Amid rising rates of children’s food allergies, surprising new guidelines call for introducing babies at ages 4 to 6 months to the most allergenic foods—as a strategy to prevent food allergies.
New scientific data suggests that early introduction of highly allergenic foods—such as milk, eggs, peanuts, soy, and shellfish—may reduce children’s risk for developing food allergies, according to new recommendations from the American Academy of Allergy, Asthma & Immunology (AAAAI), published in Journal of Allergy and Clinical Immunology: In Practice.
The recommendations are a dramatic reversal of American Academy of Pediatrics (AAP) guidelines issued in 2000, which advise delaying milk until high-risk kids reach age 1; eggs until age 2; and peanuts, shellfish, tree nuts, and fish to age 3.
The AAP defined high-risk kids as those with one or more close relatives (a parent or sibling) who had an allergic condition—an extremely broad definition, given that about one in five Americans suffer from some form of allergy, according to the Asthma and Allergy Foundation of America.
In 2008, the AAP released revised guidelines, stating that there was little evidence that delaying allergenic foods prevents food allergies. However, the AAP didn’t offer any specific guidance on when to introduce these foods, leaving parents confused about the best way to protect kids.
Up to 6 million American kids have food allergies—and the rate has jumped by nearly 20 percent since 1997, for as yet unknown reasons. About 90 percent of food allergies are triggered by just eight foods: milk, soy, wheat, peanuts, tree nuts, shellfish, eggs, and fish.
To identify evidence-based prevention tactics, the AAAAI combed through medical literature and issued the following recommendations:
“There's been more studies that find that if you introduce [highly allergenic foods] early it may actually prevent food allergy," David Fleischer, MD, coauthor of the medical journal article and a pediatric allergist at National Jewish Health in Denver, told the Wall Street Journal.
"We need to get the message out now to pediatricians, primary-care physicians and specialists that these allergenic foods can be introduced early,” added Dr. Fleischer.
Among the research cited in the report are these studies:
One theory holds that if kids aren’t exposed to substances in highly allergenic foods early enough, their body is more likely to view them as foreign invaders and attack, leading to an allergy.
"The body has to be trained in the first year of life," says Katie Allen, a professor and allergist at the Murdoch Childrens Research Institute at Royal Children's Hospital in Australia, according to the Wall Street Journal.
“We think there's a critical window, probably around 4 to 6 months, when the child first starts to eat solids," she says.
Another explanation for the rise in allergies and autoimmune disorders is the “hygiene hypothesis,” the theory that we’ve become so clean that the immune system isn’t adequately challenged by germs during childhood, making it more prone to overreacting to harmless substances, such as proteins in certain foods.
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