This post is part of an Eczema Kids’ Nutrition Series where MarcieMom looks at various food types and their impact on eczema children, with topics ranging from early introduction to elimination. Often, advice on kids’ nutrition, especially on eczema, varies and MarcieMom invites Toby Amidor, MS, RD, CDN, a registered dietitian to help give her thoughts on this series written by MarcieMom.
More on Toby Amidor – Toby is the founder of Toby Amidor Nutrition where she provides food and nutrition consulting services. She is the Nutrition Expert for FoodNetwork.com and Nutrition Advisor for Sear’s FitStudio.com. She is an adjunct professor at Teachers College, Columbia University.
Fish – A Common Food Allergen to Introduce Early?
There are six common foods that make up majority of the allergic foods, and fish is one of them (the other five foods are milk, egg, soy, peanuts and wheat). Yet, there were a few studies conducted in Sweden and Norway that indicated a lower rate of eczema for children who started fish in their diets early. In a 2008 study, introduction of fish to babies before 9 month-old showed 24% less likelihood of getting eczema by one year old. In another study, one to two year old who ate fish once a week had 38% less likelihood of eczema. In the journal by American Academy of Pediatrics, late introduction of fish was strongly related to inhalant sensitization. Research had not measured notable reduction in eczema with intake of supplements nor were there differences between eating fish vis-à-vis omega-3 rich fish. It is also observed in countries that typically introduce fish in children’s diet early that there is a lower rate of fish allergy.
What’s in a Fish and What’s Omega-3?
Fish is a source of protein that contains taurine, zinc, selenium, iodine, Vitamin D and Vitamin B12. Of interest for the past decade, is the Omega-3 that is contained in fish. Omega-3 is one of the fatty acids that cannot be manufactured by the body. The long chains of the fatty acids, namely EPA and DHA, have been reported to have health benefits, including brain development of babies. Fish that are rich in Omega-3 include salmon, sardines and mackerel but for a child, intake must not be overdone as fish are also rich in mercury, especially shark, swordfish, king mackerel and tile fish. Some also advice against eating the skin of skin as it’s exposed to pollutants in the waters.
How does Fish affect Eczema?
This has no conclusive answer. From what I’ve looked up, the body is able to convert DHA to RvD2 which is a Resolvin that can regulate inflammatory responses. I’ve also read that fish oil may help to reduce leukotriene B4, which is an inflammatory substance. However, eating more fish alone may not be enough as there’s increasing suggestion that it’s the balance of Omega 3 and Omega 6 (from vegetable oils) that regulates inflammation.
MarcieMom: What’s the recommended intake of fish for an infant below 1 year old?
Toby: Since there is a higher chance of an allergic reaction to fish, it should not be introduced until the child is 1 year into the diet. If there is a family history of allergies, then even longer.
You also need to remember that many of the fish high in omega-3 fats like tuna and salmon have a very strong flavor. Kids have more taste buds than adults, so even if you do introduce them at 1-year, the kids may not accept them very easily. I suggest introducing more mild tasting fish like mahi-mahi and red snapper as a first step.
MarcieMom: Would you recommend taking fish supplements?
Toby: If a parent is worried about their child getting enough omega-3 fats, then they should seek professional guidance from a registered dietitian before giving their child fish supplements. This is especially important if a child (usually under the age of 1) is taking in formula or is still breastfeeding since they are probably getting enough. You don’t want to give too much either—there are always side effects.
MarcieMom: How can a parent help a child who has eczema balance his/her intake of Omega 3 and Omega 6?
Toby: Giving a child a well-balanced diet should do the trick. Also, if a child is breastfeeding or on formula, they should be getting enough of both nutrients. Once they get off the formula and/or breastmilk then introducing every food group to the child to help create a healthful diet is important.