Why You DON'T Need to Wait 3-5 Days Between New Foods with Carina Venter, PhD, RD

This Is Woman's Work with Nicole Kalil (0s):

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Carina Venter, PhD, RD (37s):

Another good colleague of mine published data showing that with increased diet diversity, so increased food variety in the first year of life, we see reduced prevalence of food allergies up to six years of age.

Katie Ferraro (52s):

Hey there, I'm Katie Ferraro, registered dietitian, college nutrition professor and mom of seven specializing in baby led weaning. Here on the baby-led weaning with Katie Ferraro podcast. I help you strip out all of the noise and nonsense about feeding, giving you the confidence and knowledge You need to give your baby a safe start to solid foods using baby led weaning. Wanna know what one of the biggest lies in infant feeding and starting solid foods is? No it's not Food before one is just for fun, although I do have some issues with that one. The biggest fallacy, the longest lie that is still being told two parents today by doctors all over the world actually, is this idea that you need to wait three to five days between new foods for your baby.

Katie Ferraro (1m 43s):

Today we're breaking this down with one of the world's leading experts in pediatric food allergy prevention and early feeding science. My guest is one of the most amazing women in the world, Dr. Carina Venter. She's a PhD dietitian, the globally recognized authority in infant nutrition, allergy and immunology. Carina's, a professor of pediatrics in the section of allergy and immunology at Children's Hospital Colorado and the University of Colorado School of Medicine. Her research for more than two decades now has helped shape the modern guidelines on early allergen introductions. She's all over this podcast. I think I've interviewed her more times than almost any other guest because she breaks down the science in ways that are so easy for parents to understand.

Katie Ferraro (2m 26s):

So Karina has written and published the egg ladder that a lot of pediatric dietitians are using now for babies with egg allergy. To reintroduce that she's done the milk ladders, she's on like literally every single important allergy board around the world. They all have lots of acronyms. She's the real deal when it comes to dietitians and allergy and research. And you might not be in that world and you might not read all of her publications. I can barely keep up with her. This woman is a maniac. She publishes so much, but she also works in a clinic. She works with families every single day. She's one of the rare researchers who actually knows how to feed a baby, actually interview a lot of researchers. You'd be surprised they have no clue how to feed babies despite all the infant feeding research they do.

Katie Ferraro (3m 7s):

But I know you have a baby and your baby needs to eat these potentially allergenic foods early and often it's literally the only thing you can do to lower your baby's risk of food allergy. But I know you're also nervous or anxious or maybe just confused about the best way to get all these new foods into your baby. And then you're hearing this conflicting info like, well wait, don't I need to wait three to five days between new foods? Spoiler alert, you don't, but you do need to listen to this whole interview with Karina. She's gonna explain Why the three to five day rule never actually had any evidence behind it. What the research actually shows about allergic reactions, she's literally friends with like every food allergy researcher in the world. Plus she publishes a ton of this research herself. And then she's gonna show you very simple ways how early frequent exposure to a variety of foods can support your baby.

Katie Ferraro (3m 53s):

Not only their feeding skills but it's also gonna help prevent food allergies. She's even got data that shows counting the number of foods your baby is eating leads to diet diversity, and the babies who have more foods, guess what? They have less food allergy. And Karina recently helped bring a food allergy related product to market. She's so excited about it, she's gonna tell us about it too. I was really surprised when I heard she had hooked up with a food company. But this one sounds really interesting. So with no further ado, let's dive in with Dr. Carina Venter on why you do not need to wait three to five days between new foods.

Katie Ferraro (4m 35s):

So Karina, where did the old recommendation of needing to wait three to five days between new foods for babies, where did this come from? And please tell us why does it persist? It won't go away.

