In terms of food allergy prevention, recommendations at the time of food diversification have recently evolved and in a good direction. In other words, things are getting simpler and that's good: eating should be and remain above all a moment of pleasure! It is important to specify that the dietary advice in this article (and the list of allergens) is based on the recommendations of allergology conferences and that it concerns the French population and not the international one.
Diet is one of the many ways of preventing food allergies, but there are also, for example, genetics, changes in the digestive microbiota, breastfeeding, the age of diversification, etc. When we talk about a child "at risk" of atopy or "atopic", we are talking about children with a family history of allergies.
Did you know that?
If both parents have allergies, the child is 4 times more likely to develop allergies than a child whose parents have no allergies. The risk is twice as high if only one of the parents is allergic.
Until recently, allergy prevention was based on avoidance. It was recommended to delay the introduction of foods as long as possible, especially those known as "allergenic". Now, it is recommended that contact with the allergen takes place at an optimal time, i.e. during a " window of tolerance " which is between 4 and 6 months of age. Introducing the allergen too early, but also too late, is detrimental to the development of tolerance to the allergen and facilitates the development of the allergy. Factors that facilitate the development of food tolerance include adequate vitamin D levels (so don't forget the vitamins prescribed by your doctor or paediatrician!), oral exposure to food allergens (not skin or inhalation) and a good digestive "microbiota".
Diversification should therefore be early, without restriction, even for 'risky' foods, while respecting cultural and family habits. It is essential to offer the same range of flavours and foods as during pregnancy, as your child was already used to them. Diversification will only remind him of that delicious time!
So to conclude this article, enjoy and introduce as many foods as possible between 4 and 6 months of age (while respecting the texture, the cooking, the presence of fats...)!
There is no purely established frequency for the introduction of allergens. It would be common sense. I would say no sooner than every 3 days. 1-2 per week might be a good average!
List of allergens
For your information, here is the list of allergens, 14 notifiable allergens on food packaging:
- Cereals containing gluten (i.e. wheat, rye, barley, oats, spelt, kamut or their hybridised strains) and products made from these cereals.
- Sesame seeds and sesame seed products.
- Fruits à coque, à savoir amandes, noisettes, noix, noix de cajou, noix de pécan, noix du Brésil, pistaches, noix de Macadamia et noix du Queensland, et produits à base de ces fruits.
- Crustaceans and crustacean products.
- Eggs and egg products.
- Fish and fish products.
- Mustard and mustard products.
- Milk and milk products (including lactose).
- Celery and celery products.
- Peanut and peanut products.
- Soybeans and soy products.
- Molluscs and mollusc products.
- Lupin and lupin products.
- Sulphur dioxide and sulphites.
Dietician - Nutritionist specialising in paediatrics
Source: BIDAT E., BENOIST G. Prevention of food allergies: diversification in 2019.
Revue Française d'Allergologie, February 2019.
18 Commentaires. En écrire un nouveau
Bonjour,
Je me posais la question par rapport au lait. Est-ce que le lait de vache est le seul allergène ou est-ce que le lait de chèvre par exemple fait également partie des allergènes majeurs?
Merci et bonne journée
Bonjour,
Le lait de chèvre (comme le lait de brebis) ne fait pas partie de la liste des 14 allergènes principaux, à déclaration obligatoire.
Cependant, les allergies croisées entre les laits de différents mammifères sont dues principalement aux protéines qu’ils contiennent (et peuvent posséder des similarités). Selon l’AFPRAL, 90% des allergènes de lait de vache sont communs à ceux du lait de chèvre ou de brebis. C’est pourquoi, il est nécessaire de rester vigilent si bébé montre des signes de réactions allergiques au lait de vache.
Merci à vous pour votre confiance, bonne journée
Hello,
I started the classic diversification at 4.5 months and I learned at 6 months about the allergens. It's just that I'm having a bit of trouble introducing them for 3 days in a row as baby goes to nursery on Monday, Tuesday, Thursday and Friday and I'm not allowed to bring them my own little pots. So I can only test an allergen every weekend. Baby often misses his evening feed or is too tired to eat anything other than milk.
He is 7.5 months old and I am afraid because he is already intolerant to POPs and I have only been able to test for egg. How do you think I can do this?
Also, I see everywhere that it is noted that these allergens and various recommendations are from WHO but I can't find the official information on the WHO website. Can you please give me the exact link?
Thank you!
Sandrine
Hello,
If your baby has an atopic condition, it is better to see the introduction directly with your paediatrician/allergist who will advise you.
Some allergens can be introduced in the bottle, like a little peanut butter diluted in the milk for example. The main thing is that baby is in contact with the allergen, not a large amount.
