Hello my beloved readers.

Today  I would like to write you about recent studies of American Academy Of Allergies about the early introducing solids to infants as a prevention of food allergies.

Public health and professional organizations fall into two camps when it comes to recommendations about solids foods: they either recommend starting between 4 and 6 months or at 6 months. There are well-respected organizations on both sides.

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The World Health Organization (WHO),  recommends  that infants start receiving complementary foods at six months of age in addition to breast milk. They also make it clear that solid foods are important, as the period of late infancy is a time of rapid growth and development, and breast milk alone just isn’t enough for most babies. “Complementary feeding should be timely, meaning that all infants should start receiving foods in addition to breast milk from 6 months onwards.”

European Food Safety Authority (EFSA) panel study. The needs for water, energy, protein, calcium and many other nutrients can be met by exclusive breast-feeding for six months. However, breast milk may not provide sufficient iron and zinc for some infants between the age of 4 and 6 months, and these infants will require complementary foods. Iron deficiency in fully breast-fed 6 month old infants is more likely to occur in boys and in infants with a birth weight of 2500-2999 g.

The Panel concludes that it is justified to assume that exclusive breast-feeding by well-nourished mothers for six months can meet a healthy infants need for energy, protein and most vitamins and minerals. However, nutrient intake and parallel anthropometric data after the age of 6 months are lacking.

However, several studies shows that early solid diet could increase a risk of obesity as well.

Scientific opinion and study

The expert panel from the European Academy of Allergology and Clinical Immunology recommends introduction of complementary foods between 4 and 6 months of age in breast-fed or formula-fed infants.

No current evidence suggests that the delay of introduction of solid foods beyond 4 to 6 months of age will prevent allergic disease. Delayed introduction of solid foods, especially the highly allergenic foods, may increase the risk of food allergy or eczema.

American Academy Of Allergies And Immunology recommends starting solids between 4 and 6 months based on some data  that this may decrease the risk of developing food allergies.

GENERAL ADVICE FOR COMPLEMENTARY FOOD INTRODUCTION FOR ALL CHILDREN REGARDLESS OF PREDISPOSITION TO DEVELOP ALLERGIC DISEASE

Most pediatric guidelines suggest first introducing single- ingredient foods between 4 and 6 months of age, at a rate not faster than one new food every 3 to 5 days.

Complementary foods in the United States are typically rice or oat cereal, yellow/orange vegetables (eg, sweet potato, squash, and carrots), fruits (eg, apples, pears, and bananas), green vegetables, and then age-appropriate staged foods with meats.

It is common for acidic fruits (eg, berries, tomatoes, citrus fruits, and vegetables) to cause, on contact with the skin, localized, perioral reactions that may include an erythematous rash or urticaria due to irritation from the acid in these foods and high levels of histamine-releasing compounds within the foods, respectively. These do not usually result in systemic reactions; therefore, delayed introduction of such foods is not recommended.

We do not suggest introducing one of the highly allergenic foods as one of the first complementary foods; however, once a few typical complementary foods (see above bullet) are tolerated, highly allergenic foods may be introduced as complementary foods.

Whole cow’s milk as the infant’s main drink, as opposed to cow’s milk-based formulas and other cow’s milk-based prod- ucts, such as cheese and yogurt, that are safe before age 1 year, should be avoided until age 1 year for reasons unrelated to allergic disease, that is, increased renal solute load, low iron content.

Whole peanuts and tree nuts, but not peanut/tree nut butters or other formulations, carry aspiration risk and should be avoided until the primary care physician feels they are safe.

How to introduce the highly allergenic foods

Few studies have examined the safest way to introduce highly allergenic foods. We recommend counseling parents to introduce them in the following manner:

The child can be given an initial taste of one of these foods at home, rather than at day care or at a restaurant.

Parents should be advised that for some foods, such as peanut, most reactions occur in response to what is believed to be the initial ingestion.

You can read  American Academy of allergies data here Primary Prevention of Allergic Disease Through Nutritional Interventions

How does starting solids affect the risk of allergies ?

According to Alice Callahan’s article (research scientist and  PhD in Nutrition)

 When babies start eating solid foods, new proteins bombard their GI tracts. The immune system needs to learn about these proteins and recognize them as acceptable passengers through the GI tract rather than pathogenic invaders. Food allergies represent a failure to tolerate these food proteins.

For allergies and some chronic immune diseases, there appears to be a sweet spot for when to introduce solid foods. One study found that children first exposed to wheat between 4 and 6 months (versus after 6 months) had a 4-fold decreased risk of wheat allergy.  Another found that children who first had cooked egg at 4-6 months had the lowest incidence of egg allergy, whereas those starting egg at 10-12 months had a 6-fold increased risk.

Either way, the research here suggests starting solids particularly these potentially allergenic foods  by around 6 months may reduce allergy risk.

Best,

Alina

EARLY INTRODUCTION OF SOLID FOOD MAY DECREASE ALLERGY RISK

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