Carina Venter, PhD, RD (4m 47s):

So that's very interesting Katie. I actually tried to do some research to find out where this come, where it comes from, but it seems to come from pediatric guidelines way back into the 1950s. And it was really based on expert consensus at the time. You know, trying to wait and see if a child developed allergic reactions while we're introducing foods rather than being based on evidence. We have just published a paper last week where we did a big survey amongst all the European pediatricians and it actually showed that the pediatricians that still give that advice about waiting three to five days between every new foods are those above 45 years of age.

Carina Venter, PhD, RD (5m 31s):

So I'm hesitant to call them the older pediatricians because I would fall into that category as well.

Katie Ferraro (5m 38s):

Well those guys are still teaching in medical school and teaching the new doctors the three to five day rule. So I would argue that it's all of them still doing it. 'cause I have a younger pediatrician who still says three to five days.

Carina Venter, PhD, RD (5m 48s):

Yeah, so actually just yesterday in clinic I, I had a a a parent telling me that giving one new food a day or even multiple foods a day is incorrect because her pediatrician told that just this week you have to wait five days. So yes, you know, it, it seems to be, you know, un evidence based on expert. Definitely the older generation is hanging onto this. They're teaching that to the new generation and that's really why we struggling to get rid of of the the advice. But I think the most important thing is that we really need an official statement from the American Academy of Pediatrics to say that they withdraw the advice.

Carina Venter, PhD, RD (6m 28s):

I know you've heard me say in the past that in the book Caring for your baby and Young Child from their AAP, they do say that in the past pediatricians used to advise waiting three to four, five days between each new food to see if reaction occurs. But new evidence suggests that it's safe to introduce multiple foods at once. I can even say that in my sleep. And so it is in the book and we can reference it, but we really need a much more vocal statement from the a a P to say that we can now move on from the statement.

Katie Ferraro (7m 3s):

This is the same group that tells parents start offering solid foods at four to six months but also exclusively breastfeed your baby for six months. Like those are two contra indicatory statements like you are confusing the heck out of parents. And not to diss what pediatricians do because I very much value the work that they do. And of course there are friends and colleagues and they've got a lot to do in short appointments, but they're sending a lot of mixed messages to parents. And I agree with you that if we, I just wish the groups here would act more like the Europeans. You guys are, you span, you span both continents. So every time we hear you talk with the European group, you guys are always putting out a statement that like, let's put the line in the sand. This is what we stayed, this is where we stand on this topic. Nobody ever does that here. And we're still running around, you know, decades later telling parents to wait three to five days between foods, which is asinine because If you go that slow, you and I both know that child will never develop the diet diversity that they need or could have if we're we're unnecessarily slowing parents down.

Carina Venter, PhD, RD (7m 58s):

Absolutely it it is so simple to do the math if even If you start introducing solids at six months, which we now consider late, but even If you start at six months, you've got 180 days before the child is 12 months old to introduce one year food a day. If you wait five days, it's less than 40 foods in the first year of life. And some of my newest data, I'm just writing up the paper Katie, but I'm happy to share it with you. We've actually now got data on DI diversity trajectories in the first few years of life. And the children who start slow with DI diversity, they remain slow throughout early childhood.

Carina Venter, PhD, RD (8m 38s):

And the children who start with a high di di diversity, they remain on a high diet diversity. So we really need to start introducing foods, not wait to give the chance the the child the best CH best chance on having a diverse diet throughout infancy and into later life.

Katie Ferraro (8m 56s):

Oh I can't wait to read that. I'll link to the paper whenever it's available. But just real curious, do you use the WHO definition of diet diversity or do you guys make up a better one for your paper?

Carina Venter, PhD, RD (9m 6s):

No, we didn't use the who, who definition of diet diversity because that basically counts about seven groups of food. We literally count every single food given to the child and so our numbers are much higher than than seven. Oh a

Katie Ferraro (9m 20s):

Woman after my own heart counting the foods that a baby eats. You know this is my jam. Like we've bonded over this in the past but you are the only researcher actually counting the foods carina. So keep fighting the good fight.

