Commentary by Emily Groopman, MD, PhD
Published October 2023

By around 6 months of age, infants’ motor, dental, and metabolic (gastrointestinal and renal) systems have developed sufficiently such that parents can begin to introduce complementary foods, which are defined as solid and liquid foods other than breastmilk or infant formula. The introduction of complementary foods is a key transition, during which pediatricians can help counsel parents on how to give their child the nutrients they need for optimal growth and development. However, as children begin to consume a greater variety of foods, pediatricians must also offer guidance regarding food allergies. A food allergy is defined as “an adverse health effect arising from a specific immune response that reproducibly occurs upon exposure to a given food.” Along with eczema, allergic rhinitis, and asthma, food allergies belong to the “atopic march”, a larger complex of early-onset comorbid atopic diseases, and have become an important public health concern as they have risen in prevalence, reflecting the substantial burdens they pose on the physical and psychosocial health of patients and their families, as well as their costs to the greater healthcare system.

This module outlines key aspects of food allergies, including their epidemiology, pathogenesis, clinical presentation, diagnostic evaluation, management, and longer-term prognosis, and provides pediatricians with relevant AAP-approved resources regarding these topics.

Keywords: complementary foods; allergy; atopic march; anaphylaxis; hives; celiac disease; hypersensitivity