Managing Allergies in Infants: Key Dietary Guidelines and Health Concerns

Allergy

Hello: My child is currently over 7 months old and has a history of allergies.
I would like to ask: 1.
Should egg yolks and meats be introduced only after 10 months to reduce the risk of allergies? 2.
What is the appropriate amount of egg yolk to give? Which types of meat are preferable? 3.
Do flour-based foods like steamed buns, toast, and bread also pose a risk for allergies? At what age can these be introduced? 4.
Previously, my child had persistent tearing, and the doctor mentioned it was due to nasolacrimal duct obstruction and suggested massage.
However, after massage, there has been no improvement, and I often see the eyelashes sticking to the eyeball.
Could this be due to ingrown eyelashes? Will this affect the eyes? Which specialist should we consult? 5.
My child currently weighs 10.3 kg.
If the weight is adequate, does it matter if they drink less than 500 cc of milk a day? (This has been the case for some time, and urine output is not much, but they sweat a lot.) Thank you!

Kai Ma, 30~39 year old female. Ask Date: 2009/05/19

Dr. Xiao Kaiwen reply Pediatrics

1.
Egg whites should be introduced around one year of age, while most meats are considered low-allergen complementary foods.
2.
When starting to try new complementary foods, the principle is to begin with small amounts and gradually increase, starting with purees, then moving to diced, and finally to chunked textures.
Introduce one type at a time, and only increase the quantity or introduce a new type once the child has adapted (showing no rashes or diarrhea).
3.
Flour products (grains) are also relatively high in allergens and can be introduced around one year of age.
4.
It is advisable to check for any inward-growing eyelashes during pediatric ophthalmology visits.
5.
Dairy products should gradually take a backseat to complementary foods; as long as there is adequate supplementation with complementary foods and normal growth and development, this is sufficient.
Additionally, infants and toddlers may experience fluctuations in appetite, and they might develop a preference for milk again after some time.

Reply Date: 2009/05/19

More Info

Managing allergies in infants, especially those with a known allergic predisposition, requires careful consideration of dietary guidelines and health concerns. Here’s a comprehensive response to your questions:
1. Introduction of Egg Yolks and Meats: It is generally recommended to introduce egg yolks and meats around 6 to 8 months of age, even for infants with a family history of allergies. However, some pediatricians suggest waiting until 10 months for high-risk infants. The rationale behind this is that early introduction of allergenic foods may help in developing tolerance. It’s crucial to monitor for any allergic reactions when introducing these foods.

2. Quantity and Type of Meat: When introducing egg yolks, starting with a small amount, such as half a yolk, is advisable. As for meats, lean options like chicken, turkey, and well-cooked beef are good choices. These meats provide essential nutrients like iron and protein, which are vital for your infant’s growth and development.

3. Wheat Products and Allergies: Foods made from wheat, such as bread, buns, and other baked goods, can potentially trigger allergies in some infants, particularly those with a predisposition to celiac disease or wheat allergies. It is generally recommended to introduce these foods around 8 to 12 months of age, but you should consult with your pediatrician if your infant has a known allergy or if there is a family history of gluten sensitivity.

4. Tearing and Eye Concerns: The persistent tearing you mentioned could indeed be related to nasolacrimal duct obstruction, which is common in infants. If massage has not improved the situation, it may be worth consulting a pediatric ophthalmologist to rule out other issues, such as ingrown eyelashes (trichiasis) or other ocular conditions. Regular eye examinations can help ensure that any potential problems are addressed early.

5. Milk Intake and Weight: At 7 months, if your infant weighs 10.3 kg, this is generally within a healthy range. While the recommended daily intake of formula or breast milk is around 500-700 cc, it’s important to ensure that your infant is getting adequate nutrition from solid foods as well. If your infant is not drinking enough milk but is consuming a variety of solid foods, this may be acceptable. However, if you notice decreased urine output or other signs of dehydration, it’s essential to consult your pediatrician.

Additional Dietary Guidelines for Allergies:
- Introduce New Foods Gradually: When introducing new foods, do so one at a time and wait about three to five days before introducing another. This helps identify any potential allergic reactions.

- Watch for Symptoms: Common allergic reactions include rashes, hives, swelling, gastrointestinal upset, or respiratory issues. If any of these occur, seek medical advice immediately.

- Consult with a Pediatrician or Allergist: If your infant has a history of allergies, it may be beneficial to work with a healthcare provider who specializes in allergies. They can provide tailored advice and possibly recommend allergy testing if necessary.

Conclusion:
Managing allergies in infants requires a proactive approach to diet and health monitoring. By carefully introducing new foods, observing for reactions, and consulting with healthcare professionals, you can help ensure your infant’s nutritional needs are met while minimizing the risk of allergic reactions. Always prioritize open communication with your pediatrician regarding any concerns or changes in your infant’s health.

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I have replied on 93-02-29. Wishing you good health.