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When should I introduce wheat into my baby’s diet?

Anthony Porto, MD, MPH, FAAP

Answer

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Wheat is the grain most often associated with food allergies. Wheat also contains gluten, which is linked with celiac disease. So, you may have concerns about when to introduce wheat into your little one's diet—and what (if any) effect it will have on your child.

In general, children are developmentally ready to begin solid foods between 4-6 months old. For most babies, it does not matter what the first solid foods are. Single-grain infant cereals (such as rice and oats) are traditionally introduced first.

Once your baby learns to eat a few first foods, you can gradually give them other foods—including high-allergy foods like wheat-containing products. Within a few months of starting solid foods, your baby's daily diet should include a variety of foods.

No need to wait or delay wheat introduction

There is no evidence that waiting to introduce or limiting allergy-causing foods such as wheat or other gluten-containing grains (such as rye or barley) beyond 4 to 6 months of age prevents food allergy or the onset of celiac disease. Wheat can be introduced most commonly in the form of infant cereal, for example, as wheat or multigrain cereal.

There are various types of negative immune reactions to wheat:

  • A classic food allergy. This includes symptoms such as hives or wheezing immediately after a child eats a food made with wheat.

  • Celiac disease is triggered by gluten in wheat. Typical symptoms include abdominal pain, diarrhea, irritability, poor weight gain and slow growth. Celiac disease may reveal itself shortly after a baby has their first bowl of wheat-containing infant cereal. However, in some cases symptoms are so minor that you may not notice them. In fact, the condition can smolder at a low level for years, and a diagnosis may not be made until adolescence or even adulthood.

  • Eosinophilic esophagitis is a chronic condition in which wheat protein triggers inflammation in the esophagus. Children can have trouble swallowing, food getting stuck in their throat and vomiting.

New research changed how we approach food allergy prevention

A landmark study in 2015 showed that early introduction (between 4 and 12 months) and regular feedings of foods commonly associated with allergies—particularly peanuts—may help prevent an allergy. See Peanut Allergies: What You Should Know About the Latest Research for more information.

If your child does have a wheat allergy

Talk with your pediatrician about what the best foods are for your child. Remember to offer a variety of food. This can include naturally gluten-free fruits, vegetables, meat, fish and eggs and gluten-free grains (such as quinoa, millet and amaranth).

The good news is that most wheat allergies resolve by early childhood and typically do not last until adulthood.

NOTE: The AAP recommends breastfeeding as the sole source of nutrition for your aby for about the first 6 months. It supports continued breastfeeding after solid foods are introduced as long as you and your baby desire, for 2 years or beyond. Check with your child's doctor about vitamin D and iron supplements during the first year. Remember that each child's readiness for solid foods depends on his or her own rate of development.

More information

Note: Sarah Abu-Alreesh, MD, FAAP, also contributed to this article.

Anthony Porto, MD, MPH, FAAP

​Anthony Porto, MD, MPH, FAAP is a board certified pediatrician and board certified pediatric gastroenterologist. He is an Associate Professor of Pediatrics and Associate Clinical Chief of Pediatric Gastroenterology at Yale University and Director, Pediatric Gastroenterology at Greenwich Hospital in Greenwich, CT. He is also the medical director of the Yale Pediatric Celiac Program. Within the American Academy of Pediatrics, Dr. Porto sits on the PREP Gastroenterology Advisory Board and is a member of the Section on Gastroenterology, Hepatology and Nutrition. He is also a member of the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition's Public Education Committee, a pediatric expert on nutrition for The Bump's Real Answers, and is the co-author of The Pediatrician's Guide to Feeding Babies and Toddlers. Follow him on Instagram @Pediatriciansguide.​

Last Updated
12/13/2024
Source
American Academy of Pediatrics Section on Gastroenterology, Hepatology and Nutrition (Copyright © 2024)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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