Carina Venter, PhD, RD (9m 31s):

Yes I will. And you know, this counting the foods actually comes, goes way back to 2013 when Caroline Rue from Switzerland published their first eye diversity paper in allergy and showed that it prevented allergy outcomes and Caroline just literally counted the number of foods. And so when I started to ask allergy experts around the world, how do you define diet diversity? Everybody looked at me blank. And so I got this European group together and we wrote a position statement from the European Academy of Allergy and Clinical Immunology to say that diet diversity simply means counting the number of foods eaten.

Katie Ferraro (10m 11s):

What a great idea. Okay, let's talk about what the research actually says regarding allergic reactions. Because we know the reason why especially physicians continue to perpetuate this myth that you need to wait three to five days between foods. They do it out of abundance of caution. Well we need to observe for any potential allergic reactions. Could you please tell us if your child is going to have an allergic reaction to food your baby in particular if they're gonna have an allergic reaction to food? The vast majority of the allergic reactions are going to occur when,

Carina Venter, PhD, RD (10m 41s):

So the vast majority of allergic reactions occur with in two hours by definition. However, having done thousands of food challenges throughout my life, when a child is going to react, they literally react within seconds and minutes. On the very rare occasion you would do a food challenge in a teenager to Brazil, not and towards the end of the two hours all of a sudden the child child start to react. But you know when we challenge children, particularly when we challenge babies, you're gonna know within 10, 10 minutes,

Katie Ferraro (11m 16s):

Not three to five days later, right? It's not like you, you do the Brazil nut and three days later there's a weird diaper and you're like oh my gosh they're allergic to Brazil nuts. It doesn't work like that. Doesn't

Carina Venter, PhD, RD (11m 25s):

Happen. Even the most common form of delayed reactions to food, which we call food protein induced enterocolitis syndrome, I know you also have a podcast on that with Marian Gro. The children react within one to four hours, much closer to the one hour, then the four hours. So we are really not talking very weird, delayed severe symptoms two, three days after eating a food.

Katie Ferraro (11m 52s):

But so there's this data that shows us like the vast majority of them, I understand the types where there is delayed and that is certainly the minority. So the vast majority of food allergy reactions if they're going to occur, are going to occur within minutes and up to no more than two hours following ingestion. Why can't the medical groups in the United States get their act together, get together and stop saying wait three to five days between new foods. Like it's pretty obvious to me two hours versus three to five days. Like those aren't even close.

Carina Venter, PhD, RD (12m 20s):

There's no reason why they shouldn't do it. I don't understand the hesitance about it. Actually a well known a pediatrician gave a talk this year at the A a P conference and she said that she was hesitant to present my data on diet diversity because it goes against what the a a P advise about waiting three to five days. Your

Katie Ferraro (12m 40s):

Freaking dietitian, the like world specialist in pediatric food allergies. And they're like, doctors are like hmm, I don't know if we should allow you to present your data. And I think that's a a little troublesome though because they're gatekeeping the important data that's out there. And one thing I appreciate about you know, all the media and interviews and everything you're always willing to do is that you do take the published research and you put it in a format that parents really can understand. And that's important because we also know from the data that doctors aren't getting that message right. It's been what, 20 years since the LEAP study and we still have doctors telling parents not to do peanuts until age two or three. I mean not all of them, a lot of them are starting to get the message, but it takes a really long time for these messages from research to trickle down into practice.

Katie Ferraro (13m 20s):

And guess what, by that time your baby who's 20 years old, you could have possibly prevented their food allergy by introducing the food early and often if your doctor had just told you to do that.

Carina Venter, PhD, RD (13m 31s):

It is, and you know the, the most fascinating thing as we are learning also more about the child's gut microbiome, it doesn't matter whether we are talking immediate or delayed type food allergies. They have common characteristics that we see in the gut microbiome. And the gut microbiome is crying out for diversity. So whether you're trying to prevent immediate or delayed type food allergies, open up the diet, make it diverse, feed that gut microbiome because that is the best chance your child's gonna have. Do not have food allergies and waiting five days between each new food because there's a small chance of a child having delayed symptoms is actually going to aggravate the, or increase the chances of developing that allergy and preventing it.

