Introducing Solid Foods and Breastfeeding with Infants

Atopic dermatitis (eczema) is a long-term skin condition that makes your skin red and itchy. Most often, this condition is diagnosed in infants and young children. The cause of eczema is a combination of different things, including:¹

• A problem with the skin barrier
• Environmental factors
• Genetics
• Immune system problems

What is atopy?

The term "atopic" comes from "atopy." Atopy is when someone is more likely to have allergic reactions to things in their environment. This can cause diseases like allergic rhinitis, asthma, and eczema.²

How is breastfeeding related to eczema?

There is no denying that breastfeeding is good for babies in many ways. Breastfeeding can help with bonding. It also provides important nutrients.³

There is growing evidence that breastfeeding may help protect infants from developing eczema. Also, some studies have found that breastfeeding might reduce the severity of eczema in infants. This may be because breastfeeding strengthens the skin barrier, reduces inflammation, and helps boost the immune system. Breastfeeding also promotes a healthy mix of organisms on the skin (called the skin microbiome).^4-6

While these are promising results, overall research results have been mixed. More research is needed to confirm the exact relationship between breastfeeding and eczema. However, most experts think breastfeeding is likely protective against allergies.^4-6

When should you introduce allergenic solid foods?

Eczema and food allergies seem to be highly linked. Infants who have eczema are at higher risk of developing food allergies. Doctors think this is because food allergens can enter their body through the eczema rash on their skin. But the relationship works in the opposite direction, too. Studies have shown that at least 1 in 3 cases of childhood atopic dermatitis are triggered by a food allergy.^7,8

This fact led many doctors to recommend that parents avoid introducing certain foods to babies too early. For example, the American Academy of Pediatrics (AAP) used to suggest waiting until a child was 3 years old to feed them peanut products.^7,8

Unfortunately, that advice might have contributed to the increase in peanut allergies in recent decades. The AAP changed its guidelines in 2008, suggesting that parents introduce allergenic solid foods by the time their babies were 6 months old. But, at that time, there was not enough data to recommend introducing peanuts that early. This caused confusion about which solid foods should be fed to children and when.⁷

Common allergenic solid foods include:^7,8

• Peanuts
• Cow’s milk
• Eggs
• Fish and shellfish
• Tree nuts
• Wheat
• Soy

Results from more recent studies strongly support the introduction of allergenic foods by about 6 months. Once introduced, the foods should be given regularly. One important study called the LEAP study showed that infants who ate peanuts 3 times per week were more than 86 percent less likely to develop an allergy by age 5. Studies that looked at different foods showed similar results.⁷

Like many things in medicine, recommendations change when new studies come out. Talk to your doctor about what is best for you and your child.

What else should you consider?

Breastfeeding and early feeding of allergenic foods are recommended. If you feel certain foods worsen your child’s eczema, it is important to discuss this with your doctor. As with many conditions, the cause of eczema is complex. Allergies likely play a role, but other factors are important.^1,3

Be sure to talk to your doctor about which feeding options are best. Breastfeeding and giving solid foods early are options. But they are not the only options. If needed, ask your doctor about seeing a lactation consultant. These experts can help you with breastfeeding tips and techniques as well as other options that may be better for you and your baby. This service is often covered by insurance.⁹

Feeding choices are a parent’s personal choice. With knowledge about health benefits and recommendations, you can make more confident decisions. Partnering with your doctor and other health experts might ease your decision-making process.