Starting Solids, Rashes and Food Allergies

Image by Kaz Hush

You have finally worked up the courage to offer your baby strawberries.

They squash them.

Throw them.

Rub them through their hair.

Then ten minutes later you notice a red rash around their mouth.

Suddenly your brain jumps straight to:

"Have they got a food allergy?"

If this sounds familiar, you're not alone.

As a Paediatric Nurse Consultant, one of the most common concerns I hear from parents during the starting solids journey is about rashes after food.

The tricky part is that not every rash is an allergy.

In fact, many of the rashes parents notice are simply caused by food touching sensitive skin.

Why Do Babies Get Rashes Around Food?

A baby's skin is thinner and more sensitive than an adult's.

Certain foods can temporarily irritate the skin around the mouth, cheeks and chin.

Common culprits include:

• Strawberries

• Tomatoes

• Citrus fruits

• Pineapple

This type of rash is called a contact rash.

It occurs because the food irritates the skin, not because the immune system is reacting to the food itself.

Contact rashes typically:

• Appear where the food touched the skin

• Look red or blotchy

• Do not spread widely across the body

• Settle fairly quickly

While they can look dramatic, they are generally harmless.

What Does a True Food Allergy Look Like?

A food allergy happens when the immune system reacts to a food protein.

Symptoms usually appear within minutes to two hours after eating the food.

Signs can include:

• Hives or raised welts

• Swelling of the lips, face or eyes

• Vomiting

• Tummy pain

• Diarrhoea

• Tingling or itching around the mouth

These symptoms often occur alongside each other rather than as an isolated red patch around the mouth.

What About Delayed Rashes?

Not every rash that appears after eating is caused by a food allergy.

Children can develop viral rashes, heat rashes, eczema flares and other skin conditions that happen to occur around the same time as introducing a new food.

This is why taking photos and documenting symptoms is so important.

The 5 Things The Sick Sense Wants You To Track

If your child develops a rash after eating, write down:

1. What time the food was eaten

Timing matters.

2. What time symptoms started

Did the reaction occur after 5 minutes, 30 minutes or 2 hours?

3. What symptoms occurred

Was it just a rash?

Was there vomiting?

Any swelling?

4. How much was eaten

A full serve can provide different information compared with a tiny taste.

5. How was the food prepared

Raw, cooked, baked and processed foods can sometimes trigger different reactions.

These details can help your GP or allergy specialist determine what happened and guide further assessment.

When Should You Call 000?

Some reactions are emergencies.

Call 000 immediately if your child develops:

• Difficulty breathing• Wheezing or noisy breathing• Swelling of the tongue• Swelling or tightness in the throat• Persistent cough• Hoarse voice• Difficulty talking• Becoming pale and floppy• Collapse

If your child has been prescribed an EpiPen or Anapen, follow their ASCIA Action Plan.

Should I Stop Giving Allergy Foods?

Current Australian guidelines recommend introducing common allergy foods by around 12 months of age in an age appropriate form.

Once a food has been safely tolerated, it should continue to be offered regularly.

If you suspect your child has experienced an allergic reaction, seek medical advice before reintroducing the food.

The Sick Sense Bottom Line

Starting solids is messy.

Sometimes the food ends up on the floor.

Sometimes it ends up in your baby's eyebrows.

Sometimes it leaves a rash that makes your heart skip a beat.

Most rashes are not emergencies, but every rash is an opportunity to observe, document and learn.

You do not need to know everything.

You just need to know what you're looking at, what questions to ask, and when it's time to get help.

That's the Sick Sense.

Disclaimer

This information is intended for general educational purposes only and should not replace advice from your doctor, nurse practitioner, paediatrician, allergy specialist or other qualified healthcare professional.

While every effort has been made to ensure the information is accurate and evidence based at the time of publication, individual circumstances vary and recommendations may change over time.

If you are concerned your child may be experiencing an allergic reaction, seek medical advice. If your child develops difficulty breathing, swelling of the tongue or throat, persistent coughing, becomes pale and floppy, or collapses, call 000 immediately as these may be signs of anaphylaxis.

The Sick Sense aims to empower parents and carers with practical health knowledge so they can recognise signs of illness, know when to seek help, and feel more confident caring for their children.

References

Royal Children's Hospital Melbourne. Food Allergies Fact Sheet

Sydney Children's Hospitals Network. Fruit and Vegetable Allergy Fact Sheet

Queensland Health. Food Allergy Children's Health Queensland.

Food AllergyNational Health and Medical Research Council. Rash Fact Sheet