Katie Ferraro (14m 18s):

Hey we're gonna take a quick break but I'll be right back. So Carina, is it safe for babies to have more than one new food per day? And then are there any exceptions to that guidance?

Carina Venter, PhD, RD (14m 37s):

There is no reason to be concerned about having more than one new food a day. I think, you know, for all the foods in my clinic, I would actually suggest that families perhaps do one new food a meal. You know, I have mothers who's happy to actually do a combination of fruit for breakfast all chopped up. I'm fine with that too if they're anxious then I say let's do at least one one every meal time. But when it comes to the main allergens and of course we have the top nine allergens in America and I'm going to try and say the whole list without getting confused. And that's milk, egg, wheat, soy, peanut tree nut, sesame fish and shellfish.

Carina Venter, PhD, RD (15m 22s):

Got that. That's the top nine. When it comes to introducing the top nine i, I think it is probably sensible to do one every day. I'm, I'm very happy to do peanut today and cash it tomorrow. I may have families that's really hesitant and they want to do peanut for two days and then cash it for two days. I can live with that too. But I'm definitely past the point where I would say to families, okay let's do one allergen a week. I think we can definitely just move ahead, get the allergens in and again, happy to share the link with you. We have now data that I'm publishing with a group in Ireland where we show that every allergen it is fascinating leads to production of specific microbes in the gut microbiome that specifically prevent that allergy.

Carina Venter, PhD, RD (16m 10s):

And so, you know, if we want to get the allergens in, we get need to get them in alongside the weaning process and we need to keep them in so we can nurture the gut microbiome to be a food allergy, pro protective microbiome opposed to a microbiome that just wants to lead to development of allergies.

Katie Ferraro (16m 28s):

And that's huge for parents to hear that this bears out in the research. Like literally the only thing that you can do to lower your child's risk of food allergy is to offer them these potentially allergenic foods early and often. And I know that feels scary 'cause parents are like why would I feed my baby a food that could potentially cause an allergy? But it's like you're actually gonna lower the risk of food allergy. Can you talk a little bit about the severity of food allergy? Because I tell parents like listen, I know this is scary but like death from anaphylaxis, from food ingestion in infancy is pretty much all but unheard of. Like it's not zero. I'm sure you could find a case but like your baby's not going to die from peanut allergy. Like it's scary but like wouldn't you rather know when they're younger? Isn't the, aren't the reactions less severe the younger the baby is?

Carina Venter, PhD, RD (17m 11s):

Yes. I'm so glad you asked that question because the other reason for getting the allergens in early is because the symptoms are much less severe in food allergy. We can never say never. So I wish I could say chances of anaphylaxis is 0% in babies but it is as close to zero as you can get. You know we do introduction of allergens all the time either at home in children, we do it in hospital under supervision and we don't see anaphylaxis. I know I've previously talked to you about milk and air clatters. I do handful of milk and air clatters in children with existing milk and air allergies in infancy every day, every week of my life.

Carina Venter, PhD, RD (17m 55s):

And if they're gonna react it's one Or two hives, it's a few rashes here and there. We do not see anaphylaxis. And the other important message there for to get to parents is do it early because the immune system is much friendlier and chances of severe reactions are very, very close to zero.

Katie Ferraro (18m 15s):

How does delaying the introduction of new foods affect a baby's ability to achieve diet diversity and also lower the risk of food allergy? Because some parents are like you mentioned anxiety, like the anxiety factor is there, I'm just too freaked out to do shellfish. I'll do it later when they're older. Talk about delaying versus doing it in infancy.

Carina Venter, PhD, RD (18m 33s):

That's another important angle to look at it. We know that for every allergen I published that data myself introduced in the first year of life, you bring the risk of developing other food allergen down by 33%. So every food brings the risk down a third. And I know at some point you probably have to get to zero risk but you know it's important to, to get the big number. Every food really counts, every allergen counts. And then as I've just said, you know, allergens by itself changed the gut microbiome diversity data from the EAT study beautifully show that as they were giving these babies food allergens, they gut microbiome diversify.

