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Weaning despite allergies and intolerances

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IMG_0865The first time we weaned I went to the shop and bought a box of baby rice and a bag of pears.  The baby rice went down OK but she reacted to the pears.  With our second child I wandered up and down the isles and then bought a single avocaodo!  Yes, an avocado!  I still don’t know why given that I can’t eat them and my husband doesn’t like them so even if our poor child enjoyed it she would never get to eat them anyway. I didn’t actually give it to her in the end.  It sat on the worktop until it needed to go in the bin and we started with the obligatory baby rice instead.

I think my own somewhat irrational decisions during weaning highlight the pressure we feel to give our babies the best, most natural and most varied of diets.  Conversations in baby groups suddenly turn to ‘baby-led weaning’, ‘first foods’ and Anabel Karmel so that by the time your baby is ready for weaning you’re thoroughly confused and worried that feeding a baby is a much harder task than you thought it was going to be.  The weaning cookbooks and the endless weaning paraphernalia available add to the pressure and sense of complexity.  And we haven’t even started with the practical issues of when and how often you feed them and how it fits in around their sleep cycles!

Add to all that a baby at risk of developing food allergies or intolerances (based on family history and/or reactions to allergens in formula or breastmilk) and your head is probably close to exploding with confusion and indecision!  Well, this post is how about I would wean a child with possible food-related issues based on all the mistakes we made the first two times!  Please remember that I’m a mum, not a healthcare professional and that these are my own opinions based on my own reading and experience.  Follow the advice of your healthcare team first and foremost!  Here we go…..

When….?

The current Department of Health advice is to exclusively breastfeed or formula feed until around 6 months, not introducing solids until 6 months if possible.  We all know that some babies are ready for it earlier than this but they strongly advise that no baby be weaned onto solids earlier than 4 months.  Even if your baby is at high risk of developing allergies you should still introduce solids from around 6 months, don’t be tempted to delay it further.  Doing so won’t make any difference to the development of allergies and could have a detrimental effect on energy levels and nutritional status.

What….?

Here’s the tricky bit…coming up with a plan!

Firstly, put all the weaning books that you’ve bought or borrowed to the side.  You can come back to them at a later date but if you use them now you will muddy the waters.

Next you need to plan what you’re going to feed your baby and you should start with low allergenic foods (the ones least likely to cause a reaction).  Allergy UK, which is based on the most recent evidence, has a useful fact sheet about weaning (I’ve included it at the bottom of this page).  It lists the low allergenic foods to try as follows:

First foods

  • Root vegetables e.g. carrot, swede, sweet potato, parsnip, butternut squash (mashed or pureed depending on age / ability)
  • Fruits pureed e.g. apple, pear, banana, plum, peach, apricot, avocado
  • Spinach, broccoli, green beans, courgette, cauliflower
  • Potato, yam, green banana

After a few weeks,

  • Rice e.g. baby rice, cooked flaked rice
  • Ground quinoa
  • Cornmeal, polenta (good for finger foods)
  • Breakfast cereals and pasta/ noodles based on rice, corn and quinoa
  • Red meats (lamb, beef), pork and poultry (pureed or finely shredded and chopped)
  • Lentils and pulses e.g. haricot beans, kidney beans, butter beans (mashed)
  • Any of the above in cooked tomato or fruit-based sauces

Try later as finger foods,

  • Fresh tomatoes
  • Other fruits including citrus, kiwi, berry fruits

Once you have introduced all the low allergenic foods you should move onto the highly allergenic foods, which are considered to be:

  • milk, eggs, wheat, gluten, soya
  • fish, shellfish
  • peanuts, tree nuts, seeds

There’s some debate over how long you should avoid these top allergens for.  The Department of Health recommends that there is no evidence to support delaying past 6 months, whilst other credible sources delay certain highly allergenic foods until the age of two.  To overcome this debate follow the advice of your healthcare professional and focus more on the order of food introduction, rather than on the age of your child.

