Checking for allergies and intolerances
When transitioning to solids, introduce new foods one at a time, waiting 2 to 4 days before starting another new food. This will let you see how Baby reacts to each food and will help identify any allergies or intolerances.
Don’t be concerned if the color and texture of your baby’s stool change during this time. These changes are normal and don’t indicate a problem. Signs of allergy or intolerance to look for including a new skin rash, vomiting or diarrhea. If you think Baby is allergic to a food, eliminate it from her diet and see if the symptoms also disappear. Ask your pediatrician about any new symptoms or if you suspect a food allergy.
Guidance on delaying the introduction of potential allergens
The American Academy of Pediatrics revised their guidance on allergens, indicating that there is little support for delaying the introduction allergenic foods beyond Baby’s transition to solids (typically around 4 to 6 months). As long as they are introduced one at a time, with a few days in between to watch for Baby’s reaction, foods like egg white, nut butter and fish can be introduced to Baby around 7 months and up.
Although the vast majority of babies will never develop a single food allergy, some pediatricians recommend delaying the introduction of certain foods on a case-by-case basis. Talk to your doctor about whether your child is at an increased risk for developing a food allergy – typically if she has a sibling or parent with a food allergy or other allergic condition.
Here are the foods which are most likely to cause allergic reactions, along with some conservative guidance on when to introduce them to your baby:
- • Milk — Milk products like yogurt and cheese can be introduced to Baby around 6 months. For all babies, regardless of allergy risk, wait until 1 year to give cow’s milk for drinking, as it can be more difficult for babies to digest and should never replace breast milk or infant formula, which is a richer source of nutrients for babies.
- • Wheat, soy, egg whites, fish & shellfish, peanuts & tree nuts — Most babies can be introduced to these foods around 6 months. However, if your baby is considered high-risk for food allergies, your pediatrician may advise you to wait.
Other foods that may not be well tolerated by younger babies or that may cause allergic reactions include citrus fruits, chocolate, raw strawberries, or tomatoes. If you choose to introduce these foods before 1 year, just watch for a reaction and discontinue feeding Baby the food if she seems not to tolerate it well.
Other foods to avoid or delay
Foods that can cause choking are hard foods that require too much chewing for young babies and small round foods that can lodge in the throat. Avoid these foods until age 2 or older: nuts, seeds, popcorn, snack chips, pretzels, raw carrots, raisins, whole grapes, hot dogs or sausage links, hard candy, or large chunks of meat or other tough foods. Soft but sticky foods like chewing gum, marshmallows and jelly candies can also get lodged in the throat and should be avoided.
Honey may contain spores of Clostridium botulinum, which can cause botulism. Adults’ immune systems can handle a small amount of these spores but babies under 1 year are susceptible to a life-threatening reaction to the toxins they produce. So, no honey for your honey until she’s at least 12 months old.