Carina Venter, PhD, RD (19m 14s):

And every allergen also lead to production of specific bacteria as I've highlighted. So the the flip side of introducing is a low DI diversity, higher risk for developing allergies and a gut microbiome that's much less diverse and are lacking some of the important bacteria that we need for tolerance development.

Katie Ferraro (19m 35s):

You mentioned the EAT study, it's kind of old at this point but it's still relevant, right? Is there new research coming out that's reinforcing what we learned in the EAT study and could you briefly explain what the EAT study found?

Carina Venter, PhD, RD (19m 46s):

So let's do eat and sleep. Okay. So the LEAP study was the study where they fed peanuts in the first few years of life that was followed by the EAT study where they actually fed six common food allergens in the first few years of life to see if they could prevent food allergy in the children. In the LEAP study where they only fed peanuts, they showed peanut prevention and in the EAT study where they fed six different allergens, the most of the preventative effect was really seen in peanut and egg. I don't think coming back to, is there any new research coming out, I don't think we're ever gonna see a fully funded randomized controlled trial feeding infants food allergens and particularly in the states but very exciting data from coming out of the group from Pennsylvania.

Carina Venter, PhD, RD (20m 38s):

They looked at the database in the US and the prevalence of food allergies pre the leap and the EAT study and then the change in the guidelines and now the prevalence of peanut and also other food allergies sort of like 10 years post the guidelines and there's a significant reduction in both peanut and other types of food allergies. So clearly even on a population level relaxing about allergens, giving them to babies and keeping them in the diet has helped to bring the food allergy prevalence in the United States down.

Katie Ferraro (21m 13s):

You mentioned before that you have no problems about offering one or more than one new food a day, but we both agree we generally don't offer two new potentially allergenic foods at the same time. 'cause if the baby had a reaction, how would you know which one it's from? What do you tell parents in your clinic when they ask you about the sequencing of the food? Like which one should come first? Do you do peanut egg and milk first? 'cause those tend to be the most common pediatric food allergies. 'cause I know sometimes in our program we'll start with shellfish and fish if that's what the family eats. I always tell parents it really doesn't matter. Is that what the data shows

Carina Venter, PhD, RD (21m 46s):

That that's a conversation I have every day. And my favorite topic is macadamia not, but let's start with what I say to families. I I think, and this is my clinical practice, it depends which country you're working in but, but here in the United States and to great extent also what what I advise families in the United Kingdom is to start with milk because yogurt is a food that most babies like. And then once you have yogurt in the diet, you have a vehicle to mix other allergens in. If, If you want it to mix, then we definitely follow that with peanut then egg. Some people would actually do milk, Egg and Peanut.

Carina Venter, PhD, RD (22m 27s):

I think that's the top three you need to get in the sequence. It's probably not that important specifically If you do them day after day or at max two days apart. I do wanna say something about the egg. The guidelines that I wrote always say it has to be well-cooked egg in the eat study they did boiled egg for 10 minutes. We now know from data, I'm literally publishing this week that when you boil egg you completely make off albumin undetectable to the immune system. So it's almost like you're destroying one of the main allergens in egg. And so If you do wanna start with boiled egg, it's important that you move on to scrambled egg or omelets.

Katie Ferraro (23m 10s):

So what you're saying is that the boiled egg, like you've literally blown the protein to smithing to the point where you're not even getting that allergenic protein. You gotta try some other variations of that in order to expose your baby to egg protein. You can't just do the boiled one. Yeah

Carina Venter, PhD, RD (23m 23s):

And that is actually where I quote you all the time Katie because you have those beautiful pictures where you do sort of like fried egg omelet kind of thing, which you cutting strips and then the babies can do that for baby late wean. And so I say to the moms, I'm good, we can start with a boiled egg which we are gonna puree down, but then within a week I want you on a fried egg or a omelet, cut it up in strips, look up Katie from baby led weaning on how to do it and I want that baby to hold their egg and feed themselves.