How…..?

The only things I want you to truly take from this are ‘ONE AT A TIME’ and ‘DON’T RUSH’!  These are the two things I wish we’d done when we weaned as we got ourselves in such a mess both times and it took a long time to unravel it all and work out what our girls were each reacting to.  There’s the pressure to create a varied diet for your baby but if you introduce too many foods too fast it can become impossible to identify the culprit food and both times we ended up going back to square one and starting again.

I like the method outlined by Dr Joneja, a registered dietician and author of many books on allergies and food intolerances.  I’ve included her fact sheet on weaning at the bottom of this post.  Here is a brief outline:

  • Introduce the food in it’s pure form by preparing it at home with nothing but water or their regular milk added.  Shop bought products often contain other ingredients, even if it’s just added vitamins or preserving agents so should be avoided initially (unless a shop bought version in it’s pure form can be found).
  • Trial each food for 4 days to allow for delayed and cumulative reactions to be observed.  Give the food in a small amount on day 1, none on day 2, increasing amounts on day 3 and none on day 4.  If no reactions are observed then the food can be deemed safe and you can move onto the next food.

Keeping a food and symptoms diary is a good idea at this stage so that you can keep track of any reactions and watch for patterns, which helps to distinguish them from other childhood complaints such as teething.

Very very important:  If there is a risk of your child having IgE-mediated allergies with immediate reactions to foods then you need to be weaning with the guidance of a relevant healthcare professional and you should definitely steer clear of the highly allergenic foods until you’ve had input.  This is because some food challenges should only be done in the hospital setting under medical supervision.  Generally speaking you should be safe trialling the low allergenic foods, but you should test each food on the skin first.  Joneja suggests you complete the following precautionary test:

  • Rub a little bit on the inside of the wrist and wait 30 minutes to see whether there is a local skin reaction.  If there is you should stop at this point.
  • If there is no reaction rub a little bit at the corner of the mouth and wait another 30 minutes.
  • If there is still no reaction rub a tiny amount on the tongue and wait 30 minutes.
  • If there is no reaction try feeding a tiny amount such as a half teaspoon.

If your baby ‘passes’ this precautionary stage you can move on with the food in the same way as outlined above.

Enjoy it!

Image0168Despite allergies and intolerances weaning can be fun!  And you can still make your own choices about how you want to wean.  All the low allergenic foods can be given as purees or cooked whole if you want to do Baby-Led Weaning.  You will probably need to do more research and use more creativity than the next parent who’s weaning but there is lots of advice and support out there, such as the “Allergy Buddies” Facebook group where other parents can give you product advice and food ideas free from the top allergens.  So relax, take your time and enjoy this exciting stage of development!

Further Reading

Weaning Factsheet by Allergy UK

Introducing Solid Foods by Dr Joneja

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About Jenni

Faith, family and food pretty much sums up my life! I'm a happily married Christian mum of three and I live in Liverpool in the UK. I enjoy being creative and love the challenge of parenting, although I'm a physiotherapist in my spare time. I hope you enjoy my efforts and musings.....!

2 responses »

  1. A really interesting post, Jenni. I started weaning my 6 months old yesterday, and so far, we’re not doing too well with the carrots but I will persist for a couple more days before moving on to sweet potato. With her sister’s allergies, I will make sure I introduce 1 thing at a time only, for 3 or 4 days before moving on to the next and will keep a food diary. For her sister, it was not the food but the formula I was trying to give her that started the eczema / rashes, but it took months to figure it out. It was just awful.

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    • Thanks Mel. Sounds like you have a lot of advice you could share too. The months of not knowing what your child is reacting too certainly is awful. We only realised that fructose was an addition problem for our eldest when she was 19 months and she became a different child overnight when we cut it out. But until that point, goodness, it was horrendous! I hope the weaning (including the carrots) goes well!

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