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September 20, 2016

Early Allergen Introduction for Preventing Development of Food Allergy

Author Affiliations
  • 1Section of Allergy and Clinical Immunology, Department of Pediatrics, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora
JAMA. 2016;316(11):1157-1159. doi:10.1001/jama.2016.12715

In 2000, the American Academy of Pediatrics (AAP) recommended that “solid foods should not be introduced into the diet of high-risk infants until 6 months of age, with dairy products delayed until 1 year, eggs until 2 years, and peanuts, nuts, and fish until 3 years of age” in “infants at high risk for developing allergy, identified by a strong (biparental, parent, and sibling) family history of allergy” to help prevent food allergy from developing.1 In 2008, the AAP revised this guidance, stating that new evidence raised “serious questions about the benefit of delaying the introduction of solid foods that are thought to be highly allergic.” A recommendation to not delay solid food introduction beyond 4 to 6 months of life was issued but offered no guidance regarding an optimal timing of introduction.2 However, the estimated prevalence of food allergy in the United States nearly doubled (from 3.4% to 5.1%) between 1999 and 2009, and the estimated prevalence of peanut allergy tripled (from 0.4% to 1.4%) between 1999 and 2011, although it is unclear if guidance regarding delayed introduction of allergenic foods contributed to these increases or how well the 2008 guidance has been followed.3-5

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