Solid Food Introduction
Little evidence suggests that delaying solid food introduction in breastfed infants prevents food allergies. Exclusive breastfeeding (or hypoallergenic formula) is recommended until 4-6 months of age. Cereal may be introduced at 4-6 months of age (or yellow fruits and vegetables in patients with FPIES at 6 months of age). If tolerated, other foods -- including grains, legumes, poultry and meat, egg, peanut butter, and fish -- can be introduced by 1 year of age, unless there is a reason to believe that the child may be allergic to these foods. Any food that has already been tolerated by an infant should not be restricted.
Owing to the high rate of multiple food allergies in solid-foods FPIES, it may be beneficial to avoid grains, legumes, and poultry in the first year of life because of the high likelihood that these infants may react to multiple foods. However, this is an empirical approach and has not been validated by controlled studies.
Back to the Case: Long-Term Management
The child is now 15 months old. She has successfully incorporated a variety of foods in her diet, but her parents have strictly avoided cow's milk. She has had no known exposures or possible reactions to cow's milk since 3 months of age.
Medscape Pediatrics © 2014
Cite this: Food Allergy in the Breastfed Infant - Medscape - May 13, 2014.