Age at the Introduction of Solid Foods During the First Year and Allergic Sensitization at Age 5 Years

Abstract

OBJECTIVE: The goal was to examine the relationship between age at the introduction of solid foods during the first year of life and allergic sensitization in 5-year-old children. METHODS: We analyzed data from the Finnish Type 1 Diabetes Prediction and Prevention nutrition study, a prospective, birth cohort study. We studied 994 children with HLA-conferred susceptibility to type 1 diabetes mellitus for whom information on breastfeeding, age at the introduction of solid foods, and allergen-specific immunoglobulin E levels at 5 years was available. The association between age at the introduction of solid foods and allergic sensitization was analyzed by using logistic regression. RESULTS: The median duration of exclusive breastfeeding was 1.8 months (range: 0–10 months). After adjustment for potential confounders, late introduction of potatoes (>4 months), oats (>5 months), rye (>7 months), wheat (>6 months), meat (>5.5 months), fish (>8.2 months), and eggs (>10.5 months) was significantly directly associated with sensitization to food allergens. Late introduction of potatoes, rye, meat, and fish was significantly associated with sensitization to any inhalant allergen. In models that included all solid foods that were significantly related to the end points, eggs, oats, and wheat remained the most important foods related to sensitization to food allergens, whereas potatoes and fish were the most important foods associated with inhalant allergic sensitization. We found no evidence of reverse causality, taking into account parental allergic rhinitis and asthma. CONCLUSION: Late introduction of solid foods was associated with increased risk of allergic sensitization to food and inhalant allergens.

The Possibilities of Diet Prophylaxis of Atopy in Children at the Period of Additional Feeding Introduction

“…Этот возраст считается безопас-ным для начала введения здоровым детям прикорма [11]. Именно поэтому вводимые в рацион детей воз-раста 4-6 мес жизни продукты прикорма достаточно хорошо переносятся и усваиваются, к ним развивается толерантность.…”

Infant nutrition and allergy

“…However, the concept of reverse causality has to be considered in such studies because families with a history of allergic diseases or with infants with early signs of allergy may delay the introduction of solids. Therefore, separate analyses of data for the subgroup of children with parental history of asthma or allergic rhinitis were performed in the study by Nwaru et al and results did not change, demonstrating no evidence of reverse causality (9) . These findings are consistent with those of Koplin et al who showed that infants introduced to egg at 4-6 months had a lower risk of egg allergy than those introduced to egg after that time, particularly those introduced to egg at 10-12 months of age and after 12 months of age, even after adjusting for family history of allergy and infantallergy symptoms (8) .…”

“…5 years of age and showed that late introduction of eggs and milk was associated with increased risk of eczema. However, the retrospective collection of data on the introduction of solid foods might have introduced recall bias in that study (9) . Based on the current available data, it was proposed that early complementary food introduction may hasten and/or maintain oral mucosal tolerance rather than increase the risk of food allergy (30) .…”

“…Until very recently, for infants with a family history of allergy expert guidelines recommended delaying introduction of allergenic foods (including avoiding eggs until 2 years and nuts until 3 years of age), as well as delaying solid foods until after 6 months and continuation of breast-feeding for at least 12 months (8,13,32) . These recommendations have been challenged by recent population studies, creating the concern that the current practice of delaying complementary foods until 6 months of age may increase, rather than decrease, the risk of immune disorders (1,9,13,(33)(34)(35) . In a systematic review of thirteen studies, five studies found a positive association between early introduction of solid foods (before 4 months of age) and eczema, one study found an association with pollen allergy, and others reported no association between early introduction of solid foods and the development of allergic diseases (36) .…”

Complementary Feeding, Peculiarities of Introduction. Clinical Cases

“…Зарубежными учеными установлено, что введение прикорма в более ранние или поздние сроки повышает частоту развития аллергических реакций [24][25][26]. В настоящее время детям, страдающим пищевой аллергией, прикорм назна-чают в подострый период или период ремиссии в возрас-те 5-6 мес жизни.…”