Can Children with Eczema, Rhinitis, or Asthma Eat High-Sensitivity Foods?

When preparing to add complementary foods to children, or add a food that is not eaten, many parents will think of a question: Will the child eat food allergies?

There are grounds for concern. Especially when the child has a history of eczema, rhinitis and so on, every time to add food is careful, see the food containing protein on tenterbones, but sometimes because of nutritional needs and have to eat. What to do in this case? Today we’re going to talk about how to add foods to children that may be at risk for allergies.

No.1

What foods are highly allergenic?

Although allergies can be caused by any food, the eight most common food groups, milk, eggs, soy, wheat, peanuts, wood nuts, fish and shellfish, are classified as highly allergenic.

No.2

Which children are at high risk?

Answering this question requires understanding what an allergic disease is. The most common allergic diseases include atopic dermatitis (eczema), allergic rhinitis, asthma, and food allergies.

Infants and young children are at higher risk of allergic disease if there is a family member with allergic disease. If the child already has an allergic disease, the risk of developing other types of allergic diseases is increased.

To put it simply, infants and young children with a family and personal history of allergic diseases belong to the “high risk group of allergies”; Children with no history of the disease fell into the “standard or low-risk group.”

No.3

Should the addition of highly allergenic foods be postponed?

In 2000 the American academy of pediatrics recommended delaying the introduction of highly allergenic foods. For example, for high-risk groups, milk at age 1; Add eggs at age 2; Peanuts, wood nuts and fish were added at age 3. The recommendation is based on several studies from the late 20th century that suggested that delaying the addition of certain foods might reduce the probability of allergies.

But in 2008, the American Academy of Pediatrics revised its guidelines after more and more in-depth studies came to very different conclusions:

Delaying the addition of highly allergenic foods may not reduce the risk of allergy, but may increase it. Conversely, adding certain foods early on May reduce the risk of allergies to those foods.

The researchers now agree that for “standard or low” risk children, high-allergenic foods can be introduced at any time after 4 to 6 months of age when supplemental foods are added, regardless of age (i.e., 8 months of age is not required for egg yolk consumption). For infants at high risk of allergy, the addition of complementary foods should not be postponed. Highly allergenic solid foods can also be added with caution, but it is recommended to consult an allergist first.

Although milk, eggs, soy, peanuts, wheat, nuts, fish, and shellfish are all allowed to be introduced under the age of 1, the following should be noted:

1. Soybeans, peanuts, nuts and other foods should be processed into appropriate traits to avoid asphyxiation. For example, processing peanuts into peanut butter.
2. Liquid whole milk should be avoided in infants under 1 year of age, not because of allergies, but because it can overload the kidneys and increase the risk of iron deficiency. But don’t limit your intake of milk formula and other dairy products, such as baked goods, cheese, and yogurt, until age 1.
3. It is also generally not recommended to replace breast milk or formula feeding with plant-based milk (e.g., soy milk, walnut milk, almond milk, rice milk, etc.) as it is low in protein and fat and does not meet the nutritional needs of infants.

Non-breast-fed infants who are allergic to cow’s milk protein should consult a dietitian before choosing soy formula if they cannot be relieved by hydrolyzed formula or amino acid formula.

No.4

Before adding highly allergenic foods,

Is an allergy assessment necessary for the child?

Usually not, unless the child meets one of two conditions:

1. The child has a history of severe food allergy;
2. Intractable moderate to severe eczema still exists in the child after the best treatment.

It is advisable for these symptomatic high-risk children to be evaluated by an allergist before adding a highly allergenic food, including a detailed medical history and possibly serum allergen testing and/or skin prick testing.

Most children do not fit into either of these categories and do not require allergy testing before adding highly allergenic foods.

No.5

How to add highly allergenic food?

For all children, when adding highly allergenic foods, it is necessary to follow the principle of adding complementary foods, adding only one new food at a time, starting from a small amount, and observing each new food for 3-5 days.

For “standard or low” risk groups, highly allergenic foods can be introduced at any time after the planned introduction of complementary foods.

For children at high risk, it is more prudent to add highly allergenic foods:

1. Children who have had severe allergic reactions in the past or who still have refractory moderate to severe eczema after treatment should be introduced with highly allergenic foods under the evaluation and guidance of an allergist.
2. If this is not the case, after tolerating some of the less allergenic side foods (such as ferric rice noodles, pureed vegetables), you can initially try these foods at home (rather than in a restaurant or nursery), along with oral antihistamines. If no significant allergic reaction is observed, increase the amount of the food gradually.

No.6

Is it safer to add fewer highly allergenic foods?

It is not recommended to “avoid” these hyperallergenic foods without clinical evidence to limit the variety of foods.

Because protein is diverse and comes from a wide variety of sources, nutrition will be more balanced. Moreover, limiting the variety of complementary foods before age 1 also increases the risk of allergies. If you do not care, you can refer to the following for treatment.