Pediatric Food Allergists Are Changing The Rules: What Parents Need To Know

If you had kids in the last decade like I did, you might remember a distinct shift in the way pediatricians and medical experts talked about food allergies. I certainly remember it. Sometime during my child-rearing years, I switched from letting my babies casually try peanut butter in their high chairs to the panic of “Don’t let your kids near a peanut until they’re two!” And most parents I knew at the time made the switch as well.

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Well, hold on to your yoga pants, moms, because the narrative is changing again. And it’s a huge pivot. HUGE.

First of all, if this past year has taught us anything, it’s this: we must accept that medical science is always evolving. Research studies regularly unearth new evidence, which leads to updated guidelines about how we need to do to keep our families safe. And thank goodness it does, or else we all might still be blood-letting to “cure diseases” or performing frontal lobotomies on patients with mental illness or letting our kids roll around in the back seat while we cruise down the interstate at 80 mph. And even today, Covid guidelines continue to change as we learn more about this virus, just as other fields of medicine—like cancer treatments, prenatal care, and pain management—all continue to evolve as well.

The science behind food allergies is no different. And in honor of May being Food Allergy Awareness Month, let’s talk about exactly what that science is saying, today.

To recap, sometime within the last decade, all of a sudden, parents started hearing “Wait! Don’t expose your babies to the big allergens—peanuts, eggs, shellfish, etc. until they are older.”

My kids were born in that time period, and I remember flipping that switch in our own home. The first two kids (birth years 2008 and 2010) were lapping up all the peanut butter and eating scrambled eggs well before a year old.

By the time my third child was born (in 2013), however, everything had changed, and we didn’t expose him to any of it. Plus, baby #3 in our house was already showing allergy symptoms like eczema and hives, so we were extra nervous. Two years later, when we finally did try sneaking a little peanut butter into his belly, it was too late. He’d developed a peanut allergy, and by preschool he was officially branded an “EpiPen kid,” and me an official “allergy mom.”

Now it’s 2021, eight years after our decision to withhold any exposure to big scary allergens for his first couple years of life, and pediatricians are telling moms of babies something very different.

In an interview with Dr. Wendy Sue Swanson, a pediatrician and food allergy expert, Dr. Swanson tells Scary Mommy that the new rule around feeding our kids is to “stop fearing food” and, in fact, be liberated by feeding our babies allllll the foods. Like seriously everything. Eggs, shellfish, peanuts, tree nuts, cow’s milk, soy, sesame, wheat, Thai food, Indian food, Kansas City BBQ, and bison burgers from Wyoming. She’s not kidding.

Dr. Swanson, whose official title is Wendy Sue Swanson, MD, MBE, FAAP, pediatrician and Chief Medical Officer, SpoonfulONE, is passionate about the food allergy epidemic in this country. Her work with SpoonfulONE, a one-stop shop for educating parents about food allergy prevention as well as actual, tangible food items parents can buy to ensure their kids get a diverse food plate with every meal, proves just how committed she is to this cause.

And she’s got the research to back up exactly why she thinks parents should be exposing their babies to a diverse list of foods (she even recommends 100 new foods in 100 days!), why she says “slower exposure isn’t in our baby’s best interest,” and why we need to get over our fear of foods and start as early as possible exposing our babies to peanuts, eggs, shellfish, soy, milk, sesame, wheat… and everything else too.

Listen, Dr. Swanson and the rest of the pediatric world all know this is big. “We are reversing the guidelines. We are blowing the roof off of it,” she tells Scary Mommy. She also admits that she was one of the many pediatricians who gave the “wait until two” advice years ago, but that they got it wrong, and now they know better and can advise us better.

In talking to Scary Mommy, Dr. Swanson referenced many clinical research trials that have proven how vital it is that babies be introduced to a variety of foods, including those with allergens, early on. One such study, published in 2015 in the New England Journal of Medicine, followed babies from age four months to five years. Half the kids were given peanuts three times a week, and the other half were not exposed at all. The results were ground-breaking. Early introduction of peanuts in babies’ diets reduced their chances of developing an allergy by 86%. That study truly changed the narrative on food allergies and kids.