Regarding the recommendations, you have some at the bottom of the article, here are some more:
European Academy of Allergy and Clinical Immunology, Pediatr Allergy Immunol 2008
American Academy of Pediatric, Curr Opin Pediatr 2008
European Academy of Allergy and Clinical Immunology, Allergy 2014
ESPGHAN Committee on Nutrition, JPGN 2017
Beautiful day
Hello,
It's a pity that my GP didn't mention this to me last month during my daughter's 5-month medical check-up, when I asked him about it! I asked him if there were any age limits for the introduction of fruit in relation to the risk of allergies, asking specifically about red fruit. He told me that there was no problem, that I could give her some when she was 6 months old. He told me not to give her exotic fruits, except for bananas... For the rest, he told me that there was nothing forbidden but that it was not necessarily interesting to introduce shrimp for example to an infant because it had no nutritional interest... That's the only information I had! I've only just discovered your article and my daughter will be 6 months old in a few days...
Does the optimal window of opportunity close when baby reaches 6 months or is the 7th month still a good time to introduce allergens while limiting the risks?
I am wondering about the introduction of nuts and peanuts in the form of purees, what is the maximum dose to be respected so that the child digests them correctly, to respect the energy and protein intake? Indeed, we are told to limit the protein intake with doses of fish, meat and eggs that should not be exceeded... So how can we introduce nuts while being sure not to give too much protein or too many calories?
I also wonder a lot about the introduction of dairy products (yoghurts, fromage blanc, petits suisses, cheeses). I've read that traditional dairy products are too high in protein and that it's better to give "special baby" dairy products... But I wonder because these often contain artificial flavourings (even when they are plain...) and sugar. What's more, they don't seem to have an exceptional taste... So what kind of milk should I give my baby and at what age should I give it to meet his nutritional needs? We see so much different information on this subject!
Thank you in advance for your answers as I end up being a bit confused by reading contradictory information on diversification.
Hello,
You can definitely introduce allergens after 6 months, there is still time 🙂
Regarding nuts, it is not necessary to introduce large quantities. The child just needs to be exposed. So it could be a tiny bit of peanut butter on the tip of the spoon for example.
There's no real risk of giving too much protein, unless you skip the whole jar 🙂 And oilseed purees are also interesting for their fat content, which will help baby's brain to develop well.
Special baby milk is not really interesting because it is no longer made from infant milk and is often sweet. So it's better to have a plain yoghurt with whole milk.
We've put together a whole programme of videos https://mapetiteassiette.com/videos/ which cover all the questions you might have, and then you can access our forum to discuss directly with our paediatric dietitian. Otherwise the blog already contains many articles
Have a nice day
Thank you very much for your quick answer which reassures me!
Have a nice day.
Hello,
It can be a sign of an allergic reaction indeed. To find out if this is really what it is, you need to talk to your paediatrician and do some tests if necessary.
Beautiful day
Hello,
I have just started dietary diversification (1 week ago) for my daughter who will be 5 months on 20/09/2020. Since she goes to the crèche they prefer to give only vegetables that have already been given at home or to introduce only what does not carry a big allergic risk. She goes to nursery from Monday to Friday, which means we only have the weekend to introduce new vegetables, at this rate I'm afraid I won't have time to take advantage of the "window of opportunity" to introduce as many vegetables and fruits as possible. Is it possible to give him vegetables at lunchtime and in the evening?
I hope I've been clear enough, thank you very much for your help!
Hello,
Yes, childcare facilities never introduce allergens in general. You can give vegetables/fruits in the evening.
You don't need a big amount for the child to come in contact with the allergen.
Milk is still the main food until baby is 12 months old 🙂
Have a nice day
Hello, is it possible to introduce allergens such as sesame, peanut, nut with their oil? And for the introduction of soya would you have any ideas please? Thank you very much for all that you share 😊😊
Hello,
No, because what triggers the allergy are the proteins contained in the nuts and they are not in the oils which are only fat.
For soy, it can be crushed tofu in a puree for example or cooked soybeans.
Thank you very much.
Hello,
I am in the same situation as Marie, just above. I have therefore understood that we should not delay in introducing as many foods as possible. However, what foods are suitable for babies and what foods are suitable for nuts, sesame etc?
Thank you for your precious advice.
Hello,
You have a whole bunch of oilseed puree like peanut, nut, sesame puree... It's a good way to introduce small quantities.
Hello
I thought that for seafood you had to wait ? At least 1 year ?
Have a nice day
Émilie
Hello,
The latest studies (quoted at the bottom of the article) show that the introduction of all allergens is preferable during the tolerance window. Seafood is one of them. But you don't have to start with that 🙂
Have a nice day
Hello !
However, the WHO recommends exclusive breastfeeding until 6 months. So how do you combine this exclusive breastfeeding with the "window" for introducing allergens between 4 and 6 months?
My daughter is now almost 8 months old, so it's a miss for the optimal period 🙁 We're still on fruits and vegetables. Too scared to introduce an allergen such as egg in the current containment situation!
Thanks in advance for your insights!
Hello,
It's not a problem, so don't delay introducing as many allergens as possible, even with containment, because the longer you wait the lower the tolerance will be.
For the egg, you can start by introducing it during lunch (so that you can monitor a possible reaction in the afternoon) and in very small quantities.