5 Key Points for RDNs on Early Infant Feeding: A window to prevent food allergies

By: Sherry Coleman Collins, MS, RDN, LD

New parents are bombarded with so many messages in the first several months of a baby’s life. Among those most important messages about vaccinations, sleep, and feeding is the important message of peanut allergy prevention. The conversations have to start early to ensure that parents are ready to begin infant feeding as early as 4-6 months, depending on the baby’s individual risk.

In my work in this area, I’ve had the opportunity to team up with Malina Malkani, MS, RDN, CDN, registered dietitian and infant nutrition expert to talk about the why and the how of early infant feeding. Here are the five key things that we believe RDNs need to know about the critical window of time to help prevent food allergies in early infant feeding.

1.Be Proactive with Early Introduction
Research shows, and the Dietary Guidelines for Americans supports, that feeding babies commonly allergenic foods starting around 6 months, when other complementary foods are introduced, can help reduce the risk of developing food allergies. Peanut and egg show the most potential benefit, but there’s no evidence that withholding any allergen prevents food allergies.

2.High-risk Infants May Benefit from Eating Peanut Foods Even Earlier
Babies with severe eczema and/or existing egg allergy may benefit from starting peanut foods as early as 4-6 months, in accordance with the National Institute of Allergy and Infectious Disease’s Addendum Guidelines for introducing peanut foods to prevent peanut allergies. Parents should discuss what’s best for their baby with the child’s pediatrician.

3.Feed Baby Potential Allergens at Home Following These Simple Guidelines
Follow NIAID Guidelines for home feeding of peanut foods, including starting with a healthy baby, early in the day, and be sure to monitor baby for around 2 hours after feeding. Babies should always be supervised when they are eating. Start with just a little taste on the end of a spoon and wait 10 minutes before moving forward to feed the baby the full infant-portion.

4.Modify Feeding for Baby’s Developmental Readiness
Be mindful of baby’s developmental readiness, including being sure to feed baby an infant-safe serving of these foods. Modify the texture to make it palatable and easy for baby to eat. For instance, blend 2 teaspoons of creamy peanut butter with warm water, breastmilk or formula or stir the same amount of powdered peanut butter into applesauce. Scramble eggs well and allow baby to self-feed the soft curds. Puree tougher foods like shrimp and fish to avoid them becoming a choking hazard. The DGAs have great tips for feeding baby with developmental readiness and safety in mind.

5.Make Feeding Fun!
Help anxious parents overcome their fears by teaching them how to safely feed babies and that the evidence shows there is more potential benefit than risk when it comes to feeding babies potentially allergenic foods.

These five tips, when consistently shared with parents and other healthcare professionals, have the potential to make a big difference in reducing peanut allergies in future generations with a simple nutrition intervention. "As food and nutrition experts, dietitians have an amazing opportunity to help ease parental stress around the process of starting solids. My hope is that as more caregivers feel confident and positive about the what, how and when of offering complementary, top allergenic foods during infancy, the more they'll feel empowered to feed their babies in such a way that the likelihood of food allergies is reduced,” says Malina Malkani, MS, RDN, CDN 



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