Information

 

Infant Feeding Advice

 

The last advice on infant feeding from ASCIA (australasian society of clinincal immunology and allergy) is as follows:

 

 

Breastfeed for at least 6 months

 

There are many nutritional and non-nutritional benefits of breastfeeding for both the mother and infant.

 

Breastfeeding is recommended for at least 6 months.

 

Breastfeeding can continue beyond 12 months, or for as long as mother and infant wish to continue.

 

Before 4 months

 

If complementary infant formula is required before solid foods are started, a standard cow's milk infant formula may be used (where there is no history of allergic disease in the infant's parents or siblings).

 

Infant with a history of allergic disease in the infant's parents or siblings may be placed on a partially hydrolysed formula (usually "HA" or hypo-allergenic).

These formulas are not suitable for children who have already developed cow's milk allergy.

 

Soy milk and other mammalian milks such as goat milk are not recommended for allergy prevention. 

 

From 4 - 6 months

 

When your child is ready, consider introducing a new food every 2 - 3 days according to what the family usually eats (regardless of whether the food is thought to be highly allergenic).

 

Give one new food at a time so that reactions can be more clearly identified. If a food is tolerated, continue to give this as part of a varied diet.

 

Breast milk or an appropriate infant formula should remain the main source of milk until 12 months of age, although cow's milk can be used in cooking or with other foods.

 

 


Feeding guide:          Examples only: Specific food choices will depend on what the                                                                         family eats.

 

 

Start with smooth, pureed foods:

 

 

Start with plain cereals (e.g. rice, oats, semolina) then add other foods such as smooth, cooked vegetables and smooth, cooked fruits, pureed meats.

 

 

Move on to mashed foods and finger foods:

 

Meats and fish and a wider variety of vegetables. Fresh fruits and wider variety of cereal and legumes. Yoghurt, egg custard and nut pastes.

 

 

Move on to a chopped texture. Drinks can be offered from a cup (from a developmental perspective, this is usually around 8 months):

 

Continue to increase variety as above (e.g. bread, crackers, pasta, wheat based breakfast cereals, cow's milk on cereal, cheese, egg, fish, other seafood, nut products and foods containing nuts).

 

 

For the full guide to INFANT FFEDING ADVICE see: 

http://www.allergy.org.au/images/stories/aer/infobulletins/2010pdf/ASCIA_Infant_Feeding_Advice_2010.pdf

 

 


 

 

Risk Minimisation for Food Allergy

 

Allergy to foods is a concern for children and parents with many children having a range of reactions to a variety of foods. Some reactions can be milder than others but some can be severe and potentially life-threatening. Testing (such as skin prick testing) does not help distinguish between those likely to have mild or severe reactions so once a child has been identified with a food allergy, education and avoidance strategies become very important.

 

There are 4 useful strategies to employ and for any allergic child to be taught;

  1. Question any food offered by anyone as to whether it is likely to contain the food concerned and if uncertain, reject the food.
  2. Smell the food offered – many children (and adults) can smell eg peanut or hazelnut in food and it is helpful to recognize the smell and reject the food.
  3. Taste the food offered – pause before eating and take a small portion, place it on the lip and tongue. If there is any sensation such as tingling, burning, itching or nasty taste – reject the food.
  4. Vomit if a food is swallowed and a child feels like being sick – they should be encouraged to do so.


These measures are designed to reduce the likelihood of accidental exposure to a food in sufficient quantities to produce an allergic reaction, particularly a severe one.

Epipens are often recommended as part of an action plan for anaphylaxis (severe food reaction) but is NOT the treatment for food allergy.

The treatment is Avoidance and Education.

 

 


 

 

Immunotherapy

 

The increasing incidence of allergy world wide especially in the developed countries, is a concern.

Allergy is all about the body’s immune system perceiving things in the environment as “threats” or foreign and producing antibodies to attack them.

True allergy (as opposed to various sensitivities) involves the over production of allergy antibodies called IgE (all the antibodies the body produces are given certain numbers: IgA, IgM, IgG) and these attack proteins in foods (eg: peanut, egg, milk etc.) and aeroallergens (protein particles in the air such as house dust mite, pollens and animal fur) to cause reactions by releasing histamine and other chemicals from cells around the body.

Immunotherapy or desensitization has been around a long time to try and restrict or “turn off” the body’s production of IgE.

Desensitization to house dust mite, pollens and bee stings by regular subcutaneous injections (for at least 2 years) has been available in Australia for more than 20 years.

Recently, immunotherapy or desensitization has been carried out by drops under the tongue on an every day or 2 – 3 times per week. This technique is being used extensively in Europe and has many advantages over the injection method. It is much safer, can be carried out at home, is less painful (most children do not like injections) and seems to be as effective as the injection method. However, the course is for 3 – 5 years.

Sublingual immunotherapy (SLIT) treatment is now available for desensitising children as young as 5 or 6 years with persistent hayfever/rhinitis in particular but also for asthma. It is not available for foods or bee sting allergy.

If you wish for more information about immunotherapy, please contact us here at Peninsula Paediatrics – 0477 813 722