Allergy Prevention- early introduction rather than avoidance

Discussion continues about what advice should be given to parents to prevent allergies in their children. The Australasian Society of Clinical Immunology and Allergy (ASCIA) advises for the development of immune tolerance and prevention of allergy, solid foods should be introduced between 4 to 6 months of age and that no particular allergenic foods need to be avoided (1). Sweden has also recently removed its advice to parents that high risk allergenic foods such as  fish, peanuts and eggs not be introduced duriing the infants first year.  A recent viewpoint article in the Acta Paediatrica provides a good overview of the evidence for the change of thinking in preventing allergy from avoidance to early introduction (2).

The article notes:-

1. Avoiding food allergens during pregnancy, lactation and infancy have failed to prevent food allergy

2. Avoiding peanuts in the infant's first year does not prevent peanut allergy. The incidence of peanut allergy in the UK where peanut is avoided is much higher than in Israel where peanut is introduced early in weaning and continues to be eaten throughout the first year and after.

3. Regular introduction of fish in the first year of life and before 9 months is associated with less allergy and reduced risk of eczema

4. Early introduction of eggs or milk does not effect risk of eczema or increase wheezing

5. Large birth cohort studies in Germany (GINA and LISA studies) have not found that delaying solids beyond 4-6 months or delaying the introduction of potentially allergenic foods prevents asthma, eczema, allergic rhinitis or allergy sensitisation. The Australian Childhood Asthma Prevention Study also did not find that delaying introduction of solid foods prevented asthma, eczema or allergic sensitization by age 5 years.

6. The American Academy of Paediatrics found there is little evidence that delaying solids beyond 4-6 months prevents atopic disease

7. The Australian paper by Prescott, Tang et al which formed the basis for ASCIA's Infant Feeding Advice

The article also points out the need to differentiate between prevention, and the treatment of children with allergy. Cross reactivity between proteins needs to be considered in treatment of allergy.

References

1.ASCIA. Infant Feeding Advice. www.allergy.org.au. Further information on food allergy is available from the patient information section of the website.

2.Wennergren G. What if it is the other way around? Early introduction of peanut and fish seems to be better than avoidance. Acta Paediatrica 2009;98(7):1085-1887

Comments

[Ottawa Infrared Testing]

I prevent my allergies by purifying my air quality. It is so bad for your health to be breathing in mold.