A national consensus on infant feeding and allergy prevention guidelines, held among 76 clinicians, expert stakeholders, allergy researchers, and consumers at the Australian Infant Feeding Summit found that allergenic foods were vital to reducing the risk of food allergies in infants.
According to a paper published in the Journal of Allergy and Clinical Immunology: In Practice, the first postnatal year of an infant’s life plays an important part in its risk of developing food allergies. It advised that infants between four and six months of age be introduced to “a variety of solid foods, starting with iron-rich foods, while continuing breastfeeding”.
It added that all infants, including those at high risk of allergy, “should be given allergenic solid foods, including peanut butter, cooked egg, dairy, and wheat products in the first year of life”, and that hydrolysed infant formula “is not recommended for the prevention of allergic disease”.
Environmental factors
Within a single generation, food allergies have become more prevalent worldwide, particularly in Australia. While genetic factors might be partially responsible, the speed at which such allergies have spread means environmental factors are also involved.
The timing and nature of infants’ dietary exposure to certain food nutrients and allergens are thought to “play a role in the development of the immune system and the early onset of allergic diseases like food allergies”.
While in the past, avoidance of allergenic foods like eggs and peanuts were recommended in order to curb the possibility of developing food allergies, recent research, as well as more widespread cases of food allergy, have shown the reverse to be true.
A 2015 study compared the food allergy risk in children who had had peanut introduced into their diets at four to eleven months of age, and those who had only started to consume peanuts from five years of age.
Absolute reduction
All the children were at high risk of a peanut allergy, and the study found an 11% to 25% “absolute reduction in the risk of peanut allergy in high-risk infants” (with a relative risk reduction of 80%) in children who had begun consuming peanuts at four to eleven months of age.
When it came to breastfeeding, there was “insufficient evidence” to show it prevents allergies. However, since it has other well established health benefits for both mother and child, experts recommended continuing breastfeeding while introducing solid foods to infants.
Likewise for breastmilk substitutes, there was not enough evidence as to their efficacy in minimising or preventing food allergies in infants. Furthermore, they lack the complex health benefits of breastmilk, such as establishing the infant gut microbiome.
The consensus concluded that while common allergens, specifically peanut, should be introduced into an infant’s diet within its first year of life, parents should do so with “clear and concise advice” from qualified professionals.
Source: Journal of Allergy and Clinical Immunology: In Practice
http://dx.doi.org/10.1016/j.jaip.2017.03.013
“An Australian Consensus on Infant Feeding Guidelines to Prevent Food Allergy: Outcomes from the Australian Infant Feeding Summit”
Authors: Merryn J. Netting, et al.