13 month old has only eaten paleo- do I need to introduce grains?

[mrsm14]

My 13 month old is breastfed, and up to this point has only eaten mostly paleo/Whole30 foods. He's tried and enjoyed peanut butter as well, and I'm pretty sure he's had a small piece of cheese. For his birthday he had a plantain cake with homemade whipped cream & berries. He has tried beans. So, basically he just hasn't had any grains, including corn. He's happy, great digestion, and a healthy weight. His doctor is happy with his health.

 

So, I'm wondering if I can just continue along like this, or if I need to periodically expose him to allergenic grains such as wheat and corn? I don't want to create an allergy where there is none, if that is even possible, but I don't really want to feed him wheat. We haven't eaten it for years and I don't believe it's necessary, but I don't want him to have a dangerous allergy. 

 

Can anyone point me to any resources or research on this?

[MrsStick]

By the time your child is attending events without you there it would be important for you and him to know what he can and can't have. You can teach him all you want right now but when he's out of your control you and he both need to know what he can or can't eat. Kids are kids and will eat all kinds of stuff at parties, etc. It's better for you to find out ahead of time if he does have an allergy that he needs to avoid or if he just does better off of grains. It will help you deal with school food (you can pack lunches but kids trade food all the time, plus class parties, etc. will happen) and you need the teacher to know your absolute needs as opposed to what are just preferences.

 

If your kid doesn't have any allergies it doesn't mean you need to feed him those foods, but it means that you can not panic when he goes out without you there to monitor everything that goes into his mouth.

[SpinSpin]

My four year old has been raised Paleo, and while he likes the occasional slice of toast, and he likes grilled corn on the cob, he will not touch cereals, turns his nose up at rice (although he will eat cauliflower rice...) can't quite figure out pasta and refuses oatmeal. In fact today, he had tuna for his breakfast! For his birthdays so far, he has had real cupcakes with no issues. DH wants him to at least be exposed to grains, like Mrs.Stick discusses, but we have never pushed grains and he frankly doesn't 'do' them, and he has been fine. You can always offer to see how he does, but not make a big deal about it either way. 

 

When he was little, just starting out with solids, we offered him rice and he spat it back out at us, and we just skipped the infant 'cereals' and went right on with his feedings. We did delayed start, and zucchini and avocado were his first real foods. I made all his food, never packaged stuff. In fact, I tried to give him jarred food and I got the whatcha dooin look and that was that! 

[MrsStick]

One other thing to add - most kids do have some sort of a period where they want to branch out from what they were taught (starts late elementary through high school, or at least it did with me) and learn their own way. At that point you need to know that if your son does that through food - the usual crap-filled Little Debbie type items at school instead of the school lunch, spending his own money on donuts on his way home from school or while out with friends...knowing ahead of time if he would or wouldn't have a severe reaction (potentially requiring hospitalization) will be extremely helpful for you.

[Guest Andria]

 

 

So, I'm wondering if I can just continue along like this, or if I need to periodically expose him to allergenic grains such as wheat and corn? I don't want to create an allergy where there is none, if that is even possible, but I don't really want to feed him wheat. We haven't eaten it for years and I don't believe it's necessary, but I don't want him to have a dangerous allergy. 

 

Can anyone point me to any resources or research on this?

 

A person can not develop an allergy to anything he/she has not been exposed to previously.  So, if you were able to keep your son away from wheat or corn entirely, he would never develop an allergy to them.  This is basic science.  In the real world, however, he will likely become exposed to these items at some point in his life.  It will be up to his immune system, at that point, as to whether he develops an allergy or not.

 

Just to reiterate: avoidance of foods does not create the allergy.  Yes, some foods are more allergic than others, but ultimately it is the immune system that creates the allergy.  

[drtracyb]

Actually, studies have shown the opposite.  Small amounts of exposure help the body develop immunity:

 

 

http://directorsblog.nih.gov/2015/03/03/peanut-allergies-prevention-by-early-exposure/

 

 

Peanut Allergies: Prevention by Early Exposure?

