Early Introduction of Allergenic Foods for Breastfeeding Infants and Risk of Allergy

This is an important question for us all – is the early introduction of allergenic (allergy causing) foods, such as peanuts and egg, associated with higher risk of allergy? The short answer is no.[1] In fact the risk of clinical allergy is lower when peanut and egg is introduced early (at three months) than when introduced later (at six months). It was non-significantly lower by Intention-to-Treat, but significantly lower (p<0.003) in the per protocol analysis (2.4% vs. 7.3%). ‘Compliance’ was poor; less than half of cases in the early introduction group adhered to protocol. The non-adherers had similar rates of allergy to the control (normal practice/delayed introduction) group. There appeared to be a ‘dose’ response with higher intake of allergenic foods associated with greater reductions in the incidence of allergy. Biological testing for allergy gave even stronger protective results for early introduction than did the clinical data reported above. The results are consistent with previous observational and experimental studies. Taken in the round, the results are compelling, shifting probability densities sharply in favour of effectiveness. The World Health Organization recommends exclusive breast feeding to six months of age. Time for change in guidelines in high-income countries?

— Richard Lilford, CLAHRC WM Director

Reference:

  1. Perkin MR, Logan K, Tseng A, et al. Randomized Trial of Introduction of Allergenic Foods in Breast-Fed Infants. New Engl J Med. 2016; 374: 1733-43.
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