Guidelines for Kiwi, Honey, and Cod Liver Oil for Toddlers - Pediatrics

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Kiwi, honey, and cod liver oil?


Dear Dr.
Chen,
I would like to ask you some questions regarding my two-year-old daughter:
1.
I have heard that kiwi is a high allergen fruit.
At what age is it appropriate for children to eat this fruit freely?
2.
At what age is it suitable for children to drink honey tea? I have heard that it should only be made with warm water and not cold water.
3.
At what age is it appropriate for children to take cod liver oil?
Thank you for taking the time to answer my questions.

Xiao Fen, 30~39 year old female. Ask Date: 2006/10/26

Dr. Chen Rongtai reply Pediatrics


Dear Xiaofen's mother,
I would like to address a few issues mentioned in your letter:
1.
A large-scale survey on local food allergens has found that common allergens include shellfish, milk, eggs, as well as mangoes and kiwis.
If there is a history of allergies in the household, it is advisable to avoid exposure to allergens that may trigger symptoms, rather than considering at what age one can "freely" consume such fruits.
2.
Regarding honey, it has been found in the United States that honey may lead to infant botulism.
This condition occurs when honey is contaminated with Clostridium botulinum, which releases a neurotoxin that can cause acute dysfunction of both motor and autonomic nerves, potentially leading to life-threatening situations.
The Centers for Disease Control and Prevention (CDC) in the United States recommends that honey or any products containing honey should not be given to infants under 12 months of age.
Although similar studies have not been conducted domestically, it is advisable to follow the same recommendations.
3.
Cod liver oil contains fat-soluble vitamins, which remain in the body for an extended period and can accumulate in the liver.
Therefore, deficiencies are less likely to occur, but excessive intake can lead to toxicity.
It is important to keep daily intake within the recommended dietary allowances set by the health authorities to minimize the risk of adverse effects.

Reply Date: 2006/10/26

More Info


When it comes to the dietary guidelines for toddlers, particularly regarding kiwi, honey, and cod liver oil, there are several important considerations to keep in mind.


1. Kiwi Consumption
Kiwi is known to be a potential allergen, especially in young children. The fruit contains actinidain, an enzyme that can trigger allergic reactions in some individuals. For children with a family history of allergies, it is advisable to introduce kiwi cautiously. Generally, it is recommended to wait until a child is at least 3 years old before introducing kiwi into their diet freely. However, if there are no known allergies in the family, small amounts can be introduced around the age of 1, while closely monitoring for any allergic reactions. Signs of an allergic reaction can include hives, swelling, or gastrointestinal distress.


2. Honey Consumption
Honey is a natural sweetener that should not be given to children under 12 months of age due to the risk of infant botulism. This condition is caused by the spores of Clostridium botulinum, which can be present in honey and can produce toxins in a baby’s immature digestive system. After the age of 1, honey can be introduced into a toddler's diet, but it should be done gradually. When preparing honey tea, it is important to use warm water, as hot water can destroy some of the beneficial properties of honey, while cold water is not recommended for infants due to the risk of botulism.


3. Cod Liver Oil Consumption
Cod liver oil is rich in omega-3 fatty acids and vitamins A and D, which are beneficial for overall health, particularly for bone health and immune function. However, due to its high vitamin A content, it is crucial to monitor the dosage to avoid hypervitaminosis A, which can occur with excessive intake. For toddlers, cod liver oil can be introduced around the age of 2, but it is essential to adhere to the recommended dosages provided by health authorities. Parents should consult with a pediatrician before starting any supplementation to ensure it is appropriate for their child’s specific health needs.


Additional Considerations
When introducing new foods to toddlers, it is always best to follow the "four-day rule," which involves introducing one new food at a time and waiting four days before introducing another. This allows parents to monitor for any adverse reactions or allergies.
In summary, while kiwi, honey, and cod liver oil can be beneficial additions to a toddler's diet, they should be introduced with caution and at appropriate ages. Always consult with a healthcare provider or a pediatric nutritionist for personalized advice tailored to your child's health and dietary needs. This approach ensures that your child receives a balanced diet while minimizing the risk of allergic reactions or other health issues.

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