Food Allergen Exposure Guidance for Well-Child After-Visit Summaries

Our goal is to help make food allergen introduction a key feeding milestone for all babies. We have drafted example “dot phrases” that health care professionals can edit and incorporate into well-child after-visit summaries for their patients.

EXAMPLE DOT PHRASE CONTENT 

.FAintroduction  (suggested for 4-, 6-, and 9-month well-child visit)

Foods that cause allergies are known as “food allergens.” There are 9 common food allergens that cause 90% of food allergies in children. They are: peanut, egg, cow’s milk, tree nuts (almonds, cashews, hazelnuts, pistachios, and walnuts), wheat, shellfish, fish, soy, and sesame.

Research shows you can reduce a baby’s risk of developing food allergy by feeding these foods over and over again in early life. Around 4-6 months – when you start feeding solids – you can begin introducing food allergens. Continue to include these foods in your baby’s diet several times a week for at least 1 year.

.FAreactions  (suggested for4-, 6-, 9-, 12-, and 15-month well-child visit)

While uncommon, allergic reactions are possible when introducing food allergens to infants. The two most common signs of an allergic reaction in infants are hives and/or vomiting, typically within 3 hours of feeding or less. Talk to your pediatrician about how to manage mild and severe allergic reactions.

.FAroutinefeeding  (suggested for12-, 18-, and 24-month well-child visit)

The earlier you introduce food allergens, the better – but it’s never too late to start. Research shows you can reduce a baby’s risk of developing food allergy by feeding common allergens (peanut, egg, cow’s milk, tree nuts, wheat, shellfish, fish, soy, and sesame) over and over again in early life. You should continue to include these foods in your baby’s diet several times a week for at least 1 year after introduction.

.USDAguidelines  (suggested for2-, 4-, 6-, and 9-month well-child visit)

When starting solids, the USDA Guidelines recommend:

1. Make every bite count. Infants consume small amounts of food so make sure each bite is nutrient-dense and follow your baby’s cues for being hungry and satisfied.
2. Aim to breastfeed until 4-6 months AND/OR feed an iron-fortified formula.

• Give 400 IU of Vitamin D daily for bone and immune health.

3. Feed common food allergens early and often.

• Around 4-6 months you can begin introducing these foods: peanut, egg, cow’s milk, tree nuts, wheat, shellfish, fish, soy, and sesame. Continue to include these foods in your baby’s diet several times a week through toddlerhood.

4. Work to share family meals with your infant to provide a diverse diet. Feed different, nutrient-dense foods from all food groups–including common food allergens–that vary in taste and texture.
5. Limit beverages to breastmilk, formula, or small amounts of water before 12 months. Juice and sweetened beverages are not needed.