Thursday, March 17, 2016

Infant feeding practices for allergy prevention

I can't remember the exact date, but around 2008, when I began specialising in paediatric nutrition, I also began talking about the big changes in advice we were giving parents. We began recommending parents introduce all allergenic foods within the first year of life, preferrably before nine months, and even better, while still breastfeeding. Before that, recommendations were all over the shop, ranging from first year to 3rd year introduction of certain foods, depending on the country and the professional body.

It's good to know that this advice is still relevant but the data behind it is even stronger. ASCIA (Australian Society of Clinical Immunology and Allergy) has just released new guidelines for the allergy prevention in infants. The last revision was in 2010.

To summarise some of the main points:
* Breastfeed for at least six months (the longer the better in my opinion - but certainly, breastfeeding whilst introducing first foods, may help prevent allergy)
* No regular cows milk, goats milk, soy milk, etc until the child is 12months old. Commercial infant formula to be used if not breastfeeding.
* There is no convincing evidence that HA or partially HA formulas prevent allergy in infants.
* Foods should NOT be introduced before 4months.
* There is good evidence that for infants with severe eczema and/or egg allergy, that regular peanut intake before 12 months of age can reduce the risk of developing peanut allergy.

So basically, introduce all potentially allergenic foods (egg, nuts, milk, soy, fish, shellfish) as early as possible once your baby has commenced solids, in texturally appropriate form of course. Continue to breastfeed as long as possible.

An additional good point to note from the ASCIA guidelines: Understand that the facial skin in babies is very sensitive and that many foods (including citrus, tomatoes, berries, other fruit and vegemite) can irritate the skin and cause redness on contact – this is not food allergy. Smearing food on the skin will not help to identify possible food allergies.

To see the full document, visit the ASCIA website.

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