Early introduction of foods to prevent food allergy

Abstract

Food allergy is a growing public health problem, and in many affected individuals, the food allergy begins early in life and persists as a lifelong condition (e.g., peanut allergy). Although early clinical practice guidelines recommended delaying the introduction of peanut and other allergenic foods in children, this may have in fact contributed to the dramatic increase in the prevalence of food allergy in recent decades. In January 2017, new guidelines on peanut allergy prevention were released which represented a significant paradigm shift in early food introduction. Development of these guidelines was prompted by findings from the Learning Early About Peanut Allergy study—the first randomized trial to investigate early allergen introduction as a strategy to prevent peanut allergy. This article will review and compare the new guidelines with previous guidelines on food introduction, and will also review recent evidence that has led to the paradigm shift in early food introduction.

A systematic review of infant feeding food allergy prevention guidelines – can we AGREE?

“…Food allergy prevention strategies based on delaying introduction of common food allergens in high risk individuals have been largely ineffective, 18 , 19 and, consequently, the search for effective primary prevention strategies has shifted to interventions including: timeframe for exclusive breastfeeding, breastmilk substitutes, early introduction of foods including common food allergen introduction, vitamin D and omega-3 fatty acid supplementation, and modification of the maternal and infant microbiome. 20 , 21 , 22 , 23 , 24 …”

SmartStartAllergy: a novel tool for monitoring food allergen introduction in infants

“…It has been hypothesised that routinely introducing common food allergens during the first year of life could reduce food allergy rates in Australia . To evaluate community adoption of the ASCIA guidelines and to actively monitor changes in the incidence of allergic reactions in infants, accurate data are needed.…”

Preventing immediate‐onset food allergy in infants, children and adults: Systematic review protocol

“…Due to the heterogeneous nature of interventions and populations, the reviewers expect to undertake a narrative synthesis of all topics, summarizing the results descriptively and drawing attention to any differences in outcome based on age or risk profile. The reviewers will examine whether interventions have been found to be more or less effective for groups at general or increased risk of food allergy because past research has found different effects or magnitude of effects (including safety outcomes) dependent on familial risk of allergy …”

“…The reviewers will examine whether interventions have been found to be more or less effective for groups at general or increased risk of food allergy because past research has found different effects or magnitude of effects (including safety outcomes) dependent on familial risk of allergy. 28 For some topics, such as hydrolysed infant formula or the early introduction of egg or peanut into infant diets, meta-analyses have already been conducted. 11,13,15 The reviewers will draw on these in the review narrative rather than replicating existing work.…”