Posted on March 3, 2015by Dr. Francis Collins

Credit: United States Department of Agriculture

It might seem obvious that the best way to avoid a food allergy is to steer clear of the offending item. But a recent study, published in the New England Journal of Medicine, suggests that just the opposite may be true: strict avoidance from a very early age may be the wrong strategy when it comes to kids at high risk of developing an allergy to peanuts [1].

The study found that feeding peanut-rich foods to some high-risk infants actually helps their developing immune systems learn to tolerate peanuts better, apparently helping them avoid this serious allergy later in life. While it’s too soon to recommend stepping up peanut consumption among all babies, the findings provide striking new insights into how food allergies develop and how they might be avoided.

One thing is clear: a growing number of parents and schools are contending with children with peanut allergies. In the United States, peanut allergies have quadrupled over the past 13 years and now affect more than 2 percent of Americans. This trend is so troubling that some airlines have stopped serving peanuts on flights, and it’s not uncommon for teachers to ask students not to bring peanut butter or other peanut products to school.

The latest study arose from an observation by Gideon Lack of Kings College London and his colleagues, published in 2008 [2], that Jewish children in London developed peanut allergies at 10 times the rate of their counterparts in Israel. Probing the eating habits of infants in both countries, they discovered that parents in Israel often introduce their babies to a popular peanut-based snack called Bamba around the age of 7 months. In England, parents avoid such foods until kids reached their first birthday or later.

To test their initial observation, the NIH-funded team enrolled 640 infants who were between 4 and 11 months old. All had severe eczema (an allergic skin rash) and/or egg allergy, putting them at higher risk of developing a peanut allergy. The children were divided randomly into two groups. In one, parents were asked to feed their kids Bamba and other peanut-containing foods at least three times each week until age 5. In the other, parents kept their children peanut-free for the entire study period.

Five years later, the Lack team gave each child an oral peanut challenge. They found 17 percent of children on the peanut-free diet had developed a peanut allergy, compared to only about 3 percent of the peanut eaters. Among those children who started the study already with a slight peanut sensitivity (as measured by a skin test), 35 percent of peanut avoiders developed a full-blown allergy, compared with just 10 percent of peanut eaters.

In sum, the study found that adding peanut-based foods to an infant’s diet reduced the risk of peanut allergy between 70 and 80 percent. What’s more, the strategy appears to be relatively safe; researchers reported no deaths during the study and no significant differences in serious adverse events between the peanut avoidance and peanut consumption groups.

Like all studies, this one does have its limitations. The researchers didn’t determine how much peanut protein must be eaten and how long it needs to be consumed to develop lasting peanut tolerance. It also isn’t clear whether the same strategy would work for other common food allergies, such as eggs, milk, and other kinds of nuts.

A second study, which dovetails with this work, involves a search for genes that increase the risk of peanut allergy. In the NIH-funded study, Xiaobin Wang of The Johns Hopkins University in Baltimore and colleagues examined the DNA of more than 2,700 individuals—including parents and children with and without clearly defined food allergies. They discovered a region on chromosome 6 harbors genetic risk factors for peanut allergy [3].

Wang’s team found no genetic changes there linked to milk or egg allergy. But for peanut allergy, they identified certain regions within the human leukocyte antigen (HLA) that likely contribute a significant genetic risk. The HLA is complex of genes that encode proteins that help to regulate the immune system and can be a hotspot for genes involved in allergies.

These findings represent some of the most exciting developments in a long time in understanding the causes and the potential means of prevention for peanut allergy.

[Guest Andria]

^ This study only seems to support the premise of immunotherapy, the process of exposing the body to a limited amount of antigen in order to desensitize the immune system to said allergen.  Without testing these babies for previous exposure to peanuts, via allergen specific IgE antibodies, it is not clear if they were truly never exposed to peanuts prior to the study.  Yes, the parents may have not fed peanuts or specific peanut contain products, but exposure could have occurred via cross-contamination.

 

Either way, it is not realistic to forever avoid a food product and the idea of desensitization via chronic, repeated moderate exposure does seem promising.