Give infants peanuts to help avoid allergies
Tuesday, 22 January, 2019
To reduce the risk of food allergies, infants should have eggs and peanuts incorporated into their diet within their first year of life.
This includes children at high risk,聽according to guidelines published by the (ASCIA) and summarised in the .
The guidelines, published in 2016 with additional guidance published in 2017 and 2018, include recommendations to introduce solid foods at around six聽months of age and peanut and egg before 12 months, but not before four聽months.聽The guidelines no longer recommend the use of hydrolysed formula for the prevention of allergic diseases.
The authors, led by Dr Preeti Joshi, Chair of the 鈥檚 Paediatric Committee, wrote that 鈥渇ood allergy has been increasing in incidence worldwide, with rates in Australia among the highest in the world鈥�.
鈥淭he Melbourne-based HealthNuts study reported 10% of infants under one聽year of age had a challenge proven food allergy.聽Egg and peanut had an incidence of 8.9% and 3.0%, respectively. Egg, cow鈥檚 milk, wheat, soy, peanut, tree nuts, fish and shellfish constitute the most common food allergens in Australia.鈥�
The recommendation to introduce egg and peanut early, even in high-risk infants, was largely based on results from the LEAP (Learning Early About Peanut Allergy) study, which randomised 640 children between four聽and 11 months of age with severe eczema, egg allergy or both to consume or avoid peanut containing foods until 60 months of age, at which time a peanut oral food challenge was conducted.
Among the 540 infants in the intention-to-treat group with a negative skin prick test result, the prevalence of peanut allergy at 60 months of age was 13.7% in the avoidance group and 1.9% in the consumption group.
鈥淏ased on these findings, ASCIA guidelines note that if infants already have an egg allergy or severe eczema, they are at increased risk of peanut allergy,鈥� Joshi and colleagues wrote.
鈥淭he guidelines recommend that parents should introduce peanut before 12 months (but not before 4 months) and suggest discussing how to do this with the child鈥檚 doctor.
鈥淚t is hoped that current ASCIA guidelines will assist in reversing the upward trajectory of early onset allergy disease in Australia, and that further research will continue,鈥� they concluded.
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