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Food Allergy Management and Prevention
Support Tool for Infants and Toddlers

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For Newborns

Breastfeeding

Why is breastfeeding good for your baby?

Human milk has a lot of important nutrients. Colostrum, the first milk that comes out after giving birth, helps to protect your baby, as it is rich in antibodies. This can help build their immune system.

Additionally, breastmilk also:

Gives your baby a good balance of nutrients in the first weeks of life.
Gives more diverse good gut bacteria.
Contains antibodies that help to protect infants against bacteria, viruses, and various other infections. This boosts the immune system and may lower the risk of diarrhea and respiratory infections.
May lower the chances of early eczema.
Help mouth, teeth, and jaw development.
Lower the risk for chronic diseases such as type 1 and 2 diabetes and obesity.

If you cannot or choose not to breastfeed, support is available to help you find the best infant formulas. Reach out to your healthcare team for guidance.

What should the mother’s diet be when breastfeeding?

Energy, protein, and other essential nutrients that make up breast milk come from what the mother eats. It is important for women who are breastfeeding to eat a healthy, well-balanced diet and stay hydrated.

It’s best if mothers can eat a variety of foods while pregnant and breastfeeding. If mom is not allergic to any foods, then keeping the common food allergens in the diet is great.

Good handwashing habits are important for managing food allergies. Always wash hands before and after the following:

Nursing.
Preparing your child’s meals.
Preparing additional meals for yourself or other family members.

Just because a child has a food allergy does not mean the mother has to stop breastfeeding.

Dot phrases modified from PDF found at: https://famp-it.org/wp-content/uploads/Breastfeeding-Education-Pediatrician.pdf

Additional Resources

Use the QR code below or click on the hyperlink to watch a video, Preventing Food Allergies — What You and Your Family Can Do in the First Several Months, with simple tips on what you can do in the early months of your baby’s life to help prevent food allergies.

vimeopro.com/user22732304/preventing-food-allergies

QR code for video

Visit fampitfamily.org for detailed resources on Early Introduction, Food Allergy Management, and more.

Introducing Complementary Foods

What are the current recommendations for complementary feeding and food allergens?

Waiting to introduce common food allergens to your child may increase the chance of food allergies, especially if they have eczema or a previously diagnosed food allergy.

The common food allergens are:

Peanuts
Eggs
Cow’s milk products
Tree nuts
Sesame seeds
Fish
Shellfish
Wheat
Soy

Begin complementary feeding (giving solids while breastmilk or infant formula are still the main food source) around 6 months, and as early as 4 months to 6 months, if your child is developmentally ready.

The common food allergens should be introduced at the same time as complementary foods.

The NIAID Addendum Guidelines suggest a target age of 4-6 months to introduce peanut containing foods, as this may prevent peanut allergy development in infants.
Don’t delay the introduction of egg or other major allergens beyond 4-6 months of age.
Breastfeeding should continue while solids are being introduced.

Between ages 0-4 months: Exclusive breastmilk and/or formula feeding

What form of milk?
- Human breastmilk, iron-fortified infant formula, or a combination of both
Do I need to supplement the milk with anything?
- You may need a vitamin D supplement, depending on which form of milk you choose. Talk with your healthcare team about what is best for you and your baby.

Between 4-6 months: When your child is ready, start to introduce complementary foods

How do I know when my child is ready?
- Babies show signs of readiness at different times. Usually this is between ages 4 and 6 months.
- Signs that your child may be ready for complementary foods include:
  - Being able to control the head and neck
  - Sitting up alone or with support
  - Bringing objects to the mouth
  - Trying to grasp small objects, such as food or toys
  - Swallowing food rather than pushing it back out onto the chin
What complementary foods should I give my child?
- Infants should be offered a variety of complementary foods in baby-friendly forms
- Introduce foods from all food groups: protein, fruits and vegetables, nuts and seeds, dairy, grains
- Introduce potentially allergenic foods: peanuts, eggs, cow’s milk products, tree nuts, sesame seed, shellfish, fish, wheat, and soy. These foods should be given around the same time as other complementary foods. There is no evidence that delaying the introduction of allergenic foods helps prevent food allergy
How do I know if my child is at high risk of developing a peanut allergy?
- Risk factors: If your child has severe eczema, egg allergy, or both, s/he may be at a higher risk of developing a peanut allergy.

Healthy Dietary Patterns in Your Baby’s First Year of Life

Give:

A wide variety of fruits, especially berries and whole fruits
A wide variety of vegetables from each vegetable group, which includes dark green (ex. broccoli), red/orange (ex. carrots), legumes (i.e., beans, peas, lentils), starchy vegetables (ex. potatoes)
Whole grains
Unprocessed meat

Limit:

Processed meats (ex. cold cuts)
Refined grains
100% fruit juice
Foods with high sodium content
Foods containing added sugars

Avoid:

Honey and unpasteurized foods and beverages
Sugar-sweetened beverages (ex. soda, sweet tea)
Liquid cow’s milk, fortified soy beverages, and milk alternatives (such as plant-based milk) in place of breastmilk or infant formula
Caffeinated beverages
Seafood with high mercury content
Loose nuts and other choke-risk foods

Introducing your child to the 9 major allergens:

The 9 major potentially allergenic foods should be introduced as complementary foods. There is evidence that introducing peanut-containing foods in an infant’s first year of life can reduce the risk that s/he will develop a peanut allergy There is no evidence that delaying introduction of allergenic foods beyond 6 months prevents food allergy.

Dairy
Egg
Peanuts
Tree Nutrs
Soy
Wheat
Fish
Shellfish
Sesame

Dot phrases modified from PDF found at: https://famp-it.org/wp-content/uploads/aap-statement-FAMPIT_Nutrition-Education_less12mo.pdf

Early Food Introduction

Skincare and Eczema Management

IgE Mediated
Food Allergy

Non-IgE Mediated
Food Allergy

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Project Lead
Michael Pistiner, MD, MMSc

Project Manager
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Project Coordinators
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Thank You

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Zoe Ongaro, BS
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Test your Knowledge Content
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Funding
Provided by USDA/National Peanut Board

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