Q Both my husband and I come from families with lots of allergies. We are expecting our first baby and wonder what we can do to reduce the chances our child will develop food allergies. Can you help? — K.K., Greenville

A Advice to new parents about infant feeding abounds. We encourage all moms to feed their babies breast milk exclusively for six months, and then continue as desirable by both mom and infant for up to two years. This is an important strategy for reducing food allergies. Beyond breast-feeding, there has been surprisingly little research conducted about preventing food allergies. About 5 percent of children under 3 years old, and less than 2 percent of the total population, actually have food allergies. Those numbers are smaller than most people think. While many people have some food sensitivities, many fewer have real allergies. Recently, the American College of Asthma, Allergy, and Immunology (ACAAI) made recommendations about infant feeding. I asked Mandy McNabb, a Brody medical student, to tell you about them.

Here is what Mandy learned:

Parents often are confused about advice on breast-feeding, when to wean and in which order to introduce new foods to avoid food allergies. Exclusive breast-feeding during the first months of life also is supported by the American Academy of Pediatrics and American Academy of Family Physicians.

Breast-feeding has numerous benefits, including providing necessary nutrients, protective antibodies, and supporting the mother-child relationship. Studies have shown that infants who were breast-fed had lower overall rates of diarrhea, respiratory-tract infections, and ear infections.

Breast milk also provides long-chain polyunsaturated fatty acids, which are important for development of a child's brain.

The ACAAI, like other experts, recommends introducing foods to your infant around six months. It suggests starting with puréed foods first. Some examples are non-wheat cereals like rice and barley, pureed fruits, and vegetables.

Foods should be introduced one at a time over a few days. If you follow this procedure, it will be easy to pinpoint the offending food if an allergy exists. Mixed foods or foods with a variety of ingredients should not be introduced until each ingredient has been tested for tolerance and shown not to cause any reaction.

The foods that most often cause allergic reactions to infants and children are the milk protein, casein, from cow's milk; egg white protein; peanut proteins; gluten from wheat; tree nuts; and soybean proteins. Less common are allergic reactions to the proteins in beef, fish and seafood.

Many experts recommend you avoid feeding your infant these foods until he or she is at least 12 months old. This is especially true if there is a family history of allergy. Some infants experience reactions to raw foods like kiwi fruit. These foods often cause fewer symptoms when cooked.

You should know, too, that many children actually outgrow their food allergies by the time they start elementary school. If your new baby develops a food allergy and has to eliminate foods from the diet, you want to make sure she gets all the nutrients needed for good growth and development. Be sure to ask your family doctor to refer you to a registered dietitian for meal-planning help.

It is important to realize that children and adults can react to a food but not be allergic to it. This is called food sensitivity. Food sensitivities are not true food allergies. They are not life-threatening but might cause a rash or gastrointestinal discomfort.

The reaction may or may not happen each time a child eats the food. When a person has a food sensitivity, the reaction may depend on the dose, how much is eaten, or what other foods are eaten at the same time.

A common food sensitivity is lactose intolerance. This occurs more often in adults than children. If a person has too little of the lactase enzyme to help digest milk sugars, they may experience gas or bloating or diarrhea. Anyone who limits their dairy intake because of this food sensitivity needs to make sure they get enough calcium in other foods, beverages or supplements.

One other thought about infant feeding: It is common practice for some parents to put cereal in the bottle, thinking that it helps the baby sleep. Health professionals discourage this feeding behavior because studies have shown infants being fed solid foods before four months of age are at increased risk for skin rashes and asthma.

A good Web site on food allergies is www.foodallergy.org

Professor Kathy Kolasa, a registered dietitian and Ph.D., works with the Family Medicine Center, Brody School of Medicine at East Carolina University. Contact her at kolasaka@ecu.edu, or in care of The Daily Reflector, P.O. Box 1967, Greenville, NC 27835.