A food allergy occurs when the body has an abnormal immune reaction to a food. Common allergenic foods include peanuts, milk, eggs, and fish. Symptoms of an allergic reaction can range from itchy hives to life-threatening anaphylaxis. As a result, allergy sufferers must be constantly vigilant about the ingredients in the products they consume and the foods consumed around them. Parents of young children with food allergies must work with schools and care providers to ensure that their children are not accidentally exposed to foods to which they are allergic. Many also avoid exposing infants to allergenic foods for fear that early exposure may increase the chance of developing allergies.
Researchers wanted to evaluate whether beginning the consumption of allergenic foods at 3 months or 6 months was a more effective way to prevent the development of food allergies in average-risk, breastfed infants. The trial, published in The New England Journal of Medicine, found that the early introduction of allergenic foods at 3 months in average-risk, breastfed infants is associated with lower rates of food allergy at 3 years compared to introduction at 6 months.
About the Study
The randomized trial included 1,303 breastfed infants from the general population who were 3 months of age. Participants were randomly assigned to early introduction of allergenic foods at 3 months (567 infants) or standard introduction at 6 months (595 infants). All participants continued to breastfeed for 5 months or more. Participants in the early introduction group were given 2 skin-prick tests and a food challenge. Participants who had a food challenge reaction were advised to avoid the specific food, but to continue feeding the other foods.
Participants were given 2 grams (.035 ounces) of each food 2 times per week beginning with cow's milk (yogurt) and followed by these foods in random order:
- Peanuts
- Boiled hen's eggs
- Sesame
- Whitefish
Wheat was the last food introduced.
Participants were followed for a period of 3 years with all parents completing online questionnaires and early introduction parents completing a weekly food diary. In an analysis of the 89.2% of participants who completed the treatment, the study found that:
- 2.4% of the early introduction vs. 6.4% of the standard introduction developed any food allergy
- 0% of the early introduction vs. 2.5% of the standard introduction developed a peanut allergy
- 1.4% of the early introduction vs. 5.2% of the standard introduction developed egg allergy
There was no significant difference between the 2 groups in the development of milk, sesame, fish, or wheat allergies.
How Does this Affect You?
A randomized trial is considered the most reliable form of research, but how the research is done will affect its reliability. Only 89.2% of participants adhered to the trial. A lower rate of adherence among participants could impact study outcomes. However, this may also be a sign that the study protocol was too demanding and caused parents to have difficulty complying.
Previous studies of food allergens in children at high risk have also concluded that avoiding these foods in early years did not prevent the development of a food allergy.
Current guidelines now state that high-risk infants with severe eczema and/or egg allergy should be introduced age-appropriate peanut-containing food at age 4-6 months to reduce the risk of peanut allergy. There are no current guidelines for other potentially allergic foods.
Talk to your doctor about your infants nutrition. It is always important to be aware of negative reactions when introducing any new foods to your baby. If your infant is at risk for a food allergy, talk to the doctor. A skin-prick test may help to determine the food to which your infant is allergic. This information can help guide treatment and help you and the doctor discuss the best nutrition plan for your child.
RESOURCES
Family Doctor—American Academy of Family Physicians http://familydoctor.org
Kids Health—Nemours Foundation http://www.kidshealth.org
References
Feeding the term infant. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T911037/Feeding-the-term-infant#anc-1893419781 . Updated December 26, 2016. Accessed January 26, 2017.
Peanut allergy. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T912798/Peanut-allergy . Updated January 9, 2017. Accessed January 26, 2017.
Perkin MR, Logan K, et al. Randomized trial of introduction of allergenic foods in breast-fed infants. N Engl J Med. 2016 May 5;374(18):1733-1744. Available at: http://www.nejm.org/doi/full/10.1056/NEJMoa1514210. Accessed January 26, 2017.