Any parent/caregiver of an infant approaching weaning. Particularly infants who are thought to have an increased risk of food allergy, such as those with eczema, or where there are parents or other siblings living in the house who have a food allergy.
Excluding or delaying the introduction of foods into infants’ diets increases the risk of the child developing an allergy to the food. This is particularly the case for children with eczema if excluding egg, peanut products and cow’s milk.
Many parents are understandably concerned about introducing certain foods into their child’s diet. However, evidence from large clinical trials, such as the LEAP and EAT studies, have shown early introduction help prevent allergy to egg and peanut.
It is recommended that weaning foods including fruit and vegetables, egg and peanut products are introduced into all baby’s diets from 6 months old.
In infants at risk of food allergies, particularly those with a family history or those with eczema, weaning of these foods may best be commenced from 4 months old if your baby is developmentally ready to start solid foods. Your baby does not require any allergy tests before commencing weaning.
Only give your baby foods in an age-appropriate form to avoid risk of choking – i.e. do not give whole nuts, instead nuts in butter form.
You can still breastfeed your baby alongside introducing solids. The evidence has shown that early introduction of solids does not affect your breastfeeding relationship or lead to more obese babies.
Introduce each new food in small quantities on separate days. Initially give ¼ teaspoon amount, and if tolerated, increase quantity over the next few days. Once successfully introduced, it is important to ensure the food is given as a regular part of the diet.
If another household member is allergic to the food being introduced, this should be taken into consideration and cross contamination risk minimised.
It is uncommon for babies to develop rashes or vomiting after first exposure to a food. The risk of severe allergic reaction, even in babies at higher risk of food allergy is much less than 1%.
Most common allergic reactions are hives on the face, a slightly swollen lip or vomiting. These can be treated with an age-appropriate antihistamine. The child does not need immediate medical review, but it would be worth taking a photo with your phone and discussing the reaction with your health visitor or GP.
Breathing problems (persistent cough, noisy breathing, wheeze) or floppiness (all signs of anaphylaxis) are uncommon. If this occurs, you should take your baby to see a doctor immediately.
Tomatoes, strawberries, citrus fruit, aubergines and many other foods can cause a rash around the mouth in babies. In this case, the food does not need to be removed from the diet. Making sure the food goes into the mouth rather than around it is the best way to avoid this problem.
Applying Vaseline or another a moisturiser before feeding may also help to prevent the problem. Otherwise wipe around the mouth with a wet cloth and if the rash is obviously itchy give a dose of antihistamine.