How to prevent allergies: Add eggs and peanuts to diets early on in life

by RNZ / 14 January, 2019
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Allergies are far more common in countries where allergenic foods are avoided during early childhood, Australasian scientists have found, rubbishing previous advice that had little basis.

Scientists are recommending adding eggs and peanuts to infants' diets in the first year of life to help prevent allergies. 

New guidelines by the Australasian Society of Clinical Immunology and Allergy suggests the addition after four months of age.

Lead author of the guidelines published in the Medical Journal of Australia, Preeti Joshi, said food allergy had been becoming increasingly common globally with rates in Australia among the highest in the world.

"There is an urgent need to prevent food allergy as there is no current cure. As such, any measures which have proven efficacy in primary prevention should be given significant consideration in public health policy," she said.

ASCIA published the guidelines in 2016, with additions made in 2017 and 2018.

In its most recent recommendations, Dr Joshi and her colleagues said while previous recommendations had been to avoid certain allergenic foods during early childhood, but studies had found little reason for that.

"During the 2000s, multiple cohort studies reported finding no evidence that delayed introduction of allergenic foods was associated with reduced rates of food allergy.

"In 2008 a cross-sectional study reported that the prevalence of peanut allergy was 10-fold higher among children in the UK (where infant peanut avoidance was recommended) compared with Israeli children of similar ancestry (where peanut is usually introduced at around 6-7 months)", the authors wrote.

Dr Joshi said there was now "moderate" evidence that regular peanut intake before 12 months of age could reduce the risk of developing a peanut allergy.

A trial of 640 children between 4 and 11 months of age with severe eczema, egg allergy, or both, found those who avoided peanut-containing foods were more likely to develop peanut allergies than those who did not.

"The 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's doctor."

"We acknowledge that there is a cultural fear of peanut introduction. This does need to be balanced by a practical approach whereby infants have access to introduction of peanut in a timely fashion.

"It is somewhat reassuring that there have been no reports of fatalities to peanut under 12 months of age anywhere in the world, even in countries that have practised early introduction of peanut (e.g., Israel) for many years."

The guidelines also recommended introducing solid foods about 6 months of age, and no longer recommended the use of hydrolysed formula for the prevention of allergic diseases.

This article was first published on Radio NZ.

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