It's estimated that 40% of children in the US are impacted by multiple food allergies.1 In this article, we will focus on infants and the presentation of food allergies, diagnosis, and alternative feeding options to consider for infants who are impacted.
Food allergies occur when the immune system responds abnormally to a specific food. This immune-mediated response will reoccur every time that certain food is consumed. Note that food allergies are different from food intolerance (a non-immune-mediated reaction) because food intolerance doesn't involve the immune system.2
There are 4 kinds of immune-mediated reactions2:
Undiagnosed food allergies can be extremely harmful to infants, so recognizing the symptoms and providing an early diagnosis is key.
Diagnosing food allergies can include reviewing the patient’s medical history, performing a medical examination, eliminating certain foods from the lactating mother's diet to see if symptoms cease or persist, or a trial of hypoallergenic formula, if necessary. Note: For IgE-mediated food allergies, predictive value tests can help physicians confirm a food allergy diagnosis, but these tests are not considered diagnostic on their own.2
Breastfeeding is the optimal nutrition source for infants. However, it can be challenging to manage food allergies in breastfeeding infants, as there is a limited amount of data published on the presence of food proteins in human milk, and food elimination diets may adversely impact the nutritional status of the lactating mother. If parents choose to continue breastfeeding and try an elimination diet, they should work closely with their healthcare provider throughout the process. If parents decide to pursue formula-feeding options instead, finding a nutrition product that works for their infant with food allergies may require trying multiple formulas.
Depending on the infant's immune reaction, here are some possible formula-feeding options to consider2,4:
Developing the skills and awareness to recognize how infant food allergies present in our patients can help remediate an infant's immune response. By providing the feeding option that best addresses the child with food allergies, you can help your patients and their caregivers enjoy a higher quality of life.
References: 1. Warren CM, et al. Ann Allergy Asthma Immunol. 2023;130(5):637-648.e5. 2. Boyce JA, et al. J Allergy Clin Immunol. 2010;126(6 suppl):S1-S58. 3. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Food and Nutrition Board; Committee on Food Allergies: Global Burden, Causes, Treatment, Prevention, and Public Policy, Oria MP, Stallings VA, eds. Finding a Path to Safety in Food Allergy: Assessment of the Global Burden, Causes, Prevention, Management, and Public Policy. Washington (DC): National Academies Press (US); November 30, 2016. 4. American Academy of Pediatrics Committee on Nutrition. Formula Feeding of Term Infants. In: Greer FR, Abrams SA eds. Pediatric Nutrition. 9th ed. American Academy of Pediatrics; 2025:108.
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Help us make Pediatric ProConnect a go-to resource for your pediatric nutrition information. Please let us know how you use PediatricProConnect.com, as well as any new topics or resources you would like to have added to our site.
You can request samples of Similac Alimentum, a hypoallergenic infant formula with immune-nourishing 2'-FL HMO, for your patients with colic symptoms due to cow's milk protein sensitivity.
The American Academy of Pediatrics (AAP) has released its first edition of clinical practice guidelines for the evaluation and management of childhood overweight and obesity, so you can learn how to support patients who may be impacted.
Hampl SE, Hassink SG, Skinner AC, et al. Pediatrics. 2023;151(2):e2022060640. doi:10.1542/peds.2022-060640
This Canadian study found that a higher maternal social advantage during pregnancy was associated with a higher-quality infant diet in their first year. Among infants with a positive diet score, it was more likely that mothers had higher income, more education, and higher diet score.
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