A Practical Approach to Food Allergy Prevention

This is a Partner Post with Ready, Set, Food!

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When I started Sophie on solids, I was really nervous— about her possibly choking, or being allergic to a certain food. I was hesitant to introduce her to the top 8 allergenic foods— eggs, peanuts, milk, fish, soybeans, tree nuts, shellfish and wheat. But rather than avoid them, I sought out research articles on PubMed to find out where the science community stood on the topic. And that’s when I found the landmark studies that strongly suggested that early allergen introduction significantly reduces the risk of babies developing food allergies.

This put my mind at ease, and I started introducing Sophie, at 6 months old, to the main 8 offenders. I wasn’t aware of a program like Ready, Set, Food! at the time, so I didn’t have a systematic approach, besides waiting 4 days to intro her to a new allergen (which is recommended).

After discovering Ready, Set, Food!, my understanding of the importance of allergy introduction deepened. I learned that milk, egg and peanuts are the most common allergenic foods, making up over 80% of childhood food allergies. I also learned that food allergies are on the rise—now 1 in 13 children are affected by a food allergy, and a peanut allergy, in particular, has tripled since 1997. A big contributor to this increase is delayed peanut introduction.

The most important piece to allergy introduction, though, is sustained exposure, and that is what Ready, Set, Food! developed— a system that uses an evidence-based approach to gently guide food allergen introduction, incorporating the exact protein amounts used in the landmark studies. Their system starts with a very small amount of the food protein before gradually increasing to the maintenance amount, as recommended by allergists, and is easy to stick to and make a habit, because their product comes in a powder form in a stickpack— perfectly portioned. So all you have to do is pour it into baby’s bottle or mix it into their pureed food. The beauty of this is that whether a mom is EBF, Formula feeding, a combination of both, endeavoring babyled weaning— the powder works with all feeding styles.

A lot of moms have questions and concerns about introducing allergens to their babies, so I asked for feedback on questions you wanted answers to, and reached out to Katie Marks-Cogan, M.D., Co-founder, of Ready, Set, Food!, and Board-certified Allergist, who is also a mom of 2 gorgeous little ones. Here are your questions and her responses.

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What might put a baby at an increased risk of developing a food allergy?

Dr. Marks-Cogan:

There are many different things that can determine a baby’s risk for food allergies, including these common risk factors:

Eczema (Atopic Dermatitis)

Atopic dermatitis, a type of eczema, is considered to be the most important risk factor for food allergy development in children. Research has shown that 67% of infants with severe eczema and 25% of infants with mild eczema will develop a food allergy. If your baby has severe eczema, current guidelines recommend that they receive allergy testing prior to the introduction of certain allergenic foods. If you’re unsure about the severity of your child’s eczema, consult with your pediatrician or allergist first.

Family History

A baby with a family history of food allergies has a slightly higher risk of developing a food allergy. Specifically, a child's risk of developing a food allergy is 13% if they have a sibling with a food allergy compared to ~8-10% in the general population. However, over 50% of kids with food allergies do not have a family history, which is why early allergen introduction is recommended for all babies.

Avoidance of Allergens

For many years, experts thought that the best way to avoid food allergy was to avoid eating allergenic foods in the first 1-3 years of life. Multiple landmark studies have helped show that the opposite is true. Delaying the introduction of allergenic foods, like peanut and egg, into an infant’s diet can actually increase their risk of specific food allergies. Therefore, it’s important for parents not to delay or avoid introducing allergenic foods.

What is the best age to start introducing common allergens to babies, and should they be given in a certain order?

Dr. Marks-Cogan:

Starting early is critical for the best chance of reducing your baby’s risk of developing food allergies. It’s also important to note that babies aren’t born with food allergies -- they develop over time. Scientists now recognize that there is a window of opportunity to train a baby’s immune system to help guide it away from allergies. That’s why, based on recent research, national health organizations are recommending allergen introduction as early as 4 months of age.

Starting with the most common allergens like milk and peanut, and/or the allergens that can greatly affect your child's quality of life is a good rule to follow. For many children, milk and egg allergy can greatly impact quality of life, so starting with those is important. The American Academy of Pediatrics (AAP) also recommends introducing 1 new food every 3-5 days so that you can determine if your baby is having a reaction to it.

Are there any possible risks to introducing allergens to my baby?

Dr. Marks-Cogan:

It’s very common for parents to be anxious about feeding their babies potentially allergenic foods, but in the three clinical trials that started early allergen introduction as early as 3-4 months of age, with over 2,000 babies, there weren’t any cases of severe anaphylaxis or hospitalizations. I recommend that parents start with small amounts of each food before increasing to larger amounts, similar to our approach with Ready, Set, Food! However, if a child shows any signs of sensitivity (e.g. rash, stomach upset), parents should stop immediately and consult their pediatrician.

Is it OK to feed my baby peanut, egg, and milk while I’m pregnant or breastfeeding? Can that reduce their risk of developing an allergy?

Dr. Marks-Cogan:

Great question, and one that I think a lot of moms are curious about. Currently, scientists do not believe that specific maternal diets during pregnancy or breastfeeding can be protective against food allergy, but this area is still being studied. That being said, the new national guidelines on infant food allergy prevention still recommend that early and sustained allergen introduction be part of a baby’s feeding routine regardless of mom’s diet.

What should I do if my baby shows signs of a possible allergic reaction or sensitivity?

Dr. Marks-Cogan:

Parents should only plan to introduce allergenic foods when their baby is healthy and an adult can monitor for any signs of a reaction for 2+ hours. Also, per pediatric guidelines, only introduce 1 new allergenic food at a time, waiting 3-5 days in between each new food introduction to identify if your child has a reaction. If your baby has an allergic reaction it is important to stop feeding that particular food and seek immediate medical advice from your pediatrician or allergist.

What can parents do to reduce their baby’s risk of developing a food allergy?

Dr. Marks-Cogan:

There is currently no cure for food allergies, which makes prevention the first and best line of defense against food allergies for families. The current recommendations for food allergy prevention include:

Consult Your Pediatrician:

Discuss the new guidelines at your child’s next well visit, especially if your child has severe eczema. Don’t know where to start? Use this handy checklist of allergy prevention questions to ask your pediatrician.

Start Early:

Starting at 4-6 months of age is likely more effective at reducing a baby's risk of developing food allergies, but positive results have been seen in the studies for babies who started as late as 11 months of age. Studies suggest that delaying peanut introduction may put your child at a greater risk for developing a peanut allergy.

Once is not Enough -- The Importance of Sustaining Exposure:

Sustained introduction is just as important as early introduction. In recent landmark studies that resulted in 67-80% reduction in certain food allergies, participants sustained exposure multiple times a week for 3 to 6 months or more.

The Challenge of Sustaining Exposure:

It’s common for parents to struggle with sustaining exposure because feeding infants certain foods multiple times a week can be challenging. In fact, in one of the landmark studies, only 50% compliance was achieved among participants, indicating that early and sustained introduction is difficult at such a young age.

With the rate of food allergies rising, it’s exciting that parents have the opportunity to reverse this trend through the proven benefits of early and sustained allergen introduction. However, many parents struggle with following the new guidelines on prevention. Parenting is difficult enough, so when we discovered that there wasn’t a product on the market that made this process easy for parents, I helped a team of leading experts, physicians, and parents, create one. After over 12 months of research and development, we're proud to offer a gentle, guided system that helps reduce the risk of developing peanut, egg, and milk allergies by up to 80% for families like yours. To learn more about how Ready, Set, Food! makes early and sustained allergen introduction easy, visit our website here.

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