It’s not unusual for babies to react badly to something they ate – or that you ate, if you’re breastfeeding. And while they may just be feeling off colour, if they have the same reaction again, they may have a food intolerance or allergy. Both can cause gastric, respiratory and skin reactions, but they’re not the same – and it’s vital to know the difference.
When your baby has a food allergy
With a food allergy, baby’s immune system mistakes something in a food or beverage as harmful, and attacks it. This usually happens suddenly, and signs include a rash, hives or itchy skin, swelling of the face, tongue and lips, and difficulty swallowing or breathing, and sometimes a sudden drop in blood pressure. This can be fatal, so get medical help immediately.
“Food allergies are estimated to affect six to eight percent of babies, and it’s essential to identify the offending food and avoid it, as even a small amount can trigger a reaction each time they have it,” says Tirsa Bezuidenhout, a registered dietician and spokesperson for the Association for Dietetics in SA.
The most common offenders are peanuts, tree nuts (such as almonds and pecans), fish, shellfish, milk, eggs, soy and wheat. A reaction to gluten may signal coeliac disease, a rare long-term digestive condition that’s unpleasant but not life-threatening.
When your baby has a food intolerance
“A food intolerance, on the other hand, is a non-immune-related reaction to food or chemical substances in food, that irritate the digestive system,” says Bezuidenhout. Unlike an allergy, it’s not potentially life-threatening. Symptoms can come on anything from 30 minutes to 24 hours after ingestion, and the reactions build up then start to decline. They can include cramps or bloating, heartburn, headache and irritability.
Common offenders are lactose, a carbohydrate in milk and dairy products, and sulfites or other food additives, which can also trigger asthma.
It’s estimated that 15% of babies under a year have an intolerance of some sort, as their digestive systems are still developing, and the severity can vary widely. It can last for a few days or for years.
Your healthcare provider can establish if baby has an allergy or an intolerance. “Allergy tests can also be run, either skin or blood,” says Bezuidenhout. “Give as much information as possible to your healthcare provider, as tests are expensive and are done according to the information the parent supplies.”
You can help by keeping a diary of the foods she eats (or that you eat, if breastfeeding), and take her off the foods, then introduce them individually to help determine which are causing the problem.
If an allergy is diagnosed, you’ll need to read food labels carefully (including on condiments and seasonings). And when eating out, always inform the restaurant of any serious allergies or intolerances, so the chef takes special care to avoid cross-contamination.
The good news is that many kids grow out of intolerances and even allergies.
How to prevent allergies developing
It’s still not fully understood why some babies develop allergies and others don’t, but there may be a genetic link as there’s a greater likelihood when parents or siblings have allergies of any kind. But this doesn’t mean avoiding potentially troublesome foods. The American Academy of Pediatrics now advises early exposure to common allergenic food – it seems this may actually stop babies developing an allergy.
“Moms should also not restrict potential allergies in their own diets during pregnancy, unless they’re intolerant or allergic to the food,” says Bezuidenhout. “Only restrict foods if the infant presents symptoms of allergy or intolerance. In the case of a strong family history of allergy, it’s helpful to first introduce the food source to the infant: rub a small portion on the lips and inside the mouth, and monitor for any signs of allergic reaction. It’s also advisable to introduce small portions of a food initially, to monitor for any signs of intolerance or allergy. But don’t introduce more than one potentially allergenic food at a time.”
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