Food allergies in infants may be prevented with early introduction

Parents are advised to introduce babies to peanuts and other foods that may cause allergies at four to six months of age, a new Canadian review suggests.

As food allergies are on the rise, doctors have shifted their focus from treatment to prevention, researchers say. Babies with parents or siblings who have allergies, especially to peanut, are at higher risk.

• Babies can try allergy-provoking foods as early as 6 months
• Peanut allergies can be reduced in high-risk children, study suggests

In Monday's issue of the Canadian Medical Association Journal, Dr. Elissa Abrams and Dr. Allan Becker of the University of Manitoba review changes in advice on preventing food allergies.

"At this stage, it has been well documented that avoidance of allergenic foods is not preventive of food allergy," they wrote.

"If a family asks how to prevent allergy in their children, our current advice is to introduce the allergenic foods at four to six months of age."

The most common allergens are:

• Cow's milk.
• Soy.
• Peanut.
• Tree nuts.
• Eggs.
• Wheat.
• Fish.
• Shellfish.
• Sesame.

Once allergenic foods are introduced at home and are well tolerated then it's important to maintain tolerance by giving children these foods regularly, the researchers said.

The American Academy of Allergy, Asthma and Immunology also recommends:

• Introduce a new food every three to five days in a way that minimizes risk of choking.
• Start with grains, yellow and orange vegetables and fruit.
• Start with a small amount of potentially allergenic foods.
• Introduce highly allergenic foods at home, not at daycare.

A recent randomized controlled trial, called Learning Early About Peanut or LEAP, found introducing peanuts early instead of late to high-risk children cut the risk of food allergy. Children at high risk of peanut allergy may benefit from an allergist's evaluation before trying the food.

Unanswered questions include what is the frequency and amount of food that needs to be eaten to keep up tolerance and how long the protection lasts after early introduction?