The fact is, our country is fighting a food allergy epidemic. Six million American children have a food allergy. That’s 8% of children in this country—a number that has doubled in recent years. Six million kids who live in fear, whose parents live in fear, of an allergic reaction. Six million kids who might be bullied or teased or have to miss out on experiences in order to avoid potentially dangerous food exposure.

And if we don’t do something, that percentage is only going to increase. As Dr. Swanson explains, there is no cure for food allergies, even though treatments like oral immunotherapy are showing promise. The key, therefore, is prevention. And exposing our babies to allergens early—in their gut—is how we do it.

“70% of our immune systems are in our gut,” Dr. Swanson explains, so getting those allergens into a baby’s tummy, as opposed to just skin exposure, is essential so that the immune system learns how to interact with them, tolerate them, and break them down.

And here’s the best part, since we are all exhausted and don’t have enough hours in the day. Once parents flip the switch in their minds on how to feed their babies and toddlers, it’s actually less work, not more, like we’re doing now. The new rule is this—feed your kids the way your grandparents were fed. One meal for everyone. Quit the “this is the dinner for the grownups and the kids get mac and cheese and chicken nuggets” mindset. Start your baby at 4-6 months old eating whatever you are eating. Cut up shellfish (remove the shell) into tiny bits. Give them yogurt. Feed them foods with soy and sesame and wheat. Fry up an egg or cook one into a pancake. Add peanut butter to their oatmeal.

And, Dr. Swanson says, this part is just as essential: keep doing it. “Day after day after day after day,” she emphasizes. Don’t expose your baby to eggs one time. Expose your baby to eggs several times a week, every week for months, years even. Same with the other allergens. Ensure their diet includes all of it, over and over and over.

But Dr. Swanson also knows that feeding babies and toddlers can be hell on earth. That’s why she lives and practices by the expression “Every bite counts.”

“Toddlers are like, one day they eat five strawberries and a peanut butter sandwich and the next day they eat three bites of air and you’re like ‘What the heck?'” she says, with a laugh. Because she knows. She knows how hard it is for us to get bites into their tummies sometimes. So make every bite count, she says. Don’t make all those bites peaches and sweet potatoes and rice cereal. Put eggs in there. Put nut butter in there. Put milk in there. Sneak those allergens into those little bellies as often as possible to build up their immune system.

Another important misconception Dr. Swanson addressed is this. The food allergy epidemic is not a “peanut thing.” Only 7% of people with food allergies are mono-allergic, she tells Scary Mommy. 93% are allergic to at least one other thing. So even though we hear about peanut allergies the most, we need to ensure we work to combat the epidemic as a whole—and that includes all the allergens.

Because here’s the cold, hard truth. We as a society have created this allergy epidemic. We aren’t letting our kids’ tummies learn how to process foods other than mac and cheese and chicken nuggets and Cheerios, and our kids are suffering for it.

Looking back, did I cause my third child (the only one of my children to have food allergies and the only one not exposed to allergens as a baby) to have these allergies? I’ll never know. Some kids are just allergic to things and there is nothing anyone can do about it. But I do appreciate that the medical community knows more now, and babies and their parents don’t need to live in fear of the dreaded peanut or eggs or a piece of shrimp anymore. In fact, they should try them out right there on their Elmo plate and matching sippy cup. At only a few months old.

Dr. Swanson says that her hope is for parents and kids to be “emancipated from fear” about foods.

“Let’s raise babies who will grow up to eat anywhere, travel the world, eat anything and everything. Be completely fearless. They can fly off to Taiwan, they can fly off to Vietnam, the can eat stinky cheese in France, or they can stay in Iowa for the rest of their lives and eat whatever they want,” she says. And I agree with her. Doesn’t that sound amazing?

The rules have changed, parents. If we want to raise kids who have the best chance at being food-allergy free, early and constant exposure is the way to do it. We don’t need to fear putting high allergy foods into our babies, but rather, the real monster is what happens when we don’t.