Katie Ferraro (23m 53s):

And isn't it amazing how confident those parents get because when you see your baby picking up a piece of egg and bringing it to their mouth and exploring it and eating it and they inevitably do not have a food allergy to egg 'cause the vast majority of babies are not allergic to foods including eggs. The parents that huge weight, that fear gets lifted off their shoulder and they're like, yeah, I wanna do the scrambled eggs, I wanna do the steamed eggs. I'm like, okay, we're good with egg now let's move on to the next allergenic food and keep going. But they're excited because they see their baby making progress and they know they're moving through those allergenic foods. They're doing a huge part to lower their baby's risk of food allergy by offering those foods early and often.

Carina Venter, PhD, RD (24m 30s):

Absolutely. And then once we've done that top three in America in particular, you know cashew is one of our big allergens. So I would do cashew. Cashew also covers for pistachio. So you can pick tick off pistachio, you don't have to do pistachio once because

Katie Ferraro (24m 45s):

They cluster together, right?

Carina Venter, PhD, RD (24m 47s):

They cluster together and to the immune system, their allergens or proteins look exactly the same. So your immune system doesn't know whether you are eating a cashew or pistachio in short. So you, you can do one of the two. So if a family loves pistachio, I'll go for pistachio and you know, just cut out cashew, then I do walnut. Walnut also covers for pecan. So you can do either one of the two and then after that we normally do sesame and that's normally a good time when I can say, you know what, you can now do like a softly cooked carrot pattern, stick it in the hummus, let the baby feed themselves and then after that is one of the main ones getting them back to, you know, the other three nuts, fish and shellfish.

Carina Venter, PhD, RD (25m 31s):

I really go with what the family's eating. You know, if the fish are eating family, I'd like that to go in quickly. I also like prawn or shrimp, you know, because it's another nice baby led weaning food with the other three nights. If the family doesn't actually eat macadamia nut and Brazil nut, I don't often you know, recommend that that has to go in as one of the first foods, although I like it in at some point in the first year of life. Hazelnut is another interesting thing, you know in America if chocolate candy is gonna be it,

Katie Ferraro (26m 5s):

It's just Americans only think hazelnut is in Nutella. They don't know any other way to get it and that wouldn't be okay for your baby. So that's why we skip it.

Carina Venter, PhD, RD (26m 12s):

Yeah, so, and in America nut contamination normally means peanuts so we need to get the peanut in but if the family travels a lot to Europe, if not anything is contaminated with nuts in Europe, it's probably ha hazelnut. So I then also make a point of really getting hazelnut into the child's diet and then macadamias probably lost on my list. I'd say very few families I know get to the macadamia or not because it's really just not something we eat in the US and even in Europe. So, and then the other tricky one is soy. Now if it's family that loves to eat ami beans, especially now with baby late we, I get a lot of families eating at ami beans or they like, you know, the, the silk and tofu, the

Katie Ferraro (26m 58s):

Tofu cut and strips is the easiest baby food in the

Carina Venter, PhD, RD (27m 2s):

World then I definitely say that that's one of my, my First Foods as well. So the last few ones I'd say is a little bit vague looking at what the family's eating. Many of the babies that I see in clinic have gut growth filtering and growth issues and yeah eating behavior and they also love the tofu. So in those children as well, I default onto having soy as one of my first allergens.

Katie Ferraro (27m 28s):

But it doesn't really matter though, like there's no hardened proof data that says you should do soy before you do shellfish. Like I just, I think it's very important for both of us as dietitians that we're not perpetuating made up food rules. Like there's enough people on social media and credentialed people in the fading space doing that that you gotta tell parents, you know, we, we need to stress what's important variety of foods and early and often, but this idea that like you need to do X before Y, it really doesn't matter, but you do need to do them. And that's why I have an entire program that shows you how to make a hundred different foods safe for your baby. 'cause the reality is most families do not know how to make shellfish safe for a baby. 'cause you don't just give them a rubbery shrimp from the shrimp cocktail at the grocery store that's not safe.

