Written by: J. Claire Green, ND
The incidence of true food allergies mediated by immunoglobulins has increased significantly in the last 60 years from 1-2% to almost 10% worldwide. (1) Food allergies are different from food intolerances and food sensitivities which are mediated by other factors such as lack of digestive enzymes (lactase), histamine, or FODMAPs.
Common food allergies include tree nuts, peanuts, eggs, fish, shellfish, wheat, cow’s milk, and soy.
Many factors drive this increasing rise in allergies in young children. These include:
Some other factors remain somewhat contradictory in their impact on food allergy risk. The evidence based literature contains hundreds of studies on the impact of Vitamin D deficiency and food allergies in children. A 2017 systematic review and meta-analysis of these concluded there was no impact on Vitamin D status and food allergy. (7) However, the quality of studies overall is uneven and does not take into account personal genetics. Since Vitamin D deficiency is so common and sufficient vitamin D is critical to proper immune functioning, one should optimize levels.†
Likewise studies on exclusive breastfeeding infants compared to infant formula and bottle-fed infants and food allergy incidence are conflicting. Given the highly variable and complex make up of human breast milk and other confounding factors, this is not surprising. It is thought that food allergen components from the mother’s diet can end up in breast milk. However, breast milk also contains immunoglobulins. The immunoglobulins may create the immune-tolerant environment that can support the infant’s resilience from food allergies. (8, 9) Thus, it seems appropriate to advocate a mostly breastfed approach when possible. That said, exclusively formula-bottle fed infants are likely not at greatly increased risk from this practice either. In any case, a gradual weaning of breastmilk or formula to a more diverse solid food baby’s diet should occur from approximately 4 months of life onwards.
Synthetic chemicals such as bisphenol A, phthalates, and pesticides also show conflicting data on increased risk of food allergies. (10) Given other known hazards of these endocrine-disrupting chemicals, avoidance of BPA, phthalates, and pesticides whenever possible is encouraged.
Note that any plastic containing phthalates should be avoided. BPA-free may contain BPS instead, which is just another phthalate. Polypropylene packaging is fine as it is free of phthalates.
It was once common practice for obstetricians to recommend avoidance of peanuts or known high risk allergic food during pregnancy. The American Academy of Pediatrics reversed this position in 2008. Now it is recommended that pregnant women eat a wide range of diverse foods through pregnancy. Their infant children, especially those with skin irritants, should also eat a wide range of diverse and complementary foods beginning at 3 to 4 months of age and continuing through the first 3 years of age. This window of opportunity is critical to establish immune tolerance. (11) For preterm infants, use the corrected age or adjusted age, which is the infant’s chronological age minus the number of weeks or months they were born early. (12)
If you do see rashes or other skin irritations developing during food introductions, work with a qualified health care provider skilled in the management of food allergies.
Other strategies for supporting the body’s resilience:†
The research into skin interventions and skin irritation occurrence is mixed. This may be due to the confounding influence of the various lotions and emollients being used in trials as well as the household exposures, climate, time of year, and underlying genetics of the population studied. (18, 19) One studied protocol with positive results consisted of baths for 5–10 min with added emulsified oil (3 Tbsp per 2 gallons) at least 4 days per week. A lotion with added antihistamine was applied to the face after each bath. This protocol began at week 2 to age 8 months. Use of soaps and bubble bath products was discouraged.
Chlorine is a skin irritant and damages the skin’s DNA. (17,20) Filtering out the chlorine prior to bathing is important. Consider adding vitamin C powder to bath water prior to bathing the baby. One gram of vitamin C as ascorbic acid will neutralize 1 milligram per liter of chlorine per 100 gallons of water. The reaction occurs quickly. (17,20,21) One may also use a whole-home water filter or a chlorine bath water filter.
Sweet almond, jojoba, and evening primrose oils have the most positive research in infants for sensitive skin issues. (22) When choosing infant body care products look for choices free from sulfates, silicones, or parabens.
Use the EWG skin deep database to find an affordable and clean formulation for infants (e.g. Aveeno Baby, Aquaphor, Eucerin).
There are many factors that contribute to infant food allergies. Preventing food allergies is not always possible, but significant research supports better children’s health outcomes when they try many new foods in the first year of life. Work with your pediatrician or dietitian to assess your baby’s risk and to introduce a variety of baby foods in their first year of life.