Don’t Hold the Nuts

By Lynn Rees Lambert

Now that’s a switch.

Imagine a mother feeding her six-month-old precious baby … peanuts, whole eggs, even shellfish! No, this isn’t something ripped from the “strange but true” column. It’s the real deal.

According to the Canadian Pediatric Society and the Canadian Society of Allergy and Clinical Immunology (CSACI), it’s okay. Go ahead, introduce those once verboten foods to at-risk infants, meaning babies with a parent or sibling with a food allergy.

In fact, it’s good practice for all infants.

The change in thinking—revealed in a December 2013 position paper released by the august groups—is in line with similar advice from the American Academy of Pediatrics in the United States, which reversed its stance about six years ago. The United Kingdom followed and now Canada is onboard.

Dr. Anne Ellis, who serves on the board of directors for the CSACI and chairs the Allergy and Immunology division at Queen’s University, has long been telling parents there is no need to shield infants from foods that were once considered off limits.

“I’ve been giving parents this advice since 2008,” says Dr. Ellis, explaining that the evidence doesn’t support the theory of waiting to introduce certain foods. Studies have shown that introducing peanuts, eggs or shellfish as early as six months — once babies begin eating solids — is perfectly alright. “Waiting doesn’t decrease the risk of developing allergies.”

The official about-face has only hit the headlines now that the joint position statement by CSACI and the Canadian Pediatric Society has been released. Recommendations from the two groups ensure the topic will reach a broader audience, she explains. Plus, “it’s nice to have a Canadian document written by Canadians for Canadians.”

Reaction from parents who have been tiptoeing around the issue ranges from quite a bit of nervousness to start-the-carfor- an E.R.-dash. Dr. Ellis says she counsels parents on what to do and what to watch for.

“It’s no different than introducing any other food,” she explains. “At first, give only a small amount of the new food and watch.” Wait for half an hour, she says, to ensure there is no reaction. Warning signs include a rash around the mouth, hives, vomiting or sudden change in behaviour.

When this happens, it’s wise to head straight to the hospital emergency department.

Peanut allergies have had a “dramatic history” of late, Dr. Ellis points out, considering the incidence of infants with peanut allergies has doubled in the last decade. Yet, “the avoidance strategy has not been helpful. We have learned a lot in the last 10-20 years.”

The new protocol also extends to pregnant women. As for breastfeeding, “there is still some controversy in that area,” Dr. Ellis states.

As with all things about your baby’s health, consult your pediatrician when you have questions and concerns.

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