Early weaning and allergens

[AmalFish]

Hi everyone,
I have twins who will be 5 months next week (currently 21 weeks) and I was advised by my older son’s paediatrician that the new advice is to introduce tastes (especially of allergens ) to babies from 4 months of age now in order to avoid allergies. I started giving tiny tastes a week ago and even gave them a lick of peanut butter once. The problem is I feel incredibly anxious about doing anything against the grain and since the official nhs advice is still to wait till 6 months I keep doubting what I am doing and whether I shouldn’t have given them a taste of the peanut butter/whether or not i should continue. I’m wondering whether to go see a GP and ask for their opinion but technically the pedeatritiion’s opinion should be enough.
Does anyone have any experience of this? have I risked anything by starting around 20 weeks?

Thank you!

If they are seeing a paediatrician, they obviously are under specialist care and I would take that advice. Honestly, your GP will probably have to google it to even see what the latest guidance is.

Personally, I wouldn’t introduce ‘food’ as in meals, large amounts, sitting at the table and eating until 6 months, particularly if yours were born early and don’t yet have the head control. But exposure to known allergens is not the same thing. It sounds like it’s being done for a specific purpose. And realistically, your babies will not be less likely to have a reaction and you will not feel less anxious in 4 weeks time.

Am in France where they recommend to start weaning at 4 months. I also have puréed foods from about this time aswell as lots of milk still. There’s new research that suggests introducing foods earlier does reduce the risk of allergies. I thought it was common knowledge now so I’m surprised the NHS is still 6 months. Is it really no food before 6 months at all or is it can give some food but also continue with milk?? Can only speak from personal experience but we had no issues with giving mashed bits in small quantities alongside BF and also some formula and baby rice. I remember my son LOVED pureed apples with cinnamon and cream! And scrambled eggs, used to give a bit of mashed banana with peanut butter which he also adored.

I listened to a fascination podcast about this and would recommend it if you have reservations. It's the Zoe podcast and was aired on 15th August. 'Why one in ten children have a food allergy' with Dr Gideon Lack. He is a world expert on allergies and is a professor of paediatric allergy at Kings Cross London. His advice is to definitely wean early (4 months) and give tiny quantities of a huge variety of foods including all the usual allergens so peanuts, milk eggs etc. He explains why this hugely cuts down the risk of getting food allergies and it makes so much sense. I hope the NHS advice on weaning changes in light of his research.
I so wish I had listened to this podcast when my DS was a baby. I waited until he was 6/7 months before I gave him peanut butter and he now has a full blown peanut allergy.

There is new evidence that exposures to allergens as soon as possible is the best way of reducing the risk for allergies.
Your paediatrician is using more up to date information. It would be worth discussing portion size and frequency with them
Don't worry about the portion size being tiny. My daughter has food allergies and when we do introduction we start at a portion size equal to a grain of rice and once a week and she's 4!

I think the current research has been that it's good to give small tastes of allergens early and start weaning "properly" at 6 months.

This is all dependent on the child though! My daughter had her first reactions to foods at days old when I ate them. She didn't eat a single mouthful of food for the first 2-3 weeks of weaning and was 13 months before she ate her first meal! We had tried a most allergens but 7-8 months but didn't have nuts regularly until 18+ months as it took until then for her to regularly eat.

My twins were advised to do early weaning around 5 months (3-4 months corrected age as born at 33 weeks) due to reflux. But I found this so hard as they were not yet sitting (or anywhere near) so had to feed in bouncy chairs and they just screamed and refused. So I waited till 7 months to wean which worked better.

My twins are cmpa and possible soya allergy which was picked up at 5 months. And at 2 years we haven't got anywhere with the milk ladder. So maybe waiting wasn't the best thing to do. And I should of preserved with it. However they eat a great variety of foods (minus cows milk and soya) and don't have any other allergies

I'd also follow the paediatrician's advice. Especially if your DS sees him for allergies!

the NHS advice is 6 months for genral weaning on the basis of gut development but tasters are different and allergen research is showing exposure to allergens but especially peanuts as the research has shown early exposure reduces the chances of a peanut allergy (from around 4 months onwards)

I would keep following paediatrician advice with small tasters and exposures rather then full on weaning.

Has the research on early weaning been done on babies who are fully breastfeeding or bottle fed or both. Have they corrected for this in some way? Would be interesting to find out as babies who are breastfed already recive tastes of foods through their mothers milk anyway.

Only a very small amount of the proteins from food passes through to the breastmilk, I haven't found a good figure but one article quotes 100k fold drop in dairy protein compared to cows milk or formula. The rates of cmpa in exclusively breastfeed babies are 5 times lower than average. The link below quotes ~2% of babies have cmpa and ~0.4% of ebf. To build tolerance to a food you need exposure to the proteins.

Three European birth cohorts that followed infants for the first year of life, and assessed the infants for CMA, confirmed by oral CM challenge, have reported a CMA incidence of 1.9–2.2%.15, 16, 17 In these birth cohorts, the incidence of CMA in exclusively breastfed infants (prior to the introduction of any breast milk substitutes or solid foods) was determined to be 0.4–0.8 %.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10656250/

Tastes and allergies are 2 very different things. Yes there is a link between earlier introduction of allergens and a decrease risk of allergies later in life.
This is relatively new literature and therefore it often takes time for this to be updated in the nice guidelines (these are the guidelines the nhs use as a kind if road map to treatment).

However even their weaning site has been updated on the introduction of allergens and now highlights the importance of introducing these allergens by 12 months.

Is there a specific risk of allergens in your case? By that I mean have they already been diagnosed with a cows milk protein allergy or is there a family history of allergens or asthma / excema?

I'd definitely follow the pediatrician advice, the GP will have far less experience and knowledge of allergens/weaning. The research on giving allergens earlier than 6 months is new, and it takes ages for NHS to change their policies on anything like this. And tastes are different to giving full on meals.