Katie Ferraro (28m 10s):

So I think there are some nuances there and that's where obviously the expertise comes in, but we don't wanna freak parents out. And you obviously deal with anxious parents every day, as do I.

Carina Venter, PhD, RD (28m 20s):

No, that's true. I definitely think my first four is always gonna be milk, egg, peanut and cashew. Again, that order is not set in stone, but I'd like those first four in the rest. I really look at the family's eating habits, what the mother is, you know, happy to introduce. Very interestingly, just this week we have introduced mustard into a tiny little baby because his sister has got a very, very severe mustard allergy. And the parents, that was their number one wish is to get mustard into this baby. So yes, it's mustard. My first winning food for every baby I see. Absolutely not. But in this family it, it was particularly important and we did it very successfully.

Katie Ferraro (29m 4s):

Hey, we're gonna take a quick break, but I'll be right back.

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Katie Ferraro (29m 45s):

Corina, I want you to tell us about the food product that you helped develop and bring to market. I was so surprised when you told me that that was something you were working on. I know you always have top secret projects. First of all, you're a maniac. I don't know how you produce so much research, teach everywhere, speak everywhere, and then have time to do like a food product too. So I'd love to hear what you've been working on.

Carina Venter, PhD, RD (30m 5s):

Oh, so this fruit food product is called Grow Happy. The website is www dot let's grow happy.com. This for me, really is a dream come true. My research is really focused on early diet diversity in allergy prevention, and then also introduction of the, the major food allergens. And so I worked with the founders, Stephanie Webo, and we created the range where we introduced the five top allergens. So we don't have milk because I feel babies should rather just eat yogurt. But we have in this range, peanut, egg, cashew, walnut and sesame.

Carina Venter, PhD, RD (30m 48s):

Each one of the five allergens are in a, a separate packet or sachet. It's mixed with two to three different fruit and vegetables. Again to get the diet diversity because I, I truly believe, and I think my research have shown that when you introduce the allergens within a diverse diet, you have so much better chance of tolerance induction. I didn't want to it to be like ordinary pouch baby food.

Katie Ferraro (31m 15s):

Thank you Corina. Because babies don't need to suck food out of a plastic pouch. Like that's not developmentally necessary.

Carina Venter, PhD, RD (31m 22s):

There's no spout because I don't want the babies to be sucking it out of, of a packet. We give clear instructions, you know, on, on how to mix it. I've even done baby led weaning friendly foods. You know, like I baked it in waffles and cookies, which you can cut up in strips. We spend a lot of time on getting the allergenicity of the egg just right. So it's not like a boiled egg, but you know, it's sort of like a step between a boiled egg and and anomaly. So the egg format is perfect and I think it's just an easy way, you know, to introduce the allergens but also keep it in because I think Katie, we've sort of like referred to that earlier on in our discussion, but one thing the immune system does not like is when we chop and change our minds.

Carina Venter, PhD, RD (32m 8s):

So once we introduce an allergen, we have to keep it in, you know, ideally twice a week. Look, If you skip cashew on a Wednesday because it was a crazy day, you don't have to get up in the middle of the night, wake up the be up and feed the cashew. But you know, for most of it there needs to be some consistency. The immune system need to see the allergens continuously, you know, and continually, you know, to, to really develop that tolerance over time. And so hope we are hoping also that with this range it gives a a vehicle for early introduction as well as continued intake over time.

