Women's & Infants' Blog

(Current recommendations for introducing possibly allergenic foods to infants)

Along with your baby’s first smile and first words, the first introduction of potentially allergenic foods is a much anticipated milestone. It was long believed that delaying exposure to such foods gave an infant’s immune and digestive system time to develop and prepare for contact. However, current research supports the opposite.

According to the American Academy of Pediatrics, there doesn’t seem to be any value in delaying the introduction of any food beyond six months of age. Genetic factors account for an estimated 50-70% of asthma and allergies. This means the tendency to react to certain allergens will not change if the food is introduced at six months or after your baby turns one. At six months, an infant’s gut should be ready to accept solid foods without increasing his or her risk of an allergic reaction.

Along the same line, there is no evidence that if a pregnant or breastfeeding mother avoids allergen foods (unless she herself is allergic to them) that it changes the outcome for her baby. Though some proteins and markers can cross the placenta or show up in breast milk, an adverse immune response has not been proven in the infants. Attention to what your baby actually eats should be the focus.

When introducing new foods into your infant’s diet, use these guidelines:

• Provide each new food individually, ideally over a 4-day trial period.
• Observe your baby for the development of any adverse reactions.
• If the food is well tolerated, move on to another single food.
• Mixed food should be withheld until each food in the mixture has been introduced to the infant on its own and well tolerated.

Source List

Pediatric Nutrition Handbook, 6^th Edition, American Academy of Pediatrics, 2009

Joneja, Janice PhD. “Infant Food Allergy: Where Are We Now?” Journal of Enteral and Parenteral Nutrition- Summary of 19^th National Conference, Stanford University, Advances in Perinatal and Pediatric Nutrition,  Vol 36, Jan 2012.

(The effects of different infant food sources on allergies)

Breast milk is nature’s perfect answer to infant nutrition. But if fully breastfeeding is not an option, will certain formulas be more likely to promote allergies? Recent studies have shown the type of protein in the formula, and the extent to which it is broken down may indeed play a role.

Conventional milk-based infant formulas have come under the most criticism in recent feeding studies. They have been more closely linked to development of allergies than formulas with “hydrolyzed” or broken-down proteins.

There are different extents to which proteins in infant formula are broken down. If the formula is “extensively hydrolyzed,” the proteins are almost completely broken down, or made smaller and more digestible for the baby’s stomach. If the formula contains “partially hydrolyzed” proteins, the proteins are still broken down, but not quite as much. Compared to cow’s milk formulas, these types of formula have been shown to cause fewer allergies later in life when given to babies in place of breast milk.

Soy formula is usually only given to infants who cannot tolerate any type of milk protein, those with lactose intolerance or galactosemia. There have been many improvements to the ingredients in soy-based formula over time. They can promote healthy growth and weight gain. However, there is no evidence that soy-based formulas prevent or decrease the risk of developing allergies. Soy protein may be just as allergenic as cow’s milk protein.

So as you look at the endless isle of formula choices, make sure to consider these factors:

• Breast milk is the best option; it is what your baby is made to eat!
• If breastfeeding exclusively is not possible, choosing a formula with “extensively hydrolyzed”, or “partially hydrolyzed” proteins may reduce the risk of developing allergies.
• There is no evidence that using soy-based formulas provides protection against developing allergies.

When it comes to our babies, we all want to give them the best possible chance at a healthy, happy life. One of the most basic needs of all human beings is food and nutrition. Babies have several options for receiving nutrients: breastfeeding, pumped breastmilk, donor breastmilk, and formula. The American Academy of Pediatrics (AAP) recognizes breastfeeding and breastmilk as the “gold standard” of nutrition for all babies. The AAP recommends infants receive breastmilk exclusively for the first 6 months, and continue breastfeeding for at least 12 months or more. The longer babies are breastfed, the greater the health benefits for mom and baby.

