Feeding babies peanuts early may prevent future allergy

 

The Government is reviewing its advice warning parents not to feed babies peanuts and eggs after a new study found that eating small amounts of the foods at an early age may ward off future allergies.
Scientists at Imperial College London found that children who ate peanuts between the ages of four and 11 months had a 70 per cent reduced risk of developing an allergy to the nuts compared with children who ate them for the first time when they were older.

Children who started eating egg between the ages of four and six months had a 40 per cent reduced risk in comparison.

 

The number of children diagnosed with food allergies is thought to be on the riseDr Vanessa Garcia-Larsen, Imperial College London

Food allergies affect around one in 20 children in the UK, with peanut and egg intolerance the two most common types.
Current advice cautions parents against giving infants allergenic foods such as egg, peanut, fish and wheat, which can cause an malfunctioning immune system to over-react, triggering rashes, swelling, vomiting and wheezing.
The new research, which analysed the data from 146 studies involving more than 200,000 children, was commissioned by the UK Food Standards Agency.
Professor Anthony Frew, an expert in allergy and respiratory medicine at Brighton and Sussex Medical School, said the study showed that earlier introduction of allergen foods may be appropriate.

Eating eggs early could yield a 40 per cent risk reduction of allergy Credit: Alamy

“Much anxiety and some harm was caused by the UK Government Committee on Toxicology’s 1998 advice on peanut avoidance in high-risk infants being extrapolated to the wider low-risk population,” he said.
“Midwives and mothers’ groups assumed that in view of the targeted advice, it might be a good idea for all parents to avoid introducing these foods regardless of their child’s risk of becoming allergic.
“We now know that the opposite was in fact true.”
The Imperial College scientists warned, however, that because their research was a review of previous studies they could not say how many of the babies who were given the allergenic food at an early suffered allergic reactions.
Dr Robert Boyle, who led the research, said parents should not give egg and peanut to babies already known to have a food allergy, or other allergic conditions such as eczema.
“If your child falls into these categories, talk to your GP before introducing these foods,” he said.

He also said whole nuts should not be given to babies or toddlers because of the risk of choking.
The team also analysed whether introducing peanut, egg, milk, fish or wheat into a baby’s diet earlier affected their risk of autoimmune diseases such as coeliac disease, and found there was no effect on risk.
The number of children diagnosed with food allergies is thought to be rising, according to the researchers, although they said this may be because doctors have become better at recognising allergies.
The Food Standards Agency said the Imperial scientists had produced a high-quality review.
“The Government is considering these important findings as part of its review of complementary feeding for infants to ensure its advice reflects the best available evidence,” said a spokesman.
But he added: “Families should continue to follow the Government’s current long-standing advice to exclusively breastfeed for around the first six months because of the health benefits to mothers and babies.”

Babies fed peanut between 4-11 months of age and egg between the ages of 4-6 months may be at lower risk of developing allergies to these foods later on. This is the conclusion of a new study published in JAMA, which represents the largest analysis to date of research assessing the effects of early exposure to allergenic foods.

Researchers say their findings indicate early introduction of peanut and egg may decrease children's risk of allergies to these foods.

Food allergies occur when the body's immune system mistakingly launches an attack in response to harmless proteins in certain foods.
This can lead to symptoms such as hives, eczema, itchy mouth, nausea and vomiting, and, in severe cases, anaphylactic shock, which can be life-threatening.
According to Food Allergy Research and Education (FARE), up to 15 million people in the United States have food allergies, including 1 in every 13 children.
Cow's milk, soy, wheat, fish, shellfish, peanuts, and tree nuts account for 90 percent of all allergic reactions to foods in the U.S., with onset of such allergies typically occurring in childhood.
A number of studies have suggested that early childhood exposure to allergenic foods may significantly reduce the risk of developing an allergy to these foods. Others, however, have identified no such link.
While current guidelines for infant feeding no longer advise parents to delay exposing their children to allergenic foods, they do not recommend that such foods be introduced early.
"The implications for preventing food allergy or other immune-mediated health conditions in the general population are not clear," note the study authors, including Dr. Robert J. Boyle, of Imperial College London in the United Kingdom.

Babies fed peanut between 4-11 months at 70 percent lower allergy risk

With this in mind, Dr. Boyle and team decided to conduct a systematic review and meta-analysis of observational studies and intervention trials that assessed the effects of exposure to allergenic foods in a child's first year of life.
Of the 16,289 studies and trials reviewed, the researchers pinpointed 146 that were eligible to be included in the analysis.

Fast facts about food allergy

• Between 1997-2011, children's food allergies in the U.S. rose by around 50 percent
• Children's food allergies cost the U.S. almost $25 billion annually
• Each year, 300,000 ambulatory-care visits occur due to a food allergy reaction among children and teenagers under the age of 18.

Learn more about food allergy

Overall, the analysis revealed an association between the age at which a child is first introduced to allergenic foods and the subsequent development of food allergies.
The team identified "moderate-intensity evidence" that introducing egg to the diet of infants between 4-6 months of age reduced the risk of egg allergy by 40 percent, while introducing peanut between 4-11 months may lower peanut allergy risk by 70 percent.
In further detail, the researchers found that in a population where 5.4 percent of people have an egg allergy, introducing egg to an infant between 4-6 months of age could prevent 24 egg allergy cases per 1,000 people.
Additionally, in a population where 2.5 percent of individuals have a peanut allergy, feeding infants peanut between 4-11 months of age may prevent 18 cases of peanut allergy for every 1,000 people, the team reports.
When it came to fish, the researchers identified "low-certainty evidence" that consumption of fish prior to 6-12 months of age lowered the risk of allergic rhinitis, and there was "very low-certainty evidence" that feeding infants fish before the age of 6-9 months reduced the risk of allergic sensitization.
Furthermore, the review uncovered "high-certainty evidence" that the age at which a child is first introduced to gluten does not influence the risk of gluten intolerance or celiac disease.
"We were surprised to see no effect for celiac disease, which is a different type of allergy to egg and peanut allergy," Dr. Boyle told Medical News Today. "This suggests that early introduction of allergenic foods does not reduce risk of all types of food allergy."

Findings should inform new infant feeding guidelines

While the study did not investigate the underlying mechanisms of the link between early exposure to egg and peanut and reduced risk of allergy to these foods, Dr. Boyle speculates that it is down the immune properties of the intestine.
"Feeding peanut and egg to infants results in a different immune response to being exposed to small amounts of peanut and egg through different routes, such as touching the skin or being inhaled," Dr. Boyle told MNT.

"We think that if infants are not fed peanut or egg early, they are at risk of becoming allergic to those foods when they are exposed through casual skin or airway contact, sometimes quite indirectly through food antigens present in dust around the home," he added.
The team stresses that further research is needed to determine what form of egg and peanut is best to give to infants, noting that many of the studies reviewed used dried egg powder, which many families might not consume.
Additionally, they caution against feeding whole peanuts or peanut pieces to young babies, as they are a choking hazard.
Still, Dr. Boyle told us that their study results should inform new guidelines on infant feeding practices.

"After reading these new findings, some parents may wish to introduce egg and smooth peanut butter into the diet of their infant at the time when other solid foods are being introduced, since delaying introduction of egg and peanut is likely to increase the risk of allergy to these foods in their infant."

Dr. Robert J. Boyle

"Infants with troublesome eczema or other signs of food allergy would be best advised to see a doctor for advice and consideration of an allergy skin prick test first, since they may already have an allergy to egg or peanut," he added.
Learn how antibiotic use in early life may increase children's food allergy risk.

Written by Honor Whiteman