Bintel BriefDear Bintel: I keep kosher. Should I give shrimp to my baby to prevent allergies?
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My pediatrician recommends we expose our 11-month-old to as many high-risk allergens as possible to decrease her risk of allergies. As luck would have it, shellfish is on the list. Do we prioritize our child’s safety over kashrut and feed her shrimp?
Dear Kashrut Conflicted,
My first instinct was to say that the Jewish value of pikuach nefesh — to save a life — is higher than all other Jewish values, so yeah, just give the baby shrimp.
But since Bintel didn’t go to medical school, we reached out to Mount Sinai (the hospital in New York, not the place where Moses got the Ten Commandments) for a consult.
Good news. You don’t have to compromise your religious practice to do right for your child.
It’s unlikely that a one-time exposure to shrimp, or even several servings, would confer lifelong protection from a potential allergy, Sicherer said. And since in your kosher home, shellfish won’t be on the menu on a regular basis, there’s really no point in serving it once or twice.
“Some might argue it could be worse to just give it a few times and never again for many years,” he said. “The studies showing effectiveness of early introduction of food allergens involved routine, regular incorporation in the diet.”
And guess where the concept of exposing kids to allergens early comes from? Israel!
Sicherer said there’s a low rate of peanut allergies in Israel compared to other countries where peanuts are commonly consumed. That’s because babies in Israel often get their first peanut exposure between 6 and 10 months of age in the form of Bamba, the popular puffy snack made with peanut butter. In countries where peanut allergies are more prevalent, scientists have found, children generally do not consume anything with peanuts until after they are a year old.
Sicherer said that data from Israel led to new recommendations in 2017 for parents in the United States to mix peanut butter or peanut flour into baby food or water when babies are about 6 months old. But to effectively ward off allergies, he added, babies and toddlers have to consume peanut products at least three days a week for years.
“The newest U.S. recommendations emphasize trying to incorporate peanut and egg, two common allergens, in the infant diet around age 6 months, not earlier than 4 months,” the doctor explained. The idea, he added, is to treat potential allergens “like any other food as part of a diverse diet.”
(Babies with bad eczema are sometimes exposed to peanuts from age 4 months, he noted, because they are at higher risk of allergy.)
Good to know. And glad you don’t have to choose between your kashrut observance and your baby’s health. But what happens when she leaves your kosher nest, and either elects to eat shellfish or unknowingly ingests it as an ingredient in something else?
Odds are, she’ll still be fine. Sicherer said shellfish allergies afflict 2% to 3% of the population, and that while reactions can vary tremendously, “most people do not have severe reactions.”
One final thought on a larger issue raised by your letter: As parents, we’re sometimes subject to conflicting advice. My sons are grown now, but I remember taking one of them out on a wintry day where the first passerby said I’d overdressed the child, and the next one told me the kid wasn’t dressed warmly enough.
The point is, everybody wants to kibitz! Your diligence in thinking through this particular dilemma is admirable, and we salute your commitment as a parent to making sound medical decisions for your child regardless of religious strictures. I’m truly relieved there was no conflict here in the end between religion and science — and no need to sully your kosher kitchen. And like you, I would never reject a doctor’s advice out of hand. But I’ll just note that as your parenting journey continues, you may face other situations where you’ll have to make decision about whose advice to follow — a teacher? Your friends? Your own mother? Do your research, for sure! But sometimes when it comes to raising kids, you have to go with your gut and make the choice that’s right for you.
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