Sometimes I feel like a nut, sometimes I don't...

Now to address the ever controversial topic of food allergies and the inconsistencies that are out there. Some people say no nuts until a year, some say 2 years, some will say even 5 years. Some say it depends on the family history, etc. Aaargh! It gets confusing, even for me. Let's start with the facts. First of all, Mr. Peanut and his monocle always creeped me out a little, even as a kid.


Q: What causes food allergies?
A: The simple version is that most food allergies are triggered by proteins that are contained in the particular food.

Q: What foods are the common culprits in food allergies?
A: The most common ones are cow's milk, eggs (egg whites), nuts and shellfish. Other ones that are out there include citrus fruits, berries, kiwi fruit and wheat.

Q: Do genetics play a role in the development of food allergies?
A: Absolutely, especially if a close relative has a history of anaphylaxis with certain foods. Other things in the family history that raise the likelihood of developing allergies include asthma, eczema or seasonal allergies.

Q: Why are food allergies so much more common these days?
A: That is a loaded question. Part of it is that we are a whole heck of a lot better at detecting food allergies now due to more sensitive testing. Another possibility is the hygiene hypothesis.

Q: Come again?
A: So the hygiene hypothesis is an idea that floats around the medical community that as a society becomes more clean and industrialized, the immune system switches from fighting off infections and parasites to fighting off allergens. So our germaphobia and Purell addiction may not be as harmless as we all thought. For example, if you go to developing countries, allergies to foods are pretty uncommon. In fact, many poorer countries regularly give foods like shellfish, eggs and nuts to children under a year without any problems. These are also places that have a high incidence of intestinal parasites and other infection. The thought is that the immune system is so busy fighting off tapeworm and such that it doesn't have the "time" to develop allergies. Then again, can you imagine being allergic to a whole group of foods when there isn't that much food to go around? It really wouldn't make much sense from a biological standpoint!

Q: So when can I give my kid peanut butter, eggs, etc?
A: Dude, slow your roll. I'm getting there. There are no standard guidelines for this, hence the confusion. In fact, the AAP just came out with a revised policy statement (look at the "Summary" section) regarding maternal food exposure in PG and the first 6 months.

Q: Seriously, DrBabyMamaDrama, about the food...
A: Fine. Here are a couple of links to some sites re: the foods to introduce when (Link 1 and Link 2). But for those who don't want to read...
-Cow's Milk: okay after 12 months
-Whole Eggs and Egg whites: okay after 2 years
-Nuts and Shellfish: okay after 3 years
-Honey: okay after 12 months (not technically a food allergy, but honey contains the spores that cause botulism, so as much as we all love Botox, we don't love it that much)
**My kid who is less than a year has already had some whole eggs and shellfish, so don't follow my example**

Q: So is there anything that I can do to prevent food allergies?
A: The simple answers are to breastfeed for as long as possible (ideally, exclusively for 6 months) and to delay solid foods until 6 months, especially if there is a family history of any allergic symptoms. When you decide to introduce solids, make sure they are cooked (reduces the allergenic potency of foods by denaturing the proteins that trigger the reactions) and introduce one food a time.

Now I do always wonder why some of the prepared baby foods have things like strawberries in it when they are a relatively common allergy. They need to hire me as a food consultant! I could certainly come up with something more appetizing than "Blueberry Buckle Dessert". Since when does a 9 month old need dessert? You will eat your banana and you will like it, thank you very much!