 Breastmilk is beneficial for NICU infants due to its biological properties and unique chemical composition. This makes it the perfect food for growing babies. Often times very small or special needs babies are unable to take in large enough quantities of milk to gain weight. Human Milk Fortifier may then be used to increase the number of calories per feeding in order to meet weight gain goals. Unique benefits of breastmilk for the NICU baby include:

• Significantly less infection rates related to the immune system properties passed from the mother to the baby
• Lower rates of gastrointestinal infections/complications due to more rapid emptying of the stomach/intestines and increased digestive ability
• Potential for improved intellectual and motor development
• Potential for improved eyesight
• Potential for increased bonding between mother and baby

We know how precious each baby is to their parents and family. The Lactation and NICU team at Overlake look forward to working with you toward meeting your breastfeeding goals and supporting you as you give your baby the healthy gift of breastmilk.

Patricia’s Story:

Patricia, a lactation educator at Overlake Women’s Clinic, was at the park with her grandchildren. Her grandson found a new friend at the park and after they had talked and played for quite awhile, Patricia struck up a conversation with this new playmate’s mother. When the mother learned Patricia works at the Women’s Clinic, she related how this little boy playing had been identified to require further testing to rule out hearing loss during their post-partum follow up appointment at the Women’s Clinic.  After further testing with an audiologist, hearing loss was determined and this infant was able to receive a cochlear implant at a very early age. Because of this, his speech and language have not experienced the delays usually associated with childhood hearing loss. She was so thankful for the expert care she received at the Women’s Clinic and the referral for follow up.

Most children hear and listen to sounds even before birth. Speech is developed by hearing and imitating the sounds they hear coming from their parents and other people who care for them. But for every 1,000 children born in the United States, two to three are born deaf or hard of hearing. Early intervention for these children is essential to ensure they have all the resources available for the best chance to develop speech and language as successfully as Patricia’s new friend. For this reason, every state has established an Early Hearing Detection and Intervention programs. Overlake Medical Center has actively participated in Washington’s program since its inception and has one of the most successful Newborn Hearing Screen programs in the state because of our unique approach to this testing. Our dedicated staff closely follows up with families to ensure appropriate screening, re-screening and follow up occurs for every baby, resulting in one of the highest rates of follow up in the state.

FAQ’s about Hearing Screening at Overlake Medical Center:

When will my baby’s hearing be screened?

Your baby’s hearing will be screened during your post-partum follow up visit at the Women’s Clinic. If you are a Group Health patient or are unable to attend your post-partum visit, you will come to the Women’s Clinic, after you go home with your baby, for a separate hearing screening. You will be told the results of your test at the time of your screening and receive a certificate when your baby passes. If your baby does not pass the first time, it may be due to fluid or debris in the ear canal and you will be scheduled for a rescreen in three weeks. If the results indicate your baby may have hearing loss, you will receive your next steps for further testing.

How will my baby’s hearing be screened?

       The otoacoustic emissions (OAE) test shows whether parts of the ear respond properly to sound. During this test, a soft sponge earphone is inserted into your baby’s ear canal and emits a series of sounds to measure an “echo” response from the cochlea that occurs in normal hearing ears. If there is no echo, it could indicate hearing loss. These sounds are soft and the test is not painful in any way.

Why is it important to have my baby’s hearing screened early?

The most important time for a child to learn language is in the first three years of life. In fact, children begin learning speech and language in the first six months of life. Research suggests that children with hearing loss who get help early develop better language skills than those who don’t. The earlier you know about a child’s hearing loss, the sooner you can make sure your child benefits from strategies that will help him or her learn to successfully communicate.

As you embark on the wonderful journey of parenthood, rest assured that your child’s hearing will be tested with the greatest of care at Overlake Medical Center.

Both in Washington state and across the United States, newborn infants undergo screening for congenital disorders. Most infants receive their first screening prior to leaving the hospital. A second screening is done between 7-14 days. The process of screening is obtaining several drops of blood from your infant on a filter card. The blood is then dried and sent to the Washington state lab for evaluation.

What are they exactly testing with the blood? The screening is used to identify inherited problems that when detected early may prevent serious complications. Currently Washington state tests for 24 disorders through one sample of blood. The results of the tests will be reported back to your pediatrician and discussed during one of your visits. 

Additional information may be found at the following websites:

• http://www.doh.wa.gov/YouandYourFamily/InfantsChildrenandTeens/NewbornScreening.aspx
• http://www.cdc.gov/ncbddd/pediatricgenetics/newborn_screening.html