioedema), itchiness (pruritis), eczema and breathing difficulties [rhinitis (runny or congested nose), wheeze, cough]. Delayed reactions to food (usually over 2 hours after ingestion), known as non IgE mediated food allergy, are more difficult to diagnose. Symptoms are mainly gastrointestinal e.g. loose, offensive poo, mucus or blood in poo, constipation, vomiting, gastro oesophageal reflux, sore bottom or nappy rash, poor weight gain and eczema. If you suspect that your baby does have a reaction to a food, consult your GP or health visitor. If it is an immediate reaction, don t test it out for yourself by trying the food again, avoid that food and see your GP as soon as possible. More about peanuts The Government revised its advice about peanuts in 2009, based on a review of the evidence which showed there was no clear evidence that eating or not eating peanuts (or foods containing peanuts) during pregnancy, breastfeeding or early childhood had any effect on the chances of a child developing a peanut allergy. The revised recommendations state that if you would like to eat peanuts or foods containing peanuts (such as peanut butter) during pregnancy and while breastfeeding, you can do so unless you are allergic to them or your health professional advises you not to. Foods containing peanuts include peanut butter, peanut (groundnut) oil and some snacks. Whole peanuts or nuts should not be given to children under 5 years of age because they could choke on them. Allergy UK Planwell House LEFA Business Park Edgington Way Sidcup Kent DA14 5BH 3

4 Summary table of introduction of appropriate foods and textures. First weaning (not before 17 weeks) Serve food as: From 6 months (26 weeks) 7 to 9 months 9 to 12 months Smooth purees Well mashed foods Mashed foods with some lumps and soft finger foods Mashed, chopped and minced family meals and finger foods Introduce: Smooth cereals, e.g. baby rice, flaked rice, ground quinoa, cornmeal Gluten containing foods (wheat, barley, rye) bread and cereals, oats, pasta, cous cous Bread, chapatti, cereals, pasta, rice, polenta, noodles, cous cous Bread, chapatti, cereals, pasta, rice, polenta, noodles, cous cous Soft cooked pureed/ mashed fruit bananas, pears, apple, stone fruit, avocado, tomato pureed / sauce, citrus flavours Soft cooked/ mashed fruit bananas, pears, apple, stone fruit, avocado, tomato pureed / sauce, citrus flavours Raw soft fruit and finger foods e.g. banana, melon, mango, avocado, kiwi, berry fruits Stewed fruit, fresh tomato, citrus fruits Raw soft fruit and finger foods e.g. banana, melon, mango, avocado, kiwi, berry fruits Stewed fruit, fresh tomato, citrus fruits, Soft cooked root and green vegetables, potatoes, yam, green banana Mashed root and green vegetables, potatoes, yam, green banana Raw soft vegetables e.g cucumber, courgette and soft cooked vegetables, potatoes, yam, green banana Raw soft vegetables e.g cucumber, courgette and lightly cooked vegetables, potatoes, yam, green banana Pureed pulses/ lentils Meat and poultry (pureed) Finely chopped/ pureed meat & poultry Smooth Peanut butter, smooth nut spreads, Finely chopped/ minced meat & poultry Peanut butter, nut spreads, Chopped/ minced meat & poultry Peanut butter, nut spreads, Well cooked egg, Fish Well cooked egg Fish and shellfish Well cooked egg Fish and shellfish Allergy UK Planwell House LEFA Business Park Edgington Way Sidcup Kent DA14 5BH 4

5 Key points Breast feed where possible for the first 6 months of life, introducing solids as recommended by your health visitor Recent research shows breastfeeding does not protect against allergy, but has many other heath benefits, so is always recommended where possible If you are considering stopping breastfeeding before 6 months, consider replacing breast milk with a partially or extensively hydrolysed infant formula Introduce solids, no earlier than 17 weeks of age as recommended by your health visitor Don t delay introducing foods after 6 months, even if you are a high risk atopic family Then introduce high allergenic foods one at a time, when your baby is well Continue to breast feed if possible throughout the weaning process, but especially while introducing new foods Parents of children at risk of allergy should ask their GP, health visitor or allergy specialist before introducing foods containing peanuts, if they have eczema or egg allergy. Last updated: May 2016 Next review date: May 2019 Version 7 Allergy UK Planwell House LEFA Business Park Edgington Way Sidcup Kent DA14 5BH 5