When I was a kid, food allergies were so rare that nobody even thought about them. But nowadays food allergies afflict about 1 child in 25 in the U.S., a startling 18% increase from rates of just 10 years ago. Such rapid increases mean that something about our lifestyles or environment is probably increasing risk for food allergies, but there is not much consensus on what factors might be contributing. When I became a parent, I wondered if my diet while pregnant or breastfeeding would matter, and agonized over what solids to introduce, and when. I heard so much contradicting advice that I decided to sift through all the most recent research myself.
The reason you’ll see a lot of conflicting advice in baby books and websites is because the American Academy of Pediatrics (AAP) used to advise avoiding all sorts of foods until children reached 1-3 years of age, but in 2008 they “revised” their policy. Actually “reversed” is a better word for it, because they now recommend no restrictions of any kind other than waiting to introduce solids until 4-6 months. There is no evidence that a mother’s diet, in pregnancy or during breastfeeding, has any effect on allergy risk. The AAP also found no evidence that it helps to delay introduction of allergenic foods like egg, soy, nuts or fish. My daughter’s pediatrician echoed the new policy: “Really the only food that’s an absolute no-no is honey before age 1, because of the risk of botulism,” he said. “But,” he added, “A lot of parents feel more comfortable waiting until later to try the more allergenic foods, just to be on the safe side.” Now this made me wonder: was this cautious approach really safer? Would it hurt to wait?
I had recently read that African Americans have the highest rate of peanut allergies in the U.S, higher than whites or Hispanics. I was very surprised by this, because peanuts are a staple food in Africa; in fact, peanut allergies are so rare there that nuts are used as the base for a popular nutritional supplement (charmingly named “Plumpy Nut”) used to feed starving children in Africa. I wondered if delaying introducing nuts in the U.S. could be part of the reason for the higher rate of allergy in African Americans. Conflicted, I asked my Japanese-American mother what Japanese people feed babies. “Tofu and fish,” she said promptly. “Perfect baby foods, nice and soft.” I thought about this, and realized I had never heard of a Japanese person allergic to soy or fish. It turns out there is actually some preliminary evidence that it may be helpful to carefully introduce allergenic foods between 6 and 12 months of age; waiting longer may make children more likely to be allergic to the new food when they finally encounter it at an older age.
Now the last thing I want to do is to make parents of allergic children feel guilty for not introducing allergens early. Just remember that genetics accounts for most risk. But if you’re a new parent looking for any way to reduce risk, however small, then you might want to reconsider whether delaying introducing a variety of foods is really “safer.”
In the end, I decided to feed my daughter everything except honey until 12 months, and since she turned one I’ve just tried to give her a taste of everything I eat, unless it’s extremely spicy. So far, we’ve been lucky: no mysterious hives or rashes, and a toddler who likes miso soup and shrimp gyoza.