Doctors’ Notes
BackHoney, Nuts, & Other Infant Food Concerns
There’s a lot of information out there that explains when to introduce certain foods over the first two years of life. But what about foods like eggs, nuts, honey, and other foods that are known for their food safety concerns or allergenic qualities?
When can they be introduced? This Nutrition Note will cover some of these questionable foods with what the latest evidence suggests. Here goes…
Honey
Honey should not be fed to infants younger than 1 year old. This isn’t about allergy as much as it is about food safety, and in particular, a type of bacteria known as Clostridium. This type of bacteria can contaminate honey and cause infant botulism, leading to muscle weakness. To reduce the risk of infant botulism, do not introduce honey or any honey-containing foods (i.e., honey graham crackers) until after baby’s first birthday.
Soy Foods
Soy protein is one of the eight major food allergens. However, according to the Soyfoods Association of North America, only an estimated 0.1% of Americans are allergic to soy. Regardless, soy foods such as tofu and edamame are not suggested as a first food, and may be more appropriately offered once baby has been eating a variety of foods between 6–8 months. As with all new foods, be on the lookout for symptoms of an allergy, but there is no convincing evidence that delaying the introduction of soy beyond this point has a significant protective effect against the development of allergy. Tofu, edamame, and the like are easy to prepare and serve, and are a super source of protein for little ones.
Fish & Eggs
Back in the day (as recently as five years ago), the American Academy of Pediatrics (AAP) recommended waiting until after 1 year old to introduce fish and other foods that were considered “highly allergenic.” But in 2008, the AAP revised their recommendation, citing no evidence to support that delaying the introduction of these foods would make babies less likely to develop allergies. In fact, some evidence suggests introducing these foods earlier may protect against allergies. So the AAP now says we can decide when to give our babies fish, eggs, and wheat before 1 year of age, unless there is a high risk for allergies. Some pediatricians may suggest waiting until 9 or 10 or even 12-24 months before offering shellfish. This is less about causing allergies and more about it being easier to deal with a reaction in an older baby if there is an allergy.
Nuts
The newest guidelines recommend introducing peanut products to infants around 6 months. If your baby has an egg allergy or severe eczema, talk with your provider first. Otherwise, it’s fine to introduce peanut butter (either mixed in baby cereal or other foods, or off your clean finger — globs of peanut butter can be a choking hazard) or peanut powder (made for babies to mix in with other food). As with any food, monitor for any reactions such as hives, and call the office if you have any concerns. Nuts themselves are a choking hazard and should be avoided until kids can handle them well — even up to age 4.
Popcorn
Popcorn is a choking hazard and should not be introduced until later. Many pediatricians suggest avoiding it until age 4 or 5.
Sugary Treats
Babies don’t need sugary treats — neither do we, really! — so they should not be offered on a regular basis. When baby is a little bit older, a bite of birthday cake here and there certainly isn’t going to cause any harm, but it’s a good idea to not get into a habit of sweet foods and drinks.
The Current Verdict
So, the current verdict is, postponing foods like eggs, fish, and peanuts does not prevent food allergies. However, you may want to delay their introduction if your family has a history of food allergies or your child has eczema. Whatever you decide, be sure to introduce new foods one at a time and wait at least three days before introducing the next new food. If you have any questions or concerns, talk with your doctor at Kids Plus.
For additional guidance, check out American Academy of Pediatrics’ Healthy Children site and the Academy of Nutrition and Dietetics’ Eat Right site.
Anne Marie Kuchera, our Kids Plus Nutrition Consultant, is a Licensed Professional Counselor and Registered Dietitian.