Katie Ferraro (32m 46s):

Oh, wonderful. Well we'll definitely check it out and I'll put a link to that product in the description. Karina, thank you so much for your time and for sharing all this information. I hope everybody walks away with the peace of mind to know that you do not need to wait three to five days between trying new foods. Any final word, like let's say you've got that mom and she's in your, maybe not even in your clinic because people are in your clinic, are at higher risk for food allergy or, or they're there for a medical reason. A mom of a typically developing baby and the baby's turning six months of age, she's listening to this while she's walking the baby, folding some laundry maybe on her way to work, and she's a little bit nervous about starting the allergenic food. She's done some avocado, banana, sweet potato, you know, those simple starter foods.

Katie Ferraro (33m 26s):

What advice would you give to her if she's scared about starting new foods? Because she hears messages like, wait three to five days between new foods, so there must be something wrong and my baby could have a food allergy. What do you tell that mom to help alleviate her anxiety but also do what's best by her baby?

Carina Venter, PhD, RD (33m 42s):

So I, I normally say, you know, the immune system is at its friendliest in early life and it is ready to accept allergens. So chance of severe reactions are very, very small. We have to learn to relax and let babies teach us how they want to eat. And babies are not scared, innate, scared of food. Babies like to eat and they like to try new things. So I also say let the baby lead the way and babies not gonna say, well that's an allergen and that's not an allergen. So I'm not eating that. I just say, you know, early life friendly immune system, early life is the best chance on changing the gut microbiome to be a friendly gut microbiome and just trust your baby and feed your baby.

Katie Ferraro (34m 28s):

Wonderful. Well thank you so much Corino, it was great to chat with you today.

Carina Venter, PhD, RD (34m 31s):

Thank you for having me.

Katie Ferraro (34m 34s):

Well, I hope you enjoyed that conversation with Carina Venter. She is one of my favorite people on the planet. I could talk to her all day every day. We actually had recorded this interview five years ago and I went to republish it and I was like, it's all current, but I just want an excuse to talk to Karina. So she very graciously came on and redid the interview and she is, she's so amazing, how does she publish so much? I'm like, do you ever sleep? She was like, she does private practice and then she works in clinic and then she publishes all this research and she's also working on the food product that she mentioned, which is called Grow Happy. So I wanna mention the website again, that's let's Grow happy.com. Grow Happy, makes Nourishing Snacks with top allergens to offer your baby early and often.

Katie Ferraro (35m 15s):

So she was involved in the science-based allergen dosing and Karina's really into the microbiome. You probably picked that up in the episode. So she contributed a lot of the data and the information to the development of this product in that it supports gut health. So it's a product that's not ultra processed, it is a food-based product, so it's not a dietary supplement. So if you're looking for an easy way to introduce some of those allergenic foods, if you've been struggling, go check out Let's grow happy.com. And you probably picked up on the fact that she's a big fan of diet diversity. So this idea of offering a wide variety of foods, she's been an advocate of baby led weaning and she's always asking for, oh, can I get a copy of your a 100 FIRST FOODS list and I'll give it to whoever wants it.

Katie Ferraro (35m 58s):

If you don't have a copy of my original a 100FIRST FOODS list yet, I give it away to everybody for free on my online workshop called BABY-LED WEANING FOR BEGINNERS. So you can sign up for that workshop. It's one hour, I know you're busy, but you gotta watch this. Okay? It's a video training that shows you how to do baby led weaning safely, like how to actually prepare the foods. And then you get the 100 First Foods list at the end of it. So you can print it out, put it on your fridge, start checking all these foods off for you baby to sign up for that workshop. Head to baby led weaning.co/workshop. I will put all of the links from what we talked about today. There was a lot of 'em. I gotta go Now, I have to go email Corina and be like, send me every single research paper you mentioned in that article.

Katie Ferraro (36m 39s):

But it's all gonna be on the show notes page for this episode, which live@blwpodcast.com/84. Thank you so much for listening and a special thank you to our partners at AirWave Media. If you like podcasts that feature food and science and using your brain, check out some of the podcasts from AirWave. We're online@blwpodcast.com. Thanks so much for listening and watching and I'll see you next time. Bye.

CarMax (37m 2s):

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