Intolerances and Allergies - Same-Same Or Different?

Introducing allergens is a topic we see frequently discussed in the Starting Solids Australia group, and we get a question about how and when to introduce high allergen foods almost every day.

Unfortunately, we also see that there remains a lot of misinformation and myths circulating around introducing high allergen foods to your LO's diet. At the same time, we also see a number of questions and discussions around potential food intolerances that your LO may have.

Anyone can be allergic to anything. However 90% of food related allergic reactions are attributed to 9 common allergen foods - cow's milk, egg, peanut, tree nuts, sesame, soy, fish, shellfish and wheat so its important to be aware and mindful of these when introducing them to your little ones.

An allergic reaction is an immune system response that may include lips, eyes, and face swelling, vomiting or wheezing, hives, with more severe anaphylactic reactions presenting with difficulty breathing, swelling in the tongue or throat, wheezing and/or dizziness. These more severe reactions are rarer.

Food intolerances and food allergies are sometimes spoken about interchangeably, but this incorrect.

A food intolerance doesn't involve the immune system, and may be associated with excessive gas, flatulence (farting), bloating, headaches, uncomfortable stomach but doesn't cause the systemic reactions that are associated with food allergies - they are uncomfortable and require treatment but they are not life threatening. These same symptoms can be similar to what you might witness in your LO as they begin to eat solids and are exposed to the many different types of foods and flavours that their gut needs to learn how to digest and pass.

Compared to what many people suggest to be true, to test for a food allergy requires that a food be introduced inside of the mouth. Testing food allergies on the skin are inaccurate and unable to accurately represent whether a child has an allergy to a certain food. Introducing high allergen foods (assuming your LO is not allergic to a particular food) around 6 months (i.e. when your LO is meeting their readiness milestones, and not before 4 months) is recommended, contrary to previous advice that suggested waiting until 12 months. It's important to continue offering high allergen foods frequently (i.e 2x per week for peanuts and eggs), so as to reduce the likelihood of developing allergies into the future.

If you suspect your LO is allergic to a particular food and has shown any of the above allergic type reactions, please cease offering the suspected food to your little one and seek medical attention. Your GP or care provider will assess whether allergy testing is indicated.

With the intolerance type symptoms, with seeing our LOs being in discomfort from a certain food or group of foods we commonly see foods being cut out prematurely leaving gaps in the child's nutrition needs. Unfortunately this may not be appropriate, it may result in unnecessary restrictions that compromise your LOs long term nutrition status, and it also potentially imposes a lot of stress on you and your family, which may not be completely necessary (or at all). Identifying and managing intolerances (as with allergies) requires a methodical approach to understand your LO's whole diet, patterns of eating, environmental factors and other things that may influence some of the symptoms you're seeing. There are also certain foods that have similar properties to the ones that your LO is having issues with, or is allergic to. As dietitians, our role is to understand what the whole picture is, and come up with the most diverse and complete diet that we can, whilst taking into consideration the food intolerances or allergies that we're working with.

If your LO has allergies it can be hard to navigate the journey into starting solids, and equally so, if you suspect your LO has intolerances towards certain foods, speaking with one of our Accredited Practicing Dietitian's (APD) can provide you with the support you need to ensure the adequacy of your LOs nutritional intake. An APD is also a recognised medical professional that is able to work in cooperation with your healthcare team in supporting you and your